Steven H Jones1, Dawn Knowles1, Elizabeth Tyler1, Fiona Holland2, Sarah Peters3, Fiona Lobban1, Brian Langshaw4, Claire Hilton1, Rita Long1, Kay Gantt5, Rebecca Owen3, Chris Roberts2, Lisa Riste6. 1. Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK. 2. Faculty of Biology, Medicine and Health, Institute of Population Health, University of Manchester, Manchester, Greater Manchester, UK. 3. Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, Greater Manchester, UK. 4. Talking Solutions, Alexandra Park, St Helens, UK. 5. South West Yorkshire Partnership, NHS Foundation Trust, Wakefield, UK. 6. Centre for Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, Greater Manchester, UK.
Abstract
BACKGROUND: Comorbid anxiety is common in bipolar disorder (BD) and associated with worse clinical outcomes including increased suicidality. Despite effective psychological treatments for anxiety, research into treating anxiety in BD is underdeveloped. This paper describes a novel psychological intervention to address anxiety in context of bipolar disorder (AIBD). METHODS: Adults with BD and clinically significant anxiety symptoms were randomized to AIBD plus treatment as usual (TAU) or TAU alone. AIBD offered 10 sessions of psychological therapy using a formulation-based approach. Feasibility and acceptability were evaluated through recruitment, retention, therapy attendance, alliance, fidelity, and qualitative feedback. Clinical outcomes were assessed at baseline, 16, 48, and 80 weeks: interim assessments of relapse at 32 and 64 weeks. RESULTS: Seventy-two participants were recruited with 88% retention to 16 weeks and 74% to 80 weeks (similar between arms). Therapy participants attended <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mover><mml:mi>x</mml:mi> <mml:mo>¯</mml:mo></mml:mover> <mml:mspace/></mml:mrow> </mml:math> 7.7 (SD 2.8) sessions. Therapeutic alliance and therapy fidelity were acceptable. Qualitative interviews indicated that participants valued integrated support for anxiety with BD and coping strategies. Some suggested a longer intervention period. Clinical outcomes were not significantly different between arms up to 80 weeks follow-up. CONCLUSIONS: AIBD is feasible and acceptable but lack of impact on clinical outcomes indicates that adaptations are required. These are discussed in relation to qualitative feedback and recent literature published since the trial completed.
BACKGROUND: Comorbid anxiety is common in bipolar disorder (BD) and associated with worse clinical outcomes including increased suicidality. Despite effective psychological treatments for anxiety, research into treating anxiety in BD is underdeveloped. This paper describes a novel psychological intervention to address anxiety in context of bipolar disorder (AIBD). METHODS: Adults with BD and clinically significant anxiety symptoms were randomized to AIBD plus treatment as usual (TAU) or TAU alone. AIBD offered 10 sessions of psychological therapy using a formulation-based approach. Feasibility and acceptability were evaluated through recruitment, retention, therapy attendance, alliance, fidelity, and qualitative feedback. Clinical outcomes were assessed at baseline, 16, 48, and 80 weeks: interim assessments of relapse at 32 and 64 weeks. RESULTS: Seventy-two participants were recruited with 88% retention to 16 weeks and 74% to 80 weeks (similar between arms). Therapy participants attended <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mover><mml:mi>x</mml:mi> <mml:mo>¯</mml:mo></mml:mover> <mml:mspace/></mml:mrow> </mml:math> 7.7 (SD 2.8) sessions. Therapeutic alliance and therapy fidelity were acceptable. Qualitative interviews indicated that participants valued integrated support for anxiety with BD and coping strategies. Some suggested a longer intervention period. Clinical outcomes were not significantly different between arms up to 80 weeks follow-up. CONCLUSIONS: AIBD is feasible and acceptable but lack of impact on clinical outcomes indicates that adaptations are required. These are discussed in relation to qualitative feedback and recent literature published since the trial completed.
Authors: Paul Gilbert; Jaskaran K Basran; Joanne Raven; Hannah Gilbert; Nicola Petrocchi; Simone Cheli; Andrew Rayner; Alison Hayes; Kate Lucre; Paschalina Minou; David Giles; Frances Byrne; Elizabeth Newton; Kirsten McEwan Journal: Front Psychol Date: 2022-07-20
Authors: Martin D Provencher; Emma Morton; Anne Sophie Beaudoin; Judith Guillemette; Evelyne Rheault; Chantal Mérette; Laurent Coque; Lisa D Hawke; Erin E Michalak Journal: Can J Psychiatry Date: 2020-08-12 Impact factor: 4.356