Department of Psychological Medicine and Neurology, Cardiff University School of Medicine, Heath Park, Cardiff, UK.
Bipolar Disord. 2011 Aug-Sep;13(5-6):571-7. doi: 10.1111/j.1399-5618.2011.00949.x.
Psychoeducational approaches are promising interventions for the long-term management of bipolar disorder. In consultation with professionals, patients, and their families we have developed a novel web-based psychoeducational intervention for bipolar disorder called Beating Bipolar. We undertook a preliminary exploratory randomized trial to examine efficacy, feasibility and acceptability.
This was an exploratory randomized controlled trial of Beating Bipolar (current controlled trials registration number: ISRCTN81375447). The control arm was treatment-as-usual and the a priori primary outcome measure was quality of life [measured by the brief World Health Organization Quality of Life (WHOQOL-BREF) scale]. Secondary outcomes included psychosocial functioning, insight, depressive and manic symptoms and relapse, and use of healthcare resources. Fifty participants were randomized to either the Beating Bipolar intervention plus treatment-as-usual or just treatment-as-usual. The intervention was delivered over a four-month period and outcomes were assessed six months later.
There was no significant difference between the intervention and control groups on the primary outcome measure (total WHOQOL-BREF score) but there was a modest improvement within the psychological subsection of the WHOQOL-BREF for the intervention group relative to the control group. There were no significant differences between the groups on any of the secondary outcome measures.
Beating Bipolar is potentially a safe and engaging intervention which can be delivered remotely to large numbers of patients with bipolar disorder at relatively low cost. It may have a modest effect on psychological quality of life. Further work is required to establish the impact of this intervention on insight, knowledge, treatment adherence, self-efficacy and self-management skills.
心理教育方法是治疗双相情感障碍的一种很有前途的长期管理方法。我们与专业人员、患者及其家属协商,开发了一种新的基于网络的双相情感障碍心理教育干预措施,称为“击败躁郁症”。我们进行了一项初步探索性随机试验,以检验其疗效、可行性和可接受性。
这是一项针对“击败躁郁症”(当前临床试验注册号:ISRCTN81375447)的探索性随机对照试验。对照组为常规治疗,主要结局指标是生活质量[采用简明世界卫生组织生活质量量表(WHOQOL-BREF)测量]。次要结局指标包括社会心理功能、洞察力、抑郁和躁狂症状以及复发情况,以及医疗资源的使用情况。将 50 名参与者随机分为“击败躁郁症”干预组加常规治疗或单纯常规治疗。干预在四个月内进行,六个月后评估结果。
干预组和对照组在主要结局指标(WHOQOL-BREF 总分)上无显著差异,但干预组的 WHOQOL-BREF 心理部分较对照组有适度改善。两组在任何次要结局指标上均无显著差异。
“击败躁郁症”可能是一种安全且吸引人的干预措施,可以远程提供给大量双相情感障碍患者,成本相对较低。它可能对心理生活质量有适度影响。需要进一步的工作来确定这种干预措施对洞察力、知识、治疗依从性、自我效能和自我管理技能的影响。