Participants

Study 3 consists of the ECS conducted in five countries (France, Italy, Germany, Norway, and Spain), with a total of 11 recruiting sites (Additional file 1: Table S2). A total of 400 participants, aged 18–65 years, diagnosed with either BD I or BD II or BD not otherwise specified (NOS) according to the DSM-5, will be enrolled: these participants will be selected from patients with BD who have had at least one contact with the mental health service in the past year. Table ​Table33 shows the inclusion and exclusion criteria. To ensure a representative sample of patients with BD, a specific stratification will be employed, according to the following schema: age will be split into two strata (18–45 and 46–65 years), sex will be split into two strata (male and female) and age of onset (before 21 years and after 21 years) will be used as a proxy of disorder severity.

Inclusion and exclusion criteria for the ECS

The study foresees 2 evaluation times: the first at the entry into the study (T0) and the second after 1 year (T1).