Co-creating meaningful recovery outcomes in bipolar disorder: a triadic approach in outpatient care

Background Traditional treatment approaches for bipolar disorder (BD) predominantly target clinical recovery. However, recent research highlights the critical role of functional, social, and personal recovery in outpatient care. Consequently, there is a growing need for a more holistic approach to this care and therefore outcome measurement. Aim Our study explores the care triad's perspectives on treatment effects and discusses distinct stakeholders contributions to the shared findings to build a meaningful and comprehensive foundation for outcome measurement Methods As part of the qualitative design, we conducted focus group discussions with stakeholders. These involved patients (n = 14), loved ones (n=4), and professionals, divided by their profession (psychiatrists (n=9), nurses (n=7), and psychologists (n=4)) to collect all perspectives on treatment effects for bipolar outpatient care. Based on these shared perspectives, Results Shared themes by the triad were found in the four domains of recovery: (1) clinical recovery: improved self-management and mood stability; (2) functional recovery: improved or preserved cognitive functions and improved well-being by lifestyle; (3) social recovery: regain and function in social roles; and (4) personal recovery: acceptance of the diagnosis and regain identity. One theme was identified separately as ´therapeutic relationship´ and serves as a precondition for qualitative treatment effect. In addition to shared outcomes, stakeholder-specific preferences for outcome measures emerged, underscoring the value of capturing perspectives from all triad members. Conclusions Outcome measurement should be grounded in shared triad stakeholder priorities while remaining responsive to stakeholder-specific treatment outcome preferences.