P01-91 - Management of Acute Depression in Bipolar Disorder. Formalized Recommendations from the French Society of Biological Psychiatry: Methodology and Perspectives

Abstract

As part of a process to improve the quality of care, the French Society of Biological Psychiatry developed recommendations for clinical practice in bipolar disorder.

Method

The method chosen for these guidelines is a formalized consensus of experts. It enables, through a series of specific clinical situations proposed to the experts, to provide recommendations for the management of bipolar disorder. The situations where defined because they are not associated to evidence-based recommendations according to the lack of controlled studies.

Results

40 experts participate to this consensus. As in most of the guidelines for the treatment of bipolar disorder, more than 50 % of experts (51,3 to 72,9%) recommend the same therapeutic strategies to treat major depressive episode whichever the type (bipolar I or II).

Unlike to other guidelines, French experts propose different therapeutic according to the presence or absence of rapid cycling. For major depressive episode without rapid cycling, 63% experts recommend a combination of an antidepressant with a mood stabilizer. In rapid cyclers, 51% experts recommend the use of a mood stabilizer in monotherapy or in combinaison, but never associated with antidepressant.

Conclusion

This methodological approach enables to get closer to everyday clinical practice and integrate specificities of prescription through a national panel of experts. On the other hand, this type of methodology highlights the research perspectives: i.e. management of acute depression with rapid cycle in bipolar disorder.