Sue Lauder1, Andrea Chester2, David Castle3, Seetal Dodd4, Emma Gliddon4, Lesley Berk5, James Chamberlain6, Britt Klein7, Monica Gilbert6, David W Austin8, Michael Berk9. 1. The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia. Electronic address: suela@barwonhealth.org.au. 2. RMIT University, Building 6, Level 5 Bowen Street, Melbourne 3000, Australia. 3. The University of Melbourne, Department of Psychiatry, St Vincent׳s Hospital, P.O. Box, 2900, Fitzroy 3065, Australia. 4. The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia. 5. The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia. 6. Healthmaps Pty Ltd, PO Box 2501, Fitzroy, 3065 Melbourne, Australia. 7. DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia; National Institute for Mental Health Research, The Australian National University, Building 63, Canberra 2000, Australia; National eTherapy Center, Swinburne University of Technology, Hawthorn, Victoria, Australia. 8. Deakin University, School of Psychology, Faculty of Health, Burwood Campus, 221 Burwood Highway, Burwood 3125, Victoria Australia. 9. The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052 Parkville, Victoria, Australia.
Abstract
BACKGROUND:Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. METHOD:Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence. RESULTS: Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence. LIMITATIONS: The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. CONCLUSION: This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.
RCT Entities:
BACKGROUND: Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. METHOD:Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence. RESULTS:Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence. LIMITATIONS: The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. CONCLUSION: This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.
Authors: John A Naslund; Kelly A Aschbrenner; Lisa A Marsch; Gregory J McHugo; Stephen J Bartels Journal: Contemp Clin Trials Date: 2015-07-16 Impact factor: 2.226
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