Treating Caregiver Stress and Health in Bipolar Disorder

描述（由申请人提供）：迫切需要社会心理干预，以帮助减轻家庭成员照顾患有双相情感障碍的亲属所经历的压力和与压力相关的健康和精神健康问题，双相情感障碍是一种影响1%人口的复发性和致残性精神障碍。本研究旨在开发和测试第一个直接针对双相情感障碍患者护理人员自我护理缺陷和身心健康受损，以及高感知压力和无效应对的干预措施。一项1-3阶段的治疗发展研究将创建、手动操作和试点测试一种促进健康的干预（HPI），该干预将有关护理压力和相关健康和心理健康风险的心理教育与CBT技术相结合，以识别和改变护理者自我护理的障碍。在第1-2阶段，由3个研究地点的3名临床研究者组成的团队将开发手册、依从性/能力和结果测量，并运行6个可行性案例。在第三阶段，46名被scid诊断为双相I或II型障碍的患者的主要护理人员（PC）将被随机分配，接受由临床研究者提供的15期HPI，或多达4期的自我管理，录像的心理教育控制条件（CC）。在意向治疗设计中，HPI与CC在减少抑郁和身体健康状况不佳（主要结局）、照顾者负担、焦虑、自我照顾/预防缺陷、无效应对和照顾者成本（次要结局）方面的疗效将使用多变量回归和/或随机效应模型进行评估。将为更大规模的研究编写培训材料。

DESCRIPTION (provided by applicant): There is a critical need for psychosocial interventions to help alleviate the stress and stress-related health and mental health problems experienced by family members caring for a relative with bipolar disorder, a recurrent and disabling mental disorder affecting 1% of the population. The proposed research aims to develop and test the first intervention to directly target the self-care deficits and compromised mental and physical health of caregivers of patients with bipolar illness, as well as the high perceived stress, and ineffective coping that help promote them. A Stage 1-3 treatment development study will create, manualize and pilot test a health-promoting intervention (HPI) that combines psychoeducation about caregiving stress and associated health and mental health risks with CBT techniques to identify and modify barriers to caregiver self-care. In Stages 1-2 a team of 3 clinical investigators from 3 research sites will develop the manual, adherence/competence and outcome measures, and run 6 feasibility cases. In Stage 3, 46 primary caregivers (PC's) of patients with SCID-diagnosed Bipolar I or II Disorder will be randomized to receive either the 15-session HPI delivered by the clinical investigators, or up to 4 sessions of a self-administered, videotaped psychoeducational control condition (CC). The efficacy of HPI vs. CC in reducing depression and poor physical health (primary outcomes) and caregiver burden, anxiety, self-care/prevention deficits, ineffective coping, and costs to caregivers (secondary outcomes) will be evaluated using multivariate regression and/or random effects models, in an intent-to-treat design. Training materials will be developed for a larger-scale study.