Modifying Group Therapy for Bipolar Abusers

修改双相情感虐待者的团体治疗

• 批准号: 6587178
• 负责人: Roger D. Weiss
• 金额: $ 23.29万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6587178
• 关键词: behavioral /social science research tag; bipolar depression; clinical research; cognitive behavior therapy; combination therapy; community mental health services; drug abuse therapy; group counseling; group therapy; human subject; human therapy evaluation; interview; patient oriented research; questionnaires; substance abuse related disorder

DESCRIPTION (provided by applicant): Bipolar disorder (BPD) and substance use disorder (SUD) frequently coexist, with poor prognostic implications. However, little research has focused on this population. "Integrated Group Therapy" (IGT) focuses on similarities in the process of recovery from BPD and SUD. In an initial open study, IGT patients had significantly fewer days of drug use than did patients who did not receive IGT. An ongoing Stage IB randomized controlled trial in 60 patients is comparing IGT vs. Group Drug Counseling (GDC), which focuses primarily on substance use. Preliminary results in the first 36 patients have favored IGT, with a significantly higher rate of attendance at group sessions, and significantly better substance use, alcohol, overall abstinence, and mood outcomes. The initial aim of the proposed study is to make IGT more easily adopted by community treatment settings by a) reducing IGT from 20 to 12 sessions and b) modifying IGT so that it can be conducted by drug counselors rather than exclusively by mental health professionals trained in psychopathology and cognitive-behavioral therapy. Patient and counselor satisfaction ratings and outside review of the revised manual will be obtained. The manual will be revised in an ongoing way, while conducting the modified treatment twice in the feasibility (i.e., pre-pilot) phase of the study. Once the manual has been finally revised, a Stage IB randomized controlled pilot study will be conducted with 60 subjects, comparing 12 sessions of revised lGT vs. GDC. Between-group treatment outcomes will be compared at 3 months (i.e., the end of treatment), 6 months, and 9 months. It is hypothesized that revised IGT will have better outcomes GDC, as measured by the primary outcomes, a) days of substance use, and b) number of weeks ill with BPD. Secondary outcomes will also be compared, including treatment retention, patient satisfaction, medication compliance, overall functioning, and engagement in HIV risk behaviors. If warranted by the results, effect sizes from the proposed study will be used to help in the preparation of a larger-scale subsequent Stage II study.

描述（由申请人提供）：双相情感障碍（BPD）和物质使用障碍（SUD）经常共存，预后不良。然而，很少有研究关注这一人群。“综合团体治疗”（IGT）侧重于从BPD和SUD恢复过程中的相似之处。在最初的开放性研究中，IGT患者的药物使用天数明显少于未接受IGT的患者。一项正在进行的IB期随机对照试验在60名患者中比较了IGT与团体药物咨询（GDC），后者主要关注物质使用。前36名患者的初步结果支持IGT，小组会议的出席率显着较高，物质使用，酒精，整体禁欲和情绪结果显着改善。 这项研究的最初目的是使IGT更容易被社区治疗环境所采用，方法是：a）将IGT从20次减少到12次，B）修改IGT，使其可以由药物咨询师进行，而不仅仅是由接受过精神病理学和认知行为治疗培训的精神卫生专业人员进行。将获得患者和咨询师的满意度评分以及对修订后手册的外部审查。手册将持续修订，同时在可行性中进行两次修改治疗（即，预试点）研究阶段。 一旦手册最终修订，将对60名受试者进行IB阶段随机对照初步研究，比较12次修订的lGT与GDC。将在3个月时比较组间治疗结局（即，治疗结束时）、6个月和9个月。假设改良IGT将具有更好的GDC结局，如通过主要结局，a）物质使用天数和B）BPD患病周数测量的。还将比较次要结局，包括治疗保留率、患者满意度、药物依从性、整体功能和参与HIV风险行为。如果结果有必要，将使用拟议研究的效应量来帮助准备后续更大规模的II期研究。