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    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, 292, 2021 DOI: 10.1016/j.jad.2021.05.051

    Accepted author manuscript, 417 KB, PDF document

    Embargo ends: 28/05/22

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Personal recovery in bipolar disorder: Systematic review and “best fit” framework synthesis of qualitative evidence: a POETIC adaptation of CHIME

Research output: Contribution to journalJournal articlepeer-review

Published
<mark>Journal publication date</mark>1/09/2021
<mark>Journal</mark>Journal of Affective Disorders
Volume292
Number of pages11
Pages (from-to)375-385
Publication StatusPublished
Early online date28/05/21
<mark>Original language</mark>English

Abstract

Background
Personal recovery, living a satisfying, hopeful life alongside symptoms, has become an increasingly valued aim across mental health care agendas internationally. However, there is little understanding of how people experience personal recovery alongside the mood challenges characteristic of a bipolar disorder diagnosis. Personal recovery frameworks have been developed for populations with mixed psychiatric diagnoses, predominantly psychotic disorders.

Methods
This systematic review of qualitative data used the widely adopted personal recovery processes Connectedness, Hope and optimism, Identity, Meaning and purpose, Empowerment (CHIME) in a “best fit” framework synthesis to understand personal recovery experiences in bipolar disorder. Included studies were coded with deductive framework analysis based on the CHIME processes and inductive thematic analysis for aspects beyond the a priori framework.

Results
A comprehensive search of six literature databases led to inclusion of twelve articles published 2010-2020. Deductive coding supported the fit with the CHIME framework but revealed difficulties, losses, and tensions within and across recovery processes. The proposed framework for personal recovery in bipolar disorder, Purpose and meaning, Optimism and hope, Empowerment, Tensions, Identity, Connectedness (POETIC), organises all CHIME processes around these tensions.

Limitations
Diversity among study participants was limited with majority middle-aged, female, Western participants.

Conclusions
The compact POETIC personal recovery framework tailored for bipolar disorder is directly applicable to clinical practice with personal recovery objectives. It highlights the need for professionals to introduce personal recovery in a realistic and balanced way to address recent criticism by service user organisations of personal recovery as overly optimistic.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, 292, 2021 DOI: 10.1016/j.jad.2021.05.051