Synopsis of the 2023 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline for the Management of Bipolar Disorder.

Abstract

Objective: The US Department of Veterans Affairs (VA) and Department of Defense (DOD) Work Group revised the 2013 VA/DOD Clinical Practice Guideline (CPG) for the Management of Bipolar Disorder (BD). This paper reviews the 2023 CPG and its development process, including how recommendations were made for evidence-based treatment in BD.

Methods: Subject experts and key stakeholders developed 20 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Recommendations were based on quality and strength of evidence and informed by other factors, including feasibility, patient perspectives, and the unique needs of people with BD. Peer review by an external group of experts then resulted in completion of the CPG.

Recommendations: While the scope of the CPG is broad, this synopsis focuses on clinically relevant recommendations related to the identification and management of BD, including the acute and maintenance phases of illness.