Intensive Psychosocial Intervention Enhances Functioning in Patients With Bipolar Depression: Results From a 9-Month Randomized Controlled Trial
Identifieur interne : 000264 ( Pmc/Corpus ); précédent : 000263; suivant : 000265Intensive Psychosocial Intervention Enhances Functioning in Patients With Bipolar Depression: Results From a 9-Month Randomized Controlled Trial
Auteurs : David J. Miklowitz ; Michael W. Otto ; Ellen Frank ; Noreen A. Reilly-Harrington ; Jane N. Kogan ; Gary S. Sachs ; Michael E. Thase ; Joseph R. Calabrese ; Lauren B. Marangell ; Michael J. Ostacher ; Jayendra Patel ; Marshall R. Thomas ; Mako Araga ; Jodi M. Gonzalez ; Stephen R. WisniewskiSource :
- The American journal of psychiatry [ 0002-953X ] ; 2007.
Abstract
Psychosocial interventions are effective adjuncts to pharmacotherapy in delaying recurrences of bipolar disorder; however, to date their effects on life functioning have been given little attention. In a randomized trial, the authors examined the impact of intensive psychosocial treatment plus pharmacotherapy on the functional outcomes of patients with bipolar disorder over the 9 months following a depressive episode.
Participants were 152 depressed outpatients with bipolar I or bipolar II disorder in the multisite Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. All patients received pharmacotherapy. Eighty-four patients were randomly assigned to intensive psychosocial intervention (30 sessions over 9 months of interpersonal and social rhythm therapy, cognitive behavior therapy [CBT], or family-focused therapy), and 68 patients were randomly assigned to collaborative care (a 3-session psychoeducational treatment). Independent evaluators rated the four subscales of the Longitudinal Interval Follow-Up Evaluation–Range of Impaired Functioning Tool (LIFE-RIFT) (relationships, satisfaction with activities, work/role functioning, and recreational activities) through structured interviews given at baseline and every 3 months over a 9-month period.
Patients in intensive psychotherapy had better total functioning, relationship functioning, and life satisfaction scores over 9 months than patients in collaborative care, even after pretreatment functioning and concurrent depression scores were covaried. No effects of psychosocial intervention were observed on work/role functioning or recreation scores during this 9-month period.
Intensive psychosocial treatment enhances relationship functioning and life satisfaction among patients with bipolar disorder. Alternate interventions focused on the specific cognitive deficits of individuals with bipolar disorder may be necessary to enhance vocational functioning after a depressive episode.
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DOI: 10.1176/appi.ajp.2007.07020311
PubMed: 17728418
PubMed Central: 3579578
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Kogan</name></author><author><name sortKey="Sachs, Gary S" sort="Sachs, Gary S" uniqKey="Sachs G" first="Gary S." last="Sachs">Gary S. Sachs</name></author><author><name sortKey="Thase, Michael E" sort="Thase, Michael E" uniqKey="Thase M" first="Michael E." last="Thase">Michael E. Thase</name></author><author><name sortKey="Calabrese, Joseph R" sort="Calabrese, Joseph R" uniqKey="Calabrese J" first="Joseph R." last="Calabrese">Joseph R. Calabrese</name></author><author><name sortKey="Marangell, Lauren B" sort="Marangell, Lauren B" uniqKey="Marangell L" first="Lauren B." last="Marangell">Lauren B. Marangell</name></author><author><name sortKey="Ostacher, Michael J" sort="Ostacher, Michael J" uniqKey="Ostacher M" first="Michael J." last="Ostacher">Michael J. Ostacher</name></author><author><name sortKey="Patel, Jayendra" sort="Patel, Jayendra" uniqKey="Patel J" first="Jayendra" last="Patel">Jayendra Patel</name></author><author><name sortKey="Thomas, Marshall R" sort="Thomas, Marshall R" uniqKey="Thomas M" first="Marshall R." last="Thomas">Marshall R. Thomas</name></author><author><name sortKey="Araga, Mako" sort="Araga, Mako" uniqKey="Araga M" first="Mako" last="Araga">Mako Araga</name></author><author><name sortKey="Gonzalez, Jodi M" sort="Gonzalez, Jodi M" uniqKey="Gonzalez J" first="Jodi M." last="Gonzalez">Jodi M. Gonzalez</name></author><author><name sortKey="Wisniewski, Stephen R" sort="Wisniewski, Stephen R" uniqKey="Wisniewski S" first="Stephen R." last="Wisniewski">Stephen R. Wisniewski</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">17728418</idno><idno type="pmc">3579578</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579578</idno><idno type="RBID">PMC:3579578</idno><idno type="doi">10.1176/appi.ajp.2007.07020311</idno><date when="2007">2007</date><idno type="wicri:Area/Pmc/Corpus">000264</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000264</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intensive Psychosocial Intervention Enhances Functioning in Patients With Bipolar Depression: Results From a 9-Month Randomized Controlled Trial</title><author><name sortKey="Miklowitz, David J" sort="Miklowitz, David J" uniqKey="Miklowitz D" first="David J." last="Miklowitz">David J. Miklowitz</name></author><author><name sortKey="Otto, Michael W" sort="Otto, Michael W" uniqKey="Otto M" first="Michael W." last="Otto">Michael W. Otto</name></author><author><name sortKey="Frank, Ellen" sort="Frank, Ellen" uniqKey="Frank E" first="Ellen" last="Frank">Ellen Frank</name></author><author><name sortKey="Reilly Harrington, Noreen A" sort="Reilly Harrington, Noreen A" uniqKey="Reilly Harrington N" first="Noreen A." last="Reilly-Harrington">Noreen A. Reilly-Harrington</name></author><author><name sortKey="Kogan, Jane N" sort="Kogan, Jane N" uniqKey="Kogan J" first="Jane N." last="Kogan">Jane N. Kogan</name></author><author><name sortKey="Sachs, Gary S" sort="Sachs, Gary S" uniqKey="Sachs G" first="Gary S." last="Sachs">Gary S. Sachs</name></author><author><name sortKey="Thase, Michael E" sort="Thase, Michael E" uniqKey="Thase M" first="Michael E." last="Thase">Michael E. Thase</name></author><author><name sortKey="Calabrese, Joseph R" sort="Calabrese, Joseph R" uniqKey="Calabrese J" first="Joseph R." last="Calabrese">Joseph R. Calabrese</name></author><author><name sortKey="Marangell, Lauren B" sort="Marangell, Lauren B" uniqKey="Marangell L" first="Lauren B." last="Marangell">Lauren B. Marangell</name></author><author><name sortKey="Ostacher, Michael J" sort="Ostacher, Michael J" uniqKey="Ostacher M" first="Michael J." last="Ostacher">Michael J. Ostacher</name></author><author><name sortKey="Patel, Jayendra" sort="Patel, Jayendra" uniqKey="Patel J" first="Jayendra" last="Patel">Jayendra Patel</name></author><author><name sortKey="Thomas, Marshall R" sort="Thomas, Marshall R" uniqKey="Thomas M" first="Marshall R." last="Thomas">Marshall R. Thomas</name></author><author><name sortKey="Araga, Mako" sort="Araga, Mako" uniqKey="Araga M" first="Mako" last="Araga">Mako Araga</name></author><author><name sortKey="Gonzalez, Jodi M" sort="Gonzalez, Jodi M" uniqKey="Gonzalez J" first="Jodi M." last="Gonzalez">Jodi M. Gonzalez</name></author><author><name sortKey="Wisniewski, Stephen R" sort="Wisniewski, Stephen R" uniqKey="Wisniewski S" first="Stephen R." last="Wisniewski">Stephen R. Wisniewski</name></author></analytic><series><title level="j">The American journal of psychiatry</title><idno type="ISSN">0002-953X</idno><idno type="eISSN">1535-7228</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">Psychosocial interventions are effective adjuncts to pharmacotherapy in delaying recurrences of bipolar disorder; however, to date their effects on life functioning have been given little attention. In a randomized trial, the authors examined the impact of intensive psychosocial treatment plus pharmacotherapy on the functional outcomes of patients with bipolar disorder over the 9 months following a depressive episode.</p></sec><sec id="S2"><title>Method</title><p id="P2">Participants were 152 depressed outpatients with bipolar I or bipolar II disorder in the multisite Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. All patients received pharmacotherapy. Eighty-four patients were randomly assigned to intensive psychosocial intervention (30 sessions over 9 months of interpersonal and social rhythm therapy, cognitive behavior therapy [CBT], or family-focused therapy), and 68 patients were randomly assigned to collaborative care (a 3-session psychoeducational treatment). Independent evaluators rated the four subscales of the Longitudinal Interval Follow-Up Evaluation–Range of Impaired Functioning Tool (LIFE-RIFT) (relationships, satisfaction with activities, work/role functioning, and recreational activities) through structured interviews given at baseline and every 3 months over a 9-month period.</p></sec><sec id="S3"><title>Results</title><p id="P3">Patients in intensive psychotherapy had better total functioning, relationship functioning, and life satisfaction scores over 9 months than patients in collaborative care, even after pretreatment functioning and concurrent depression scores were covaried. No effects of psychosocial intervention were observed on work/role functioning or recreation scores during this 9-month period.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Intensive psychosocial treatment enhances relationship functioning and life satisfaction among patients with bipolar disorder. Alternate interventions focused on the specific cognitive deficits of individuals with bipolar disorder may be necessary to enhance vocational functioning after a depressive episode.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0370512</journal-id><journal-id journal-id-type="pubmed-jr-id">457</journal-id><journal-id journal-id-type="nlm-ta">Am J Psychiatry</journal-id><journal-id journal-id-type="iso-abbrev">Am J Psychiatry</journal-id><journal-title-group><journal-title>The American journal of psychiatry</journal-title></journal-title-group><issn pub-type="ppub">0002-953X</issn><issn pub-type="epub">1535-7228</issn></journal-meta><article-meta><article-id pub-id-type="pmid">17728418</article-id><article-id pub-id-type="pmc">3579578</article-id><article-id pub-id-type="doi">10.1176/appi.ajp.2007.07020311</article-id><article-id pub-id-type="manuscript">NIHMS440490</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Intensive Psychosocial Intervention Enhances Functioning in Patients With Bipolar Depression: Results From a 9-Month Randomized Controlled Trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Miklowitz</surname><given-names>David J.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Otto</surname><given-names>Michael W.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Frank</surname><given-names>Ellen</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Reilly-Harrington</surname><given-names>Noreen A.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Kogan</surname><given-names>Jane N.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Sachs</surname><given-names>Gary S.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Thase</surname><given-names>Michael E.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Calabrese</surname><given-names>Joseph R.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Marangell</surname><given-names>Lauren B.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Ostacher</surname><given-names>Michael J.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Patel</surname><given-names>Jayendra</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Thomas</surname><given-names>Marshall R.</given-names></name><degrees>M.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Araga</surname><given-names>Mako</given-names></name><degrees>M.S.</degrees></contrib><contrib contrib-type="author"><name><surname>Gonzalez</surname><given-names>Jodi M.</given-names></name><degrees>Ph.D.</degrees></contrib><contrib contrib-type="author"><name><surname>Wisniewski</surname><given-names>Stephen R.</given-names></name><degrees>Ph.D.</degrees></contrib><aff id="A1">Department of Psychology, University of Colorado, Boulder and the Department of Psychiatry, University of Colorado Health Sciences Center, Denver; Department of Psychology, Boston University, Boston; Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston; Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh; Department of Psychiatry, University of Pittsburgh School of Medicine and Community Care Behavioral Health Organization, Pittsburgh; Department of Psychiatry, Case Western Reserve University School of Medicine/University Hospitals of Cleveland, Cleveland; Menninger Department of Psychiatry, Baylor College of Medicine and VISN 16 MIRECC, VA, Houston; Center for Psychopharmacologic Research and Treatment, University of Massachusetts Medical School, Worcester, Mass.; and the Department of Psychiatry, University of Texas Health Science Center, San Antonio</aff></contrib-group><author-notes><corresp id="FN1">Address correspondence and reprint requests to Dr. Miklowitz, Department of Psychology, University of Colorado, Muenzinger Building, Boulder, CO 80309-0345; <email>miklow@psych.colorado.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>4</day><month>2</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>9</month><year>2007</year></pub-date><pub-date pub-type="pmc-release"><day>22</day><month>2</month><year>2013</year></pub-date><volume>164</volume><issue>9</issue><fpage>1340</fpage><lpage>1347</lpage><abstract><sec id="S1"><title>Objective</title><p id="P1">Psychosocial interventions are effective adjuncts to pharmacotherapy in delaying recurrences of bipolar disorder; however, to date their effects on life functioning have been given little attention. In a randomized trial, the authors examined the impact of intensive psychosocial treatment plus pharmacotherapy on the functional outcomes of patients with bipolar disorder over the 9 months following a depressive episode.</p></sec><sec id="S2"><title>Method</title><p id="P2">Participants were 152 depressed outpatients with bipolar I or bipolar II disorder in the multisite Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. All patients received pharmacotherapy. Eighty-four patients were randomly assigned to intensive psychosocial intervention (30 sessions over 9 months of interpersonal and social rhythm therapy, cognitive behavior therapy [CBT], or family-focused therapy), and 68 patients were randomly assigned to collaborative care (a 3-session psychoeducational treatment). Independent evaluators rated the four subscales of the Longitudinal Interval Follow-Up Evaluation–Range of Impaired Functioning Tool (LIFE-RIFT) (relationships, satisfaction with activities, work/role functioning, and recreational activities) through structured interviews given at baseline and every 3 months over a 9-month period.</p></sec><sec id="S3"><title>Results</title><p id="P3">Patients in intensive psychotherapy had better total functioning, relationship functioning, and life satisfaction scores over 9 months than patients in collaborative care, even after pretreatment functioning and concurrent depression scores were covaried. No effects of psychosocial intervention were observed on work/role functioning or recreation scores during this 9-month period.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Intensive psychosocial treatment enhances relationship functioning and life satisfaction among patients with bipolar disorder. Alternate interventions focused on the specific cognitive deficits of individuals with bipolar disorder may be necessary to enhance vocational functioning after a depressive episode.</p></sec></abstract><funding-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source><award-id>N01 MH080001 || MH</award-id></award-group><award-group><funding-source country="United States">National Institute of Mental Health : NIMH</funding-source><award-id>R37 MH029618 || MH</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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