Steven H Jones1, Gina Smith1, Lee D Mulligan1, Fiona Lobban1, Heather Law1, Graham Dunn1, Mary Welford1, James Kelly1, John Mulligan1, Anthony P Morrison1. 1. Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
Abstract
BACKGROUND: Despite evidence for the effectiveness of structured psychological therapies for bipolar disorder no psychological interventions have been specifically designed to enhance personal recovery for individuals with recent-onset bipolar disorder. AIMS: A pilot study to assess the feasibility and effectiveness of a new intervention, recovery-focused cognitive-behavioural therapy (CBT), designed in collaboration with individuals with recent-onset bipolar disorder intended to improve clinical and personal recovery outcomes. METHOD: A single, blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused CBT plus TAU (n = 67). RESULTS: Recruitment and follow-up rates within 10% of pre-planned targets to 12-month follow-up were achieved. An average of 14.15 h (s.d. = 4.21) of recovery-focused CBT were attended out of a potential maximum of 18 h. Compared with TAU, recovery-focused CBT significantly improved personal recovery up to 12-month follow-up (Bipolar Recovery Questionnaire mean score 310.87, 95% CI 75.00-546.74 (s.e. = 120.34), P = 0.010, d = 0.62) and increased time to any mood relapse during up to 15 months follow-up (χ2 = 7.64, P<0.006, estimated hazard ratio (HR) = 0.38, 95% CI 0.18-0.78). Groups did not differ with respect to medication adherence. CONCLUSIONS: Recovery-focused CBT seems promising with respect to feasibility and potential clinical effectiveness. Clinical- and cost-effectiveness now need to be reliably estimated in a definitive trial. Royal College of Psychiatrists.
BACKGROUND: Despite evidence for the effectiveness of structured psychological therapies for bipolar disorder no psychological interventions have been specifically designed to enhance personal recovery for individuals with recent-onset bipolar disorder. AIMS: A pilot study to assess the feasibility and effectiveness of a new intervention, recovery-focused cognitive-behavioural therapy (CBT), designed in collaboration with individuals with recent-onset bipolar disorder intended to improve clinical and personal recovery outcomes. METHOD: A single, blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused CBT plus TAU (n = 67). RESULTS: Recruitment and follow-up rates within 10% of pre-planned targets to 12-month follow-up were achieved. An average of 14.15 h (s.d. = 4.21) of recovery-focused CBT were attended out of a potential maximum of 18 h. Compared with TAU, recovery-focused CBT significantly improved personal recovery up to 12-month follow-up (Bipolar Recovery Questionnaire mean score 310.87, 95% CI 75.00-546.74 (s.e. = 120.34), P = 0.010, d = 0.62) and increased time to any mood relapse during up to 15 months follow-up (χ2 = 7.64, P<0.006, estimated hazard ratio (HR) = 0.38, 95% CI 0.18-0.78). Groups did not differ with respect to medication adherence. CONCLUSIONS: Recovery-focused CBT seems promising with respect to feasibility and potential clinical effectiveness. Clinical- and cost-effectiveness now need to be reliably estimated in a definitive trial. Royal College of Psychiatrists.
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