G Murray1, N D Leitan2, M Berk3, N Thomas2, E Michalak4, L Berk5, S L Johnson6, S Jones7, T Perich8, N B Allen9, Michael Kyrios10. 1. Swinburne University, Melbourne, Australia. Electronic address: gwm@swin.edu.au. 2. Swinburne University, Melbourne, Australia. 3. Deakin University, Melbourne, Australia; University of Melbourne, Melbourne, Australia. 4. University of British Columbia, Vancouver, Canada. 5. University of Melbourne, Melbourne, Australia. 6. University of California, Berkeley, Berkeley, USA. 7. Lancaster University, Lancaster, UK. 8. University of New South Wales, Sydney, Australia. 9. University of Oregon, Eugene, USA. 10. Australian National University, Canberra, Australia.
Abstract
OBJECTIVES: People in the late stage of bipolar disorder (BD) experience elevated relapse rates and poorer quality of life (QoL) compared with those in the early stages. Existing psychological interventions also appear less effective in this group. To address this need, we developed a new online mindfulness-based intervention targeting quality of life (QoL) in late stage BD. Here, we report on an open pilot trial of ORBIT (online, recovery-focused, bipolar individual therapy). METHODS: Inclusion criteria were: self-reported primary diagnosis of BD, six or more episodes of BD, under the care of a medical practitioner, access to the internet, proficient in English, 18-65 years of age. Primary outcome was change (baseline - post-treatment) on the Brief QoL.BD (Michalak and Murray, 2010). Secondary outcomes were depression, anxiety, and stress measured on the DASS scales (Lovibond and Lovibond, 1993). RESULTS: Twenty-six people consented to participate (Age M=46.6 years, SD=12.9, and 75% female). Ten participants were lost to follow-up (38.5% attrition). Statistically significant improvement in QoL was found for the completers, t(15)=2.88, 95% CI:.89-5.98, p=.011, (Cohen׳s dz=.72, partial η(2)=.36), and the intent-to-treat sample t(25)=2.65, 95% CI:.47-3.76, (Cohen׳s dz=.52; partial η(2)=.22). A non-significant trend towards improvement was found on the DASS anxiety scale (p=.06) in both completer and intent-to-treat samples, but change on depression and stress did not approach significance. LIMITATIONS: This was an open trial with no comparison group, so measured improvements may not be due to specific elements of the intervention. Structured diagnostic assessments were not conducted, and interpretation of effectiveness was limited by substantial attrition. CONCLUSION: Online delivery of mindfulness-based psychological therapy for late stage BD appears feasible and effective, and ORBIT warrants full development. Modifications suggested by the pilot study include increasing the 3 weeks duration of the intervention, adding cautions about the impact of extended meditations, and addition of coaching support/monitoring to optimise engagement.
OBJECTIVES:People in the late stage of bipolar disorder (BD) experience elevated relapse rates and poorer quality of life (QoL) compared with those in the early stages. Existing psychological interventions also appear less effective in this group. To address this need, we developed a new online mindfulness-based intervention targeting quality of life (QoL) in late stage BD. Here, we report on an open pilot trial of ORBIT (online, recovery-focused, bipolar individual therapy). METHODS: Inclusion criteria were: self-reported primary diagnosis of BD, six or more episodes of BD, under the care of a medical practitioner, access to the internet, proficient in English, 18-65 years of age. Primary outcome was change (baseline - post-treatment) on the Brief QoL.BD (Michalak and Murray, 2010). Secondary outcomes were depression, anxiety, and stress measured on the DASS scales (Lovibond and Lovibond, 1993). RESULTS: Twenty-six people consented to participate (Age M=46.6 years, SD=12.9, and 75% female). Ten participants were lost to follow-up (38.5% attrition). Statistically significant improvement in QoL was found for the completers, t(15)=2.88, 95% CI:.89-5.98, p=.011, (Cohen׳s dz=.72, partial η(2)=.36), and the intent-to-treat sample t(25)=2.65, 95% CI:.47-3.76, (Cohen׳s dz=.52; partial η(2)=.22). A non-significant trend towards improvement was found on the DASS anxiety scale (p=.06) in both completer and intent-to-treat samples, but change on depression and stress did not approach significance. LIMITATIONS: This was an open trial with no comparison group, so measured improvements may not be due to specific elements of the intervention. Structured diagnostic assessments were not conducted, and interpretation of effectiveness was limited by substantial attrition. CONCLUSION: Online delivery of mindfulness-based psychological therapy for late stage BD appears feasible and effective, and ORBIT warrants full development. Modifications suggested by the pilot study include increasing the 3 weeks duration of the intervention, adding cautions about the impact of extended meditations, and addition of coaching support/monitoring to optimise engagement.
Authors: Michael Berk; Robert Post; Aswin Ratheesh; Emma Gliddon; Ajeet Singh; Eduard Vieta; Andre F Carvalho; Melanie M Ashton; Lesley Berk; Susan M Cotton; Patrick D McGorry; Brisa S Fernandes; Lakshmi N Yatham; Seetal Dodd Journal: World Psychiatry Date: 2017-10 Impact factor: 49.548
Authors: Amirhossein Modabbernia; Mohammadhossein Yaghoubidoust; Chung-Ying Lin; Bengt Fridlund; Erin E Michalak; Greg Murray; Amir H Pakpour Journal: Qual Life Res Date: 2015-12-29 Impact factor: 4.147
Authors: Elli Weisbaum; Nicholas Chadi; Miriam Kaufman; Catherine Malboeuf-Hurtubise; Sara Ahola Kohut; Christine Viner; Jake Locke; Dzung X Vo Journal: JMIR Res Protoc Date: 2017-11-27
Authors: Victoria Cosgrove; Emma Gliddon; Lesley Berk; David Grimm; Sue Lauder; Seetal Dodd; Michael Berk; Trisha Suppes Journal: Int J Bipolar Disord Date: 2017-08-06
Authors: Maria Faurholt-Jepsen; Klaus Munkholm; Mads Frost; Jakob E Bardram; Lars Vedel Kessing Journal: BMC Psychiatry Date: 2016-01-15 Impact factor: 3.630