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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Medical burden, body mass index and the outcome of psychosocial interventions for bipolar depression
Australian and New Zealand Journal of Psychiatry, Volume 50, No. 7, Year 2016
Notification
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Description
Objective: Individuals with bipolar disorder experience a disproportionately high incidence of medical co-morbidity and obesity. These health-related problems are a barrier to recovery from mood episodes and have been linked with unfavorable responses to pharmacological treatment. However, little is known about whether and how these characteristics affect responses to adjunctive psychotherapy. Method: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy plus pharmacotherapy with collaborative care (a three-session psycho-educational intervention) plus pharmacotherapy. We conducted a post-hoc analysis to evaluate whether medical burden and body mass index predicted and/or moderated the likelihood of recovery and time until recovery from a depressive episode among patients in the two treatments. Results: Participants who had medical co-morbidity and body mass index data constituted 199 of the 293 patients in the original Systematic Treatment Enhancement Program for Bipolar Disorder trial. Higher medical burden predicted a lower likelihood of recovery from depression in both treatment conditions (odds ratio = 0.89), but did not moderate responses to intensive psychotherapy vs collaborative care. Intensive psychotherapy yielded superior recovery rates for individuals of normal body mass index (odds ratio= 2.39) compared with collaborative care, but not among individuals who were overweight or obese. Conclusion: Medical co-morbidity and body weight impacts symptom improvement and attention to this co-morbidity may inform the development of more personalized treatments for bipolar disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Authors & Co-Authors
Peters, Amy T.
United States, Chicago
University of Illinois at Chicago
Berk, Michael
Australia, Geelong
Deakin University
Australia, Melbourne
University of Melbourne
Dougherty, Darin Dean
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Nierenberg, Andrew Alan
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Deckersbach, Thilo
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Statistics
Citations: 14
Authors: 5
Affiliations: 10
Identifiers
Doi:
10.1177/0004867415616694
ISSN:
00048674
Research Areas
Mental Health
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study
Case-Control Study
Study Approach
Quantitative