title: Psychoeducation and online mood tracking for patients with bipolar disorder: A randomised controlled trial.
abstract: Psychoeducation is an effective adjunct to medications in bipolar disorder (BD). Brief psychoeducational approaches have been shown to improve early identification of relapse. However, the optimal method of delivery of psychoeducation remains uncertain. Here, our objective was to compare a short therapist-facilitated vs. self-directed psychoeducational intervention for BD.
  
  
  
  BD outpatients who were receiving medication-based treatment were randomly assigned to 5 psychoeducation sessions administered by a therapist (Facilitated Integrated Mood Management; FIMM; n=60), or self-administered psychoeducation (Manualized Integrated Mood Management; MIMM; n=61). Follow-up was based on patients' weekly responses to an electronic mood monitoring programme over 12 months.
  
  
  
  Over follow-up, there were no group differences in weekly self-rated depression symptoms or relapse/readmission rates. However, knowledge of BD (assessed with the Oxford Bipolar Knowledge questionnaire (OBQ)) was greater in the FIMM than the MIMM group at 3 months. Greater illness knowledge at 3 months was related to a higher proportion of weeks well over 12 months.
  
  
  
  Features of the trial may have reduced the sensitivity to our psychoeducation approach, including that BD participants had been previously engaged in self-monitoring.
  
  
  
  Improved OBQ score, while accelerated by a short course of therapist-administered psychoeducation (FIMM), was seen after both treatments. It was associated with better outcome assessed as weeks well. When developing and testing a new psychosocial intervention, studies should consider proximal outcomes (e.g., acquired knowledge) and their short-term impact on illness course in bipolar disorder.
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Bilderbeck
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Lauren Z
authors.initials: LZ
authors.lastname: Atkinson
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: McMahon
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
authors.forename: Merryn
authors.initials: M
authors.lastname: Voysey
authors.affiliation: Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Judit
authors.initials: J
authors.lastname: Simon
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Price
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rendell
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Hinds
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: John R
authors.initials: JR
authors.lastname: Geddes
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK; MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Holmes
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK; Semel Institute, UCLA, Los Angeles, CA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.affiliation: University Department of Psychiatry, University of Oxford, Oxford, UK. Electronic address: guy.goodwin@psych.ox.ac.uk.
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011380:Programmed Instructions as Topic; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bipolar disorder; Psychoeducation; Randomised controlled trial; Relapse; Self-monitoring