Bipolar Illness Therapy, Family Burden, Costs & Health

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DESCRIPTION (provided by applicant): Bipolar affective disorder is a severe, disabling mental disorder characterized by recurrent episodes of depression and mania, which impact adversely on the health, emotional and economic well-being of the family members that help care for the patient. The proposed research is an ancillary study to Systematic Treatment Enhancement Project for Bipolar Disorder (STEP-BD), which aims to test the effectiveness of the family vs. individually-based psychosocial treatments employed in this clinical trial to alleviate the emotional burdens and adverse health and economic effects of caring for relative with acute mania or depression. It also claims to examine the effects of reductions in burden over the course of treatment on the patients' clinical outcomes. The primary family caregivers (PC's) of 300 patients with SCID-diagnosed Bipolar or II Disorder selected to participate in the Randomized Clinical Pathways (RCP's) for Acute Depression or Relapse Prevention will be evaluated on measures of family burden, health and coping: 1) pre-treatment; 2) post-treatment; and 3) six months later. Random effects regression models will be used to test the hypothesis of a differential effect of treatment with family-focused therapy (FFT) vs. treatment with individual intensive psychotherapy (Cognitive Behavioral or Interpersonal Social Rhythms Therapy), or individual nonintensive psychoeducation on: 1) the degree of burden reported by the family members of patients with bipolar disorder overtime, and 2) the resource costs associated with informal care. The results of the study will examine an important source of variance in clinical outcome not included in the STEP-BD protocol. They will help us understand how family burden and coping impact on the health and health practices of caregivers of person with bipolar illness.