A Peters1, L G Sylvia2, P V da Silva Magalhães3, D J Miklowitz4, E Frank5, M W Otto6, N S Hansen2, D D Dougherty2, M Berk7, A A Nierenberg2, T Deckersbach2. 1. University of Illinois at Chicago,Chicago, IL,USA. 2. Massachusetts General Hospital,Boston, MA,USA. 3. Universidade Federal de Rio Grande de Sul,Porte Alegre,Brazil. 4. UCLA School of Medicine,Los Angeles, CA,USA. 5. University of Pittsburgh,Pittsburgh, PA,USA. 6. Boston University,Boston, MA,USA. 7. Deakin University,Melbourne,Australia.
Abstract
BACKGROUND: The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy. METHOD: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention). We assessed whether the number of previous mood episodes, age of illness onset, and illness duration predicted or moderated the likelihood of recovery and time until recovery from a depressive episode in patients in the two treatments. RESULTS: Independently of treatment condition, participants with one to nine prior depressive episodes were more likely to recover and had faster time to recovery than those with 20 or more prior depressive episodes. Participants with fewer than 20 prior manic episodes had faster time to recovery than those with 20 or more episodes. Longer illness duration predicted a longer time to recovery. Participants were more likely to recover in intensive psychotherapy than collaborative care if they had 10-20 prior episodes of depression [number needed to treat (NNT) = 2.0], but equally likely to respond to psychotherapy and collaborative care if they had one to nine (NNT = 32.0) or >20 (NNT = 9.0) depressive episodes. CONCLUSIONS: Number of previous mood episodes and illness duration are associated with the likelihood and speed of recovery among bipolar patients receiving psychosocial treatments for depression.
RCT Entities:
BACKGROUND: The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy. METHOD: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention). We assessed whether the number of previous mood episodes, age of illness onset, and illness duration predicted or moderated the likelihood of recovery and time until recovery from a depressive episode in patients in the two treatments. RESULTS: Independently of treatment condition, participants with one to nine prior depressive episodes were more likely to recover and had faster time to recovery than those with 20 or more prior depressive episodes. Participants with fewer than 20 prior manic episodes had faster time to recovery than those with 20 or more episodes. Longer illness duration predicted a longer time to recovery. Participants were more likely to recover in intensive psychotherapy than collaborative care if they had 10-20 prior episodes of depression [number needed to treat (NNT) = 2.0], but equally likely to respond to psychotherapy and collaborative care if they had one to nine (NNT = 32.0) or >20 (NNT = 9.0) depressive episodes. CONCLUSIONS: Number of previous mood episodes and illness duration are associated with the likelihood and speed of recovery among bipolarpatients receiving psychosocial treatments for depression.
Authors: Michael Berk; Lesley Berk; Marc Udina; Steven Moylan; Lesley Stafford; Karen Hallam; Sherilyn Goldstone; Patrick D McGorry Journal: Aust N Z J Psychiatry Date: 2012-02 Impact factor: 5.744
Authors: David J Miklowitz; Michael W Otto; Ellen Frank; Noreen A Reilly-Harrington; Stephen R Wisniewski; Jane N Kogan; Andrew A Nierenberg; Joseph R Calabrese; Lauren B Marangell; Laszlo Gyulai; Mako Araga; Jodi M Gonzalez; Edwin R Shirley; Michael E Thase; Gary S Sachs Journal: Arch Gen Psychiatry Date: 2007-04
Authors: Terence A Ketter; John P Houston; David H Adams; Richard C Risser; Adam L Meyers; Douglas J Williamson; Mauricio Tohen Journal: J Clin Psychiatry Date: 2006-01 Impact factor: 4.384
Authors: Benedetto Vitiello; Mark A Riddle; Gayane Yenokyan; David A Axelson; Karen D Wagner; Paramjit Joshi; John T Walkup; Joan Luby; Boris Birmaher; Neal D Ryan; Graham Emslie; Adelaide Robb; Rebecca Tillman Journal: J Am Acad Child Adolesc Psychiatry Date: 2012-07-31 Impact factor: 8.829
Authors: Thilo Deckersbach; Amy T Peters; Louisa G Sylvia; Alexandra K Gold; Pedro Vieira da Silva Magalhaes; David B Henry; Ellen Frank; Michael W Otto; Michael Berk; Darin D Dougherty; Andrew A Nierenberg; David J Miklowitz Journal: J Affect Disord Date: 2016-05-31 Impact factor: 4.839
Authors: Amy T Peters; Sally M Weinstein; Ashley Isaia; Anna VAN Meter; Courtney A Zulauf; Amy E West Journal: J Psychiatr Pract Date: 2018-05 Impact factor: 1.325
Authors: Alexandra K Gold; Amy T Peters; Michael W Otto; Louisa G Sylvia; Pedro Vieira da Silva Magalhaes; Michael Berk; Darin D Dougherty; David J Miklowitz; Ellen Frank; Andrew A Nierenberg; Thilo Deckersbach Journal: Aust N Z J Psychiatry Date: 2018-07-26 Impact factor: 5.744
Authors: Masoud Kamali; Samantha Pegg; Jessica A Janos; William V Bobo; Benjamin Brody; Keming Gao; Terence A Ketter; Susan L McElroy; Melvin G McInnis; Dustin J Rabideau; Noreen A Reilly-Harrington; Richard C Shelton; Louisa G Sylvia; Mauricio Tohen; Andrew Nierenberg Journal: J Psychiatr Res Date: 2021-06-02 Impact factor: 5.250