Bibliographic study of factors that influence the non-adhesion to treatment in patients with bipolar affective disorder

Review of clinical studies dealing with bipolar affective disorder (BD) in order to identify the main factors that contribute to non-adherence to treatment, as well as to identify proposals and suggestions that can minimize this problem. The methodology used is based on the Scielo, BIREME and Pubmed databases. 35 studies were selected that were related to the theme non-adherence to treatment in bipolar patients, referring to the period from 2005 to 2019. In the analysis of the data obtained, the determining factors of non-adherence to treatment were grouped into three categories: drug therapy; patient's own characteristics, life history and personality, family dynamics and cultural insertion; and, related to the institution, the psychiatrist and the engaged multiprofessional team. It is concluded that non-adherence is part of the course of treatment for bipolarity, varying between services, but it is not exclusive to it, since, in general, other clinical diseases of a chronic nature also present with varying degrees of non-adherence. Therefore, the interdisciplinary team must be available and accessible to the patient to answer questions and discuss their treatment. BD is considered to be a biopsychosocial problem and requires frequent, multidisciplinary interventions from the perspective of multidisciplinary psychoeducation, as a key element of better adherence to treatment.