Abstract
Bipolar disorders rank as one of the most disabling illnesses in working age adults worldwide. Despite this, the quality of care offered to patients with this disorder is suboptimal, largely due to limitations in our understanding of the pathology. Improving this scenario requires the development of a critical mass of expertise and multicentre collaborative projects. Within the framework of the European FP7 programme, we developed a European Network of Bipolar Research Expert Centres (ENBREC) designed specifically to facilitate EU-wide studies. ENBREC provides an integrated support structure facilitating research on disease mechanisms and clinical outcomes across six European countries (France, Germany, Italy, Norway, Spain and the UK). The centres are adopting a standardised clinical assessment that explores multiple aspects of bipolar disorder through a structured evaluation designed to inform clinical decision-making as well as being applicable to research. Reliable, established measures have been prioritised, and instruments have been translated and validated when necessary. An electronic healthcare record and monitoring system (e-ENBREC©) has been developed to collate the data. Protocols to conduct multicentre clinical observational studies and joint studies on cognitive function, biomarkers, genetics, and neuroimaging are in progress; a pilot study has been completed on strategies for routine implementation of psycho-education. The network demonstrates ‘proof of principle’ that expert centres across Europe can collaborate on a wide range of basic science and clinical programmes using shared protocols. This paper is to describe the network and how it aims to improve the quality and effectiveness of research in a neglected priority area.
Highlights
Bipolar disorders (BD) are characterised by recurrent manic and depressive episodes that usually commence in early adulthood and affect 1% to 4% of the general population (Merikangas et al 2007)
In order to disseminate systematic clinical assessment and high quality treatment protocols and to foster research to improve the management of BD and to develop a better understanding of the mechanisms underlying this complex condition, we have developed a network of bipolar expert centre at a European level: European Network of Bipolar Research Expert Centre (ENBREC, www.enbrec.eu)
The European College of Neuropsychopharmacology (ECNP) is concerned to support the development of independent collaborative international research networks of basic scientists and practising clinicians within Europe, and has established the ECNP-NI to help meet this goal
Summary
Bipolar disorders (BD) are characterised by recurrent manic and depressive episodes that usually commence in early adulthood and affect 1% to 4% of the general population (Merikangas et al 2007). According to the World Health Organization study on global burden of disease, BD are ranked sixth amongst the most disabling illnesses in working age adults worldwide (above schizophrenia which is ranked eighth) (Lopez and Murray 1998) - findings that are reinforced by the recent European study on the burden of mental health (Olesen et al 2012). BD is often unrecognised or misdiagnosed leading to inappropriate or delayed treatments, with significant and devastating health and social consequences (Baca-Garcia et al 2007; Hirschfeld et al 2003; Scott and Leboyer 2012). The significant disease burden attributable to BD is amplified by additional, often multiple psychiatric and physical comorbidities, and premature mortality (Leboyer and Kupfer 2010). Rates of completed suicide have generally been estimated to be between 10% and 20% (Müller-Oerlinghausen et al 2002). Even if recent studies are more optimistic, rates in BD exceed unipolar depression and schizophrenia (Bostwick and Pankratz 2000; Dutta et al 2007)
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