{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T08:03:28Z","timestamp":1784275408202,"version":"3.55.0"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":96,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Camb. prisms Glob. ment. health"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bipolar disorder (BD) is associated with substantial disability and caregiver burden. In Pakistan, prevalence is unusually high, and limited mental health services place families at the center of care. Cultural and religious beliefs strongly shape how the illness is recognized, understood and managed. This study explored how individuals living with BD and their caregivers understand and navigate the illness within this context. Semi-structured interviews were conducted with 12 adults diagnosed with BD (type I or II) and 12 caregivers recruited through a national registry. Open-ended questions explored illness understanding, caregiving challenges, cultural influences and preferences for family intervention. Interviews were conducted in Roman Urdu, audio-recorded, transcribed verbatim and analyzed using Braun and Clarke\u2019s reflexive thematic analysis. Purposive and snowball sampling ensured diversity in gender, socioeconomic status and residence. Patients described blended biomedical and cultural explanations of BD, symptom-related disruption, treatment barriers, stigma and coping through routines and religious practices. Caregivers reported confusion at illness onset, financial and emotional burden, inconsistent support and the need to navigate biomedical and spiritual care pathways. Both groups emphasized the need for accessible, family-inclusive interventions. The findings support development of culturally tailored, scalable and faith-sensitive family interventions.<\/jats:p>","DOI":"10.1017\/gmh.2026.10197","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:29:53Z","timestamp":1775550593000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Lived experiences of bipolar disorder and family caregiving in Pakistan"],"prefix":"10.1017","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-1211","authenticated-orcid":false,"given":"Madeha","family":"Umer","sequence":"first","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muqaddas","family":"Asif","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Living and Learning"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer Bukhsh","family":"Khoso","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Living and Learning"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett D.M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqra","family":"Hassan","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Living and Learning"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6937-9552","authenticated-orcid":false,"given":"Siqi","family":"Xue","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Langhani","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Living and Learning"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy-Lee","family":"Dennis","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Lunenfeld-Tanenbaum Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farooq","family":"Naeem","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Mulsant","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Living and Learning"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nusrat","family":"Husain","sequence":"additional","affiliation":[{"name":"University of Manchester \u2013 The Victoria University of Manchester Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ishrat","family":"Husain","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"S2054425126101976_r22","first-page":"e134","article-title":"The impact of task-sharing scalable mental health interventions on non-specialist providers: A scoping review","volume":"11","author":"Sangraula","year":"2024","journal-title":"Cambridge Prisms: Global Mental Health"},{"key":"S2054425126101976_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2009.04.006"},{"key":"S2054425126101976_r26","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.35.5.720"},{"key":"S2054425126101976_r27","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-23461-1"},{"key":"S2054425126101976_r29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2007.01158.x"},{"key":"S2054425126101976_r6","unstructured":"ChatGPT (2025, February). 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