title: A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder.
abstract: BACKGROUND
  Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design.
  
  
  METHODS
  Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence.
  
  
  RESULTS
  Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence.
  
  
  CONCLUSIONS
  The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline.
  
  
  CONCLUSIONS
  This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.
authors.affiliation: The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia. Electronic address: suela@barwonhealth.org.au.
authors.forename: Sue
authors.initials: S
authors.lastname: Lauder
authors.affiliation: RMIT University, Building 6, Level 5 Bowen Street, Melbourne 3000, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chester
authors.affiliation: The University of Melbourne, Department of Psychiatry, St Vincent׳s Hospital, P.O. Box, 2900, Fitzroy 3065, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.affiliation: The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia.
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.affiliation: The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Gliddon
authors.affiliation: The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Berk
authors.affiliation: Healthmaps Pty Ltd, PO Box 2501, Fitzroy, 3065 Melbourne, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Chamberlain
authors.affiliation: DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia; National Institute for Mental Health Research, The Australian National University, Building 63, Canberra 2000, Australia; National eTherapy Center, Swinburne University of Technology, Hawthorn, Victoria, Australia.
authors.forename: Britt
authors.initials: B
authors.lastname: Klein
authors.affiliation: Healthmaps Pty Ltd, PO Box 2501, Fitzroy, 3065 Melbourne, Australia.
authors.forename: Monica
authors.initials: M
authors.lastname: Gilbert
authors.affiliation: Deakin University, School of Psychology, Faculty of Health, Burwood Campus, 221 Burwood Highway, Burwood 3125, Victoria Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Austin
authors.affiliation: The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052 Parkville, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012648:Self Care / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D012944:Social Support; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult; D016903:Drug Monitoring
keywords: Bipolar disorder; CBT; Internet; Online; Psychoeducation; Psychological