Treating Caregiver Stress and Health in Bipolar Disorder

描述(由申请人提供)：迫切需要心理社会干预，以帮助缓解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心理健康问题，双相情感障碍是一种反复发作的致残精神障碍，影响1%的人口。这项拟议的研究旨在开发和测试第一种干预措施，直接针对双相情感障碍患者的照顾者的自我护理缺陷和受损的心理和身体健康，以及有助于促进他们的高感知压力和无效应对。阶段1-3治疗开发研究将创建、手册和试点测试健康促进干预(HPI)，将关于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，以识别和修改照顾者自我护理的障碍。在第1-2阶段，一个由来自3个研究地点的3名临床研究人员组成的团队将制定手册、依从性/能力和结果衡量标准，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型或II型障碍的患者的主要照顾者(PC)将被随机分配，接受临床研究人员提供的15次HPI，或最多4次自我管理的、录像的心理教育控制条件(CC)。在意向治疗设计中，将使用多元回归和/或随机效应模型评估HPI与CC在减少抑郁和较差的身体健康(主要结果)和照顾者负担、焦虑、自我护理/预防缺陷、无效应对和照顾者成本(次要结果)方面的有效性。将为更大规模的研究开发培训材料。

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.