Abstract
BackgroundBipolar disorders affect between 3–5% of the population and are associated with considerable lifelong impairment. Since much of the morbidity associated with bipolar disorder is caused by recurrent depressive symptoms, which are often only poorly responsive to antidepressants, there is a need to develop alternative, non-pharmacological interventions. Psychoeducational interventions have emerged as promising long-term therapeutic options for bipolar disorder.Methods/designThe study is an exploratory, individually randomised controlled trial. The intervention known as 'Beating Bipolar' is a psychoeducational programme which is delivered via a novel web-based system. We will recruit 100 patients with a diagnosis of DSM-IV bipolar disorder (including type I and type II) currently in clinical remission. The primary outcome is quality of life. This will be compared for those patients who have participated in the psychoeducational programme with those who received treatment as usual. Quality of life will be assessed immediately following the intervention as well as 10 months after randomisation. Secondary outcomes include current depressive and manic symptoms, number of episodes of depression and mania/hypomania experienced during the follow-up period, global functioning, functional impairment and insight. An assessment of costs and a process evaluation will also be conducted which will explore the feasibility and acceptability of the intervention as well as potential barriers to effectiveness.DiscussionBipolar disorder is common, under-recognised and often poorly managed. It is a chronic, life-long, relapsing condition which has an enormous impact on the individual and the economy. This trial will be the first to explore the effectiveness of a novel web-based psychoeducational intervention for patients with bipolar disorder which has potential to be easily rolled out to patients.Trial registrationCurrent Controlled Trials ISRCTN81375447
Highlights
Bipolar disorders affect between 3–5% of the population and are associated with considerable lifelong impairment
A clinical spectrum of bipolar disorder affects between 3–5% of the population and results in considerable lifelong social and occupational impairment [2,3,4]
Most of the morbidity associated with this disorder is caused by recurrent depressive episodes and chronic, low-grade depressive symptoms, which are present in most patients for at least half of their lifetime[5,6]
Summary
Bipolar disorders affect between 3–5% of the population and are associated with considerable lifelong impairment. Since much of the morbidity associated with bipolar disorder is caused by recurrent depressive symptoms, which are often only poorly responsive to antidepressants, there is a need to develop alternative, non-pharmacological interventions. There is currently considerable uncertainty about how best to treat these chronic depressive symptoms which have an enormous impact on the quality of life and functioning of large numbers of bipolar patients [7] Much of this uncertainty concerns the use of antidepressants. Psychoeducational interventions, which tend to employ some cognitive-behavioural techniques in the context of adjunctive pharmacological management, have emerged as more promising long-term therapeutic options for bipolar disorder [14,15,16,17,18]
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