Augmenting psychoeducation with a mobile intervention for bipolar disorder: A randomized controlled trial
Augmenting psychoeducation with a mobile intervention for bipolar disorder: A randomized controlled trial
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DOI：
10.1016/j.jad.2014.10.053
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发表时间：
2015-03-15
影响因子：
6.6
通讯作者：
Granholm, Eric L.
中科院分区：
文献类型：
--
作者：
Depp, Colin A.;Ceglowski, Jenni;Granholm, Eric L.
背景：双相情感障碍的心理社会干预措施常常难以实现且资源密集。移动技术可以改善对循证干预措施的获取，并可能提高其功效。我们评估了针对情绪症状自我管理的增强型移动生态瞬时干预的可行性、可接受性和有效性。方法：这是一项随机单盲对照试验，有 82 名被诊断患有双相情感障碍的消费者完成了为期四次的心理教育干预，并被分配到 10 周：1）移动设备提供的交互式干预，将患者报告的情绪状态与个性化自我管理策略联系起来，或 2）纸笔情绪监测。参与者在基线、6周（中点）、12周（治疗后）和24周（随访）时使用临床医生评定的抑郁和躁狂量表以及自我报告的功能进行评估。结果：12周时的保留率为93%，这两种情况都与高满意度相关。与纸笔条件相比，增强移动干预条件下的参与者在第 6 周和第 12 周时抑郁症状显着减轻（Cohen's d 均为 d = 0.48）。然而，这些效果在 24 周的随访中并未维持。条件对躁狂症状或功能障碍的影响没有显着差异。局限性：这不是一项明确的试验，无法检测调节因素和调节因素。结论：自动手机干预是可行的、可接受的，并且可能会增强简短心理教育对双相情感障碍抑郁症状的影响。然而，症状自我管理移动干预措施一旦停止，其效果的维持可能会受到限制。由 Elsevier B.V. 出版
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. Published by Elsevier B.V.