OBJECTIVE: Recent studies demonstrate the poor psychosocial outcomes associated with bipolar disorder. Occupational functioning, a key indicator of psychosocial disability, is often severely affected by the disorder. The authors describe the effect of acute treatment with interpersonal and social rhythm therapy on occupational functioning over a period of approximately 2.5 years. METHOD:Patients with bipolar I disorder were randomly assigned to receive either acute and maintenance interpersonal and social rhythm therapy, acute and maintenance intensive clinical management, acute interpersonal and social rhythm therapy and maintenance intensive clinical management, or acute intensive clinical management and maintenance interpersonal and social rhythm therapy, all with appropriate pharmacotherapy. Occupational functioning was measured with the UCLA Social Attainment Scale at baseline, at the end of acute treatment, and after 1 and 2 years of maintenance treatment. RESULTS: The main effect of treatment did not reach conventional levels of statistical significance; however, the authors observed a significant time by initial treatment interaction. Participants initially assigned to interpersonal and social rhythm therapy showed more rapid improvement in occupational functioning than those initially assigned to intensive clinical management, primarily accounted for by greater improvement in occupational functioning during the acute treatment phase. At the end of 2 years of maintenance treatment, there were no differences between the treatment groups. A gender effect was also observed, with women who initially received interpersonal and social rhythm therapy showing more marked and rapid improvement. There was no effect of maintenance treatment assignment on occupational functioning outcomes. CONCLUSIONS: In this study, interpersonal and social rhythm therapy, with its emphasis on amelioration of interpersonal and role functioning, improved occupational functioning significantly more rapidly than did a psychoeducational and supportive approach with no such emphasis on functional capacities.
RCT Entities:
OBJECTIVE: Recent studies demonstrate the poor psychosocial outcomes associated with bipolar disorder. Occupational functioning, a key indicator of psychosocial disability, is often severely affected by the disorder. The authors describe the effect of acute treatment with interpersonal and social rhythm therapy on occupational functioning over a period of approximately 2.5 years. METHOD:Patients with bipolar I disorder were randomly assigned to receive either acute and maintenance interpersonal and social rhythm therapy, acute and maintenance intensive clinical management, acute interpersonal and social rhythm therapy and maintenance intensive clinical management, or acute intensive clinical management and maintenance interpersonal and social rhythm therapy, all with appropriate pharmacotherapy. Occupational functioning was measured with the UCLA Social Attainment Scale at baseline, at the end of acute treatment, and after 1 and 2 years of maintenance treatment. RESULTS: The main effect of treatment did not reach conventional levels of statistical significance; however, the authors observed a significant time by initial treatment interaction. Participants initially assigned to interpersonal and social rhythm therapy showed more rapid improvement in occupational functioning than those initially assigned to intensive clinical management, primarily accounted for by greater improvement in occupational functioning during the acute treatment phase. At the end of 2 years of maintenance treatment, there were no differences between the treatment groups. A gender effect was also observed, with women who initially received interpersonal and social rhythm therapy showing more marked and rapid improvement. There was no effect of maintenance treatment assignment on occupational functioning outcomes. CONCLUSIONS: In this study, interpersonal and social rhythm therapy, with its emphasis on amelioration of interpersonal and role functioning, improved occupational functioning significantly more rapidly than did a psychoeducational and supportive approach with no such emphasis on functional capacities.
Authors: E Frank; D J Kupfer; J M Perel; C Cornes; D B Jarrett; A G Mallinger; M E Thase; A B McEachran; V J Grochocinski Journal: Arch Gen Psychiatry Date: 1990-12
Authors: Lewis L Judd; Hagop S Akiskal; Pamela J Schettler; Jean Endicott; Jack Maser; David A Solomon; Andrew C Leon; John A Rice; Martin B Keller Journal: Arch Gen Psychiatry Date: 2002-06
Authors: David J Kupfer; Ellen Frank; Victoria J Grochocinski; Patricia A Cluss; Patricia R Houck; Debra A Stapf Journal: J Clin Psychiatry Date: 2002-02 Impact factor: 4.384
Authors: I Elkin; M T Shea; J T Watkins; S D Imber; S M Sotsky; J F Collins; D R Glass; P A Pilkonis; W R Leber; J P Docherty Journal: Arch Gen Psychiatry Date: 1989-11
Authors: Faith B Dickerson; John J Boronow; Cassie R Stallings; Andrea E Origoni; Sara Cole; Robert H Yolken Journal: Psychiatr Serv Date: 2004-01 Impact factor: 3.084
Authors: Konstantinos N Fountoulakis; Lakshmi Yatham; Heinz Grunze; Eduard Vieta; Allan Young; Pierre Blier; Siegfried Kasper; Hans Jurgen Moeller Journal: Int J Neuropsychopharmacol Date: 2017-02-01 Impact factor: 5.176
Authors: Martha Sajatovic; Sergio A Strejilevich; Ariel G Gildengers; Annemiek Dols; Rayan K Al Jurdi; Brent P Forester; Lars Vedel Kessing; John Beyer; Facundo Manes; Soham Rej; Adriane R Rosa; Sigfried Ntm Schouws; Shang-Ying Tsai; Robert C Young; Kenneth I Shulman Journal: Bipolar Disord Date: 2015-09-19 Impact factor: 6.744