BACKGROUND: Relapse prevention for bipolar disorder increases time to relapse but is not available in routine practice. AIMS: To determine the feasibility and effectiveness of training community mental health teams (CMHTs) to deliver enhanced relapse prevention. METHOD: In a cluster randomised controlled trial, CMHT workers were allocated to receive 12 h training in enhanced relapse prevention to offer to people with bipolar disorder or to continue giving treatment as usual. The primary outcome was time to relapse and the secondary outcome was functioning. RESULTS:Twenty-three CMHTs and 96 service users took part. Compared with treatment as usual, enhanced relapse prevention increased median time to the next bipolar episode by 8.5 weeks (hazard ratio 0.79, 95% CI 0.45-1.38). Social and occupational functioning improved with the intervention (regression coefficient 0.68, 95% CI 0.05-1.32). The clustering effect was negligible but imprecise (intracluster correlation coefficient 0.0001, 95% CI 0.0000-0.5142). CONCLUSIONS: Training care coordinators to offer enhanced relapse prevention for bipolar disorder may be a feasible effective treatment. Large-scale cluster trials are needed.
RCT Entities:
BACKGROUND: Relapse prevention for bipolar disorder increases time to relapse but is not available in routine practice. AIMS: To determine the feasibility and effectiveness of training community mental health teams (CMHTs) to deliver enhanced relapse prevention. METHOD: In a cluster randomised controlled trial, CMHT workers were allocated to receive 12 h training in enhanced relapse prevention to offer to people with bipolar disorder or to continue giving treatment as usual. The primary outcome was time to relapse and the secondary outcome was functioning. RESULTS: Twenty-three CMHTs and 96 service users took part. Compared with treatment as usual, enhanced relapse prevention increased median time to the next bipolar episode by 8.5 weeks (hazard ratio 0.79, 95% CI 0.45-1.38). Social and occupational functioning improved with the intervention (regression coefficient 0.68, 95% CI 0.05-1.32). The clustering effect was negligible but imprecise (intracluster correlation coefficient 0.0001, 95% CI 0.0000-0.5142). CONCLUSIONS: Training care coordinators to offer enhanced relapse prevention for bipolar disorder may be a feasible effective treatment. Large-scale cluster trials are needed.
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: Erin E Michalak; Steven Jones; Fiona Lobban; Guillermo Perez Algorta; Steven J Barnes; Lesley Berk; Michael Berk; Rachelle Hole; Sara Lapsley; Victoria Maxwell; Roumen Milev; John McManamy; Greg Murray; Mauricio Tohen; Samson Tse; Manuel Sanchez de Carmona; Sheri L Johnson Journal: Int J Bipolar Disord Date: 2016-02-09
Authors: G M Goodwin; P M Haddad; I N Ferrier; J K Aronson; Trh Barnes; A Cipriani; D R Coghill; S Fazel; J R Geddes; H Grunze; E A Holmes; O Howes; S Hudson; N Hunt; I Jones; I C Macmillan; H McAllister-Williams; D R Miklowitz; R Morriss; M Munafò; C Paton; B J Saharkian; Kea Saunders; Jma Sinclair; D Taylor; E Vieta; A H Young Journal: J Psychopharmacol Date: 2016-03-15 Impact factor: 4.153
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