Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial.
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Date
2015-02-24
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Abstract
BACKGROUND 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