Browsing by Author "Depp, Colin A"
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- ItemAugmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial.(2015-02-24) Depp, Colin A; Ceglowski, Jenni; Wang, Vicki C; Yaghouti, Faraz; Mausbach, Brent T; Thompson, Wesley K; Granholm, Eric LBACKGROUND Psychosocial interventions for bipolar disorder are frequently unavailable and resource intensive Mobile technology may improve access to evidence based interventions and may increase their efficacy We evaluated the feasibility acceptability and efficacy of an augmentative mobile ecological momentary intervention targeting self management of mood symptoms METHODS This was a randomized single blind controlled trial with 82 consumers diagnosed with bipolar disorder who completed a four session psychoeducational intervention and were assigned to 10 weeks of either 1 mobile device delivered interactive intervention linking patient reported mood states with personalized self management strategies or 2 paper and pencil mood monitoring Participants were assessed at baseline 6 weeks mid point 12 weeks post treatment and 24 weeks follow up with clinician rated depression and mania scales and self reported functioning RESULTS Retention at 12 weeks was 93 and both conditions were associated with high satisfaction Compared to the paper and pencil condition participants in the augmented mobile intervention condition showed significantly greater reductions in depressive symptoms at 6 and 12 weeks Cohen s d for both were d 0 48 However these effects were not maintained at 24 weeks follow up Conditions did not differ significantly in the impact on manic symptoms or functional impairment LIMITATIONS This was not a definitive trial and was not powered to detect moderators and mediators CONCLUSIONS Automated mobile phone intervention is feasible acceptable and may enhance the impact of brief psychoeducation on depressive symptoms in bipolar disorder However sustainment of gains from symptom self management mobile interventions once stopped may be limited
- ItemIndividualized texting for adherence building (iTAB) for methamphetamine users living with HIV: A pilot randomized clinical trial.(0000-00-00) Moore, David J; Pasipanodya, Elizabeth C; Umlauf, Anya; Rooney, Alexandra S; Gouaux, Ben; Depp, Colin A; Atkinson, J Hampton; Montoya, Jessica LBACKGROUND Methamphetamine METH use poses a barrier to antiretroviral therapy ART adherence We evaluated the efficacy of the individualized texting for adherence building iTAB intervention among persons living with HIV PLWH who meet criteria for METH use disorder We examined daily associations between ART adherence and text reported METH use and depressed mood METHODS We conducted a single site 2 arm 6 week pilot randomized clinical trial comparing a personalized bidirectional text messaging system iTAB n 50 to an active control condition n 25 All participants received adherence psychoeducation and daily texts assessing METH use and depressed mood The iTAB group received personalized daily ART reminder texts ART adherence was monitored using Medication Event Monitoring System MEMS caps RESULTS Response rates to daily ART reminder texts were high 79 with good concordance between MEMS derived and text reported ART adherence p Under 001 Intervention groups did not differ in MEMS derived ART adherence 68 iTAB 70 active control p 68 however participants in the iTAB group had fewer METH use days median 14 4 iTAB 22 0 active control p 05 Text reported METH use but not depressed mood was associated with poorer MEMS derived ART adherence CONCLUSIONS High text response rates and good concordance between MEMS derived and text reported adherence suggests text messaging is a feasible intervention delivery approach that provides a valid indication of ART adherence Reductions in METH use among iTAB participants suggest daily health reminders may help attenuate substance use Further research is needed to substantiate daily text messaging as a harm reduction approach
- ItemMobile interventions for severe mental illness: design and preliminary data from three approaches.(2010-10-05) Depp, Colin A; Mausbach, Brent; Granholm, Eric; Cardenas, Veronica; Ben-Zeev, Dror; Patterson, Thomas L; Lebowitz, Barry D; Jeste, Dilip VMobile devices can be used to deliver psychosocial interventions yet there is little prior application in severe mental illness We provide the rationale design and preliminary data from 3 ongoing clinical trials of mobile interventions developed for bipolar disorder or schizophrenia Project 1 used a personal digital assistant to prompt engagement in personalized self management behaviors based on real time data Project 2 employed experience sampling through text messages to facilitate case management Project 3 was built on group functional skills training for schizophrenia by incorporating between session mobile phone contacts with therapists Preliminary findings were of minimal participant attrition and no broken devices yet several operational and technical barriers needed to be addressed Adherence was similar to that reported in nonpsychiatric populations with high participant satisfaction Therefore mobile devices seem feasible and acceptable in augmenting psychosocial interventions for severe mental illness with future research in establishing efficacy cost effectiveness and ethical and safety protocols
- ItemA Pilot Study of Mood Ratings Captured by Mobile Phone Versus Paper-and-Pencil Mood Charts in Bipolar Disorder.(2013-05-06) Depp, Colin A; Kim, Daniel H; de Dios, Laura Vergel; Wang, Vicki; Ceglowski, JenniferOBJECTIVE Patient reported mood charts are frequently used in management of bipolar disorder Although mood charts have recently been programmed in electronic devices such as mobile phones little is known about the impact of the method of data capture on the psychometric properties and validity of these data METHODS In an ongoing pilot study a sample of outpatients with bipolar disorder were randomized to either complete mood charts on a mobile phone or a standard paper and pencil mood chart as part of a 12 week intervention primary outcomes for the trial await study completion We compared these conditions across single item rating of mood state and we hypothesized that mobile phone based data capture would produce greater compliance to mood ratings variability between and within participants and concurrent validity with blinded clinician rated affective symptom severity RESULTS A total of 56 participants were randomized and 40 participants were included in the analyses There were no significant differences between conditions on demographic or clinical variables The rate of compliance was significantly higher in paper and pencil versus mobile phone ratings Ratings demonstrated significantly more variability within individuals in the mobile phone condition Mobile phone mood ratings were significantly correlated with clinician rated depressive symptom severity across the study and with manic symptom severity at the Week 6 assessment whereas paper and pencil ratings were not significantly associated with clinician rated depression or mania CONCLUSIONS Although preliminary our results suggest a lower rate of compliance with mobile phones compared to paper and pencil daily mood rating in bipolar disorder yet a greater ability to capture variability and concurrent validity in quantifying affective symptoms This clinical trial is registered at http www clinicaltrials gov as NCT01670123
- ItemRefining a personalized mHealth intervention to promote medication adherence among HIV+ methamphetamine users.(2014-10-07) Montoya, Jessica L; Georges, Shereen; Poquette, Amelia; Depp, Colin A; Atkinson, J Hampton; Moore, David J; ,Mobile health mHealth interventions to promote antiretroviral therapy ART adherence have shown promise however among persons living with HIV who abuse methamphetamine MA effective tailoring of content to match the expressed needs of this patient population may be necessary This study aimed 1 to understand patient perspectives of barriers and facilitators of ART adherence among people with HIV who use MA and 2 to obtain feedback on the thematic content of an mHealth intervention in order to tailor the intervention to this subgroup Two separate focus groups each with 10 HIV MA individuals were conducted Transcribed audio recordings were qualitatively analyzed to identify emergent themes Inter rater reliability of themes was high mean Kappa 97 Adherence barriers included MA use misguided beliefs about ART adherence memory and planning difficulties social barriers and perceived stigma and mental heath issues Facilitators of effective ART adherence were cognitive compensatory strategies promotion of well being health care supports adherence education and social support Additionally the focus groups generated content for reminder text messages to be used in the medication adherence intervention This qualitative study demonstrates the feasibility of using focus groups to derive patient centered intervention content to address the health challenge at hand in targeted populations
- ItemSingle-Session Mobile-Augmented Intervention in Serious Mental Illness: A Three-Arm Randomized Controlled Trial.(0000-00-00) Depp, Colin A; Perivoliotis, Dimitri; Holden, Jason; Dorr, Jennifer; Granholm, Eric LPsychosocial interventions for serious mental illness are resource intensive and poorly accessible Brief interventions eg single session that are augmented by follow on automated mobile health intervention may expand treatment access This was a randomized single blind controlled trial with 255 individuals diagnosed with schizophrenia or bipolar disorder Participants were randomized to one of three conditions CBT2go which combined one individual session of cognitive behavioral therapy with automated thought challenging adaptive behavior delivered through mobile devices Self Monitoring SM which combined single session illness psychoeducation with self monitoring of symptoms and treatment as usual TAU Participants were assessed at baseline 6 weeks midpoint 12 weeks posttreatment and 24 weeks follow up with our primary outcome global psychopathology Brief Psychiatric Rating Scale expanded version BPRS 24 and secondary outcomes community functioning Specific Level of Function SLOF and defeatist performance beliefs DPBs We also collected data on adverse events Outcome analyses on the primary outcome BPRS Total score indicated a significant time 0 24 wk by group interaction with significant but modest improvement comparing two active conditions CBT2go and SM relative to TAU Effects of CBT2go were not different from SM There was a significant time group interaction with better SLOF scores in CBT2go across 24 weeks but not in SM There were no time by group effects on DPBs DPBs decreased in the CBT2go condition but not in SM These results indicated that single intervention augmented by mobile intervention was feasible and associated with small yet sustained effects on global psychopathology and when inclusive of CBT community function compared with usual care