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September 5, 2006

New Treatment Model for Bipolar Disorder Shows Promise

A new care model for bipolar disorder tested in veterans across the nation reduced their manic episodes and improved their quality of life, according to a new research study.

Who did the study?

A new 3 year study, lead by Providence Veterans Affairs Medical center and Brown Medical School, on a new and cost effective treatment model for bipolar disorder was tested on over 300 veterans. The results of the study mirror a previous study published in the May 2006 issue of the Archives of General Psychology.

What was the study trying to do?

The new study provides an increase from 400+ particiants from the previous study, to a 700+ new total; which provides more validity and reliability to the results on this new treatment model.

"We applied the same symptom management approaches found in interventions for diabetes and asthma to the treatment of bipolar disorder and found that people with serious mental illness can help take control of their care,” said Mark S. Bauer, M.D., staff psychiatrist with the Providence V.A. Medical Center and professor of psychiatry and human behavior at Brown Medical School. “This finding should reduce the stigma of helplessness that so often is associated with these disorders, and it will open new avenues for the treatment of bipolar disorder.”
Method

The study utilized a group which continued to receive the same typical treatment, while another group was treated with the new multicomponent intervention program. This new program consisted of a structured treatment team of nurses and psychiatrists. The patients had weekly group sessions where nurses “discussed topics such as medication side effects and early warning signs for symptoms, which in bipolar disorder range from racing speech, bursts of optimism and impulsive behavior during manic episodes to fatigue, social withdrawal and suicidal thoughts during depressive episodes.” This allowed the patients to receive peer support, and create tangible goals for themselves. The care also included “a structured group psychoeducational program, monthly telephone monitoring of mood symptoms and medication adherence, feedback to treating mental health providers, facilitation of appropriate follow-up care, and as-needed outreach and crisis intervention.”

Results

The results where obtained by in-person blind interviewing and assessment every 3 months on mood, and severity of symptoms by means of a reliable longitudinal follow-up examine.

Though there were no significant changes between the new treatment group and the traditional in terms of depressive symptoms, there was a significant reduction in mania symptoms, as well as the amount of time the patients were affected by these mania symptoms. They found the new program reduced 5 weeks of mania during the 3 year study. “Patients also felt happier and healthier, reporting more productive time at work, better relationships with family, and more satisfaction with their care.”

Conclusions

Not only was the new program a success from a clinical standpoint, it was also cheaper than traditional methods being used right now.

“The new model was less expensive – an average of $61,398 for three years of direct treatment costs compared with $64,379 for usual care – although the difference was not statistically significant.”

“The bottom line is that we saw improvements in patients’ symptoms, function and quality of life with no change in net costs,” Bauer said.

Read Full Research Articles:

"Long-term Effectiveness and Cost of a Systematic Care Program for Bipolar Disorder" Archives of General Psychiatry. May 2006.
"Collaborative Care for Bipolar Disorder: Part I. Intervention and Implementation in a Randomized Effectiveness Trial" Psychiatric Services. July 2006.
"Collaborative Care for Bipolar Disorder: Part II. Impact on Clinical Outcome, Function, and Costs" Psychiatric Services. July 2006.

Read Press Article:

"New Treatment Model for Bipolar Disorder Shows Promise" Brown University Media Relations. August 2006.

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