Trijntje Y G van der Voort1, Berno van Meijel2, Adriaan W Hoogendoorn3, Peter J J Goossens4, Aartjan T F Beekman3, Ralph W Kupka5. 1. VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Inholland University of Applied Sciences, Department of Health, Sports & Welfare/Cluster Nursing, Research Group Mental Health Nursing, Amsterdam, The Netherlands. Electronic address: nienke.vandervoort2@inholland.nl. 2. VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Inholland University of Applied Sciences, Department of Health, Sports & Welfare/Cluster Nursing, Research Group Mental Health Nursing, Amsterdam, The Netherlands; Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands. 3. VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands. 4. Dimence Mental Health, Deventer, The Netherlands; Radboud University Medical Center, Nijmegen, The Netherlands; GGZVS, Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, The Netherlands. 5. VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Altrecht Mental Health, Utrecht, The Netherlands.
Abstract
BACKGROUND:Functioning and quality of life are impaired in bipolar patients. METHODS:Collaborative Care (CC) is a multi-component intervention, provided by a multidisciplinary team, in which a nurse-care manager plays a central role. Effects on functioning and quality of life were tested in a clinical trial. We also investigated the mediating role of depression severity on these outcome variables. RESULTS: Patients randomized to CC showed more improvement in overall functioning compared to patients in the control group who obtained care as usual (CAU), with a small effect size (ES=0.3, z=-2.5, p=0.01). In the domains of autonomy and leisure time, a medium effect was found in favor of CC (autonomy: ES=0.5, z=-2.9, p=0.004; leisure-time: ES=0.4, z=-2.4, p=0.02). No differences between conditions were found in the other domains of functioning. Concerning quality of life, patients in CC improved more in the domain physical health (ES=0.4, z=2.5, p=0.01), if compared to CAU. No differences were found in overall quality of life. Half of the effects on functioning are mediated through the effects of CC on depression severity. LIMITATIONS: At baseline, differences on the main outcomes existed between conditions. Two teams stopped participation in the experimental condition after randomization. Sample size was limited. CONCLUSION: Besides effects on depressive symptoms, CC seems to have direct beneficial effects on both level of functioning and aspects of quality of life.
RCT Entities:
BACKGROUND: Functioning and quality of life are impaired in bipolarpatients. METHODS: Collaborative Care (CC) is a multi-component intervention, provided by a multidisciplinary team, in which a nurse-care manager plays a central role. Effects on functioning and quality of life were tested in a clinical trial. We also investigated the mediating role of depression severity on these outcome variables. RESULTS:Patients randomized to CC showed more improvement in overall functioning compared to patients in the control group who obtained care as usual (CAU), with a small effect size (ES=0.3, z=-2.5, p=0.01). In the domains of autonomy and leisure time, a medium effect was found in favor of CC (autonomy: ES=0.5, z=-2.9, p=0.004; leisure-time: ES=0.4, z=-2.4, p=0.02). No differences between conditions were found in the other domains of functioning. Concerning quality of life, patients in CC improved more in the domain physical health (ES=0.4, z=2.5, p=0.01), if compared to CAU. No differences were found in overall quality of life. Half of the effects on functioning are mediated through the effects of CC on depression severity. LIMITATIONS: At baseline, differences on the main outcomes existed between conditions. Two teams stopped participation in the experimental condition after randomization. Sample size was limited. CONCLUSION: Besides effects on depressive symptoms, CC seems to have direct beneficial effects on both level of functioning and aspects of quality of life.
Authors: A Pfennig; B Soltmann; P Ritter; T Bschor; M Hautzinger; T D Meyer; F Padberg; P Brieger; M Schäfer; C U Correll; M Bauer Journal: Nervenarzt Date: 2020-03 Impact factor: 1.214