title: Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial.
abstract: BACKGROUND
  Psychosocial interventions for bipolar disorder are frequently unavailable and resource intensive. Mobile technology may improve access to evidence-based interventions and may increase their efficacy. We evaluated the feasibility, acceptability and efficacy of an augmentative mobile ecological momentary intervention targeting self-management of mood symptoms.
  
  
  METHODS
  This was a randomized single-blind controlled trial with 82 consumers diagnosed with bipolar disorder who completed a four-session psychoeducational intervention and were assigned to 10 weeks of either: 1) mobile device delivered interactive intervention linking patient-reported mood states with personalized self-management strategies, or 2) paper-and-pencil mood monitoring. Participants were assessed at baseline, 6 weeks (mid-point), 12 weeks (post-treatment), and 24 weeks (follow up) with clinician-rated depression and mania scales and self-reported functioning.
  
  
  RESULTS
  Retention at 12 weeks was 93% and both conditions were associated with high satisfaction. Compared to the paper-and-pencil condition, participants in the augmented mobile intervention condition showed significantly greater reductions in depressive symptoms at 6 and 12 weeks (Cohen׳s d for both were d=0.48). However, these effects were not maintained at 24-weeks follow up. Conditions did not differ significantly in the impact on manic symptoms or functional impairment.
  
  
  CONCLUSIONS
  This was not a definitive trial and was not powered to detect moderators and mediators.
  
  
  CONCLUSIONS
  Automated mobile-phone intervention is feasible, acceptable, and may enhance the impact of brief psychoeducation on depressive symptoms in bipolar disorder. However, sustainment of gains from symptom self-management mobile interventions, once stopped, may be limited.
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, USA. Electronic address: cdepp@ucsd.edu.
authors.forename: Colin A
authors.initials: CA
authors.lastname: Depp
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Jenni
authors.initials: J
authors.lastname: Ceglowski
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Vicki C
authors.initials: VC
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Faraz
authors.initials: F
authors.lastname: Yaghouti
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Wesley K
authors.initials: WK
authors.lastname: Thompson
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Granholm
mesh_terms: D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D040421:Cell Phone; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bipolar disorder; Depression; Ecological momentary assessment; Internet-based treatments; Psychotherapy; Technology