Steel Craig, Wright Kim, Goodwin Guy M, Simon Judit, Morant Nicola, Taylor Rod S, Brown Michael, Jennings Susie, Hales Susie A, Regan Jemma, Sibsey Michaela, Thomas Zoe, Meredith Lynette, Holmes Emily A
Oxford Health NHS Foundation Trust and University of Oxford, Oxford, UK.
University of Oxford, Oxford, UK.
Int J Bipolar Disord. 2023 Jul 22;11(1):27. doi: 10.1186/s40345-023-00305-8.
Intrusive mental imagery is associated with anxiety and mood instability within bipolar disorder and therefore represents a novel treatment target. Imagery Based Emotion Regulation (IBER) is a brief structured psychological intervention developed to enable people to use the skills required to regulate the emotional impact of these images.
Participants aged 18 and over with a diagnosis of bipolar disorder and at least a mild level of anxiety were randomly assigned (1:1) to receive IBER plus treatment as usual (IBER + TAU) or treatment as usual alone (TAU). IBER was delivered in up to 12 sessions overs 16 weeks. Clinical and health economic data were collected at baseline, end of treatment and 16-weeks follow-up. Objectives were to inform the recruitment process, timeline and sample size estimate for a definitive trial and to refine trial procedures. We also explored the impact on participant outcomes of anxiety, depression, mania, and mood stability at 16-weeks and 32-weeks follow-up.
Fifty-seven (28: IBER + TAU, 27: TAU) participants from two sites were randomised, with 50 being recruited within the first 12 months. Forty-seven (82%) participants provided outcome data at 16 and 32-weeks follow-up. Thirty-five participants engaged in daily mood monitoring at the 32-week follow-up stage. Retention in IBER treatment was high with 27 (96%) attending ≥ 7 sessions. No study participants experienced a serious adverse event.
The feasibility criteria of recruitment, outcome completion, and intervention retention were broadly achieved, indicating that imagery-focused interventions for bipolar disorder are worthy of further investigation.
侵入性心理意象与双相情感障碍中的焦虑和情绪不稳定有关，因此是一个新的治疗靶点。基于意象的情绪调节（IBER）是一种简短的结构化心理干预措施，旨在使人们能够运用调节这些意象所产生的情绪影响所需的技能。
年龄在18岁及以上、被诊断为双相情感障碍且至少有轻度焦虑的参与者被随机分配（1:1）接受IBER加常规治疗（IBER + TAU）或仅接受常规治疗（TAU）。IBER在16周内进行最多12次治疗。在基线、治疗结束时和16周随访时收集临床和健康经济数据。目的是为一项确定性试验的招募过程、时间表和样本量估计提供信息，并完善试验程序。我们还探讨了在16周和32周随访时对参与者焦虑、抑郁、躁狂和情绪稳定性结果的影响。
来自两个地点的57名参与者（28名：IBER + TAU，27名：TAU）被随机分组，其中50名在最初12个月内招募。47名（82%）参与者在16周和32周随访时提供了结果数据。35名参与者在32周随访阶段进行了每日情绪监测。IBER治疗的保留率很高，27名（96%）参与者参加了≥7次治疗。没有研究参与者经历严重不良事件。
在招募、结果完成和干预保留方面的可行性标准基本达到，表明针对双相情感障碍的以意象为重点的干预措施值得进一步研究。
