Short psychoeducational program may benefit BD patients
MedWire News: A short, mobile phone-based psychoeducational program may improve knowledge of mood-management strategies in patients with bipolar disorder (BD), study results suggest.
"Psychosocial treatment has become a well-established adjunct to pharmacotherapy for BD in adults and adolescents during the post-acute and maintenance phases of treatment," explain David Miklowitz (University of California at Los Angeles, USA) and team in Bipolar Disorders.
However, they add that "there are several impediments to the community implementation of disorder-specific psychotherapies for BD," including duration (most involve 12-21 sessions over periods of up to 12 months), lack of training for clinicians, and "paper-pencil tracking" of moods by the patient and clinicians.
The researchers therefore assessed the effectiveness of a Facilitated Integrated Mood Management (FIMM) program for BD patients involving up to six sessions of psychoeducation over a mean period of 9 weeks.
FIMM sessions focused on identifying early signs of relapse, identifying risk factors for relapse and protective factors, maintaining regular daily and nightly routines, creating a mood-management plan, promoting adherence to medications, and education about substance abuse.
Treatment facilitators were novice counselors who were trained in a 3-day workshop and supervised for 6 months.
In total, 19 patients with BD participated in the study. The participants' moods were monitored via daily and weekly text or email messages using the Altman Self-Rating Mania (ASRM) scale and the Quick Inventory of Depressive Symptoms-Self Report (QIDS-SR) scale.
They were also assessed before and after completion of the program using the Bipolar Mood Management Questionnaire (BMMQ).
The team found that patients' knowledge of mood-management strategies increased significantly over the study period, with total BMMQ scores increasing from 54.2 to 66.9. Patients also showed improvements on most of the 20 BMMQ subscale scores.
The researchers also note that patients responded to an average 81% of the daily message prompts and 88% of the weekly prompts, and most remained in a stable mood over the study period, as assessed using the ASRM and QIDS-SR.
Miklowitz and team conclude: "Results suggest that patients could be engaged and retained in the brief program, were compliant with the daily and weekly versions of mood monitoring, and showed relatively stable mood scores over the course of a 4-month interval."
They add: "The effects of FIMM on the course of BD await evaluation in randomized trials."
By Mark Cowen