Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Lana Bublik
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Mathias Kardell
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Kristina Annerbrink
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Paul Lichtenstein
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
Bo Runeson
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Sweden
Erik Pålsson
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Mikael Landén
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Background Socioeconomic factors can affect healthcare management. Aims The aim was to investigate if patient educational attainment is associated with management of bipolar disorder. Method We included patients with bipolar disorder type 1 (n = 4289), type 2 (n = 4020) and not otherwise specified (n = 1756), from the Swedish National Quality Register for Bipolar Disorder (BipoläR). The association between patients’ educational level and pharmacological and psychological interventions was analysed by binary logistic regression. We calculated odds ratios after adjusting for demographic and clinical variables. Results Higher education was associated with increased likelihood of receiving psychotherapy (adjusted odds ratio 1.34, 95% CI 91.22–1.46) and psychoeducation (adjusted odds ratio 1.18, 95% CI 1.07–1.46), but with lower likelihood of receiving first-generation antipsychotics (adjusted odds ratio 0.76, 95% CI 0.62–0.94) and tricyclic antidepressants (adjusted odds ratio 0.76, 95% CI 0.59–0.97). Higher education was also associated with lower risk for compulsory in-patient care (adjusted odds ratio 0.79, 95% CI 0.67–0.93). Conclusions Pharmacological and psychological treatment of bipolar disorder differ depending on patients’ educational attainment. The reasons for these disparities remain to be explained.
