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Internet Psychoeducation for Bipolar Affective Disorder: Basis for Preparation and First Experiences

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Abstract

There is growing evidence that patients with bipolar affective disorder (BAD), who use medication, respond well to further psychotherapeutic interventions. Internet-based psychoeducation is typically centered on the interaction between a client and therapist via the Internet. Multiple methods were required to investigate existing psychoeducational and psychotherapeutic strategies used on patients suffering from BAD. Systematic reviews and original reports of all trials of psychoeducation in BAD patients were retrieved. Patients with BAD, who were hospitalized in a psychiatric department or attended a day hospital program, were exposed to the first version of the program during the treatment, and then questioned about understandability, comprehensibility, and usefulness of each lecture. Twelve modules of the Internet E-Program for BAD were developed and the intervention was a pilot tested with twelve patients. Internet psychoeducation program for BAD is an intervention designed for universal implementation that addresses heightened learning needs of patients suffering from BAD. It is designed to promote confidence and reduce the number of episodes of the disorder by providing skills in monitoring warning signs, planning daily activities and practicing communication skills.

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References

  1. Perry A, Tarrier N, Morriss R, McCarthy E, Limb K: Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ 318:139–153, 1999.

    Article  Google Scholar 

  2. Miklowitz DJ: A review of evidence-based psychosocial interventions for bipolar disorder. Journal of Clinical Psychiatry 67(Suppl 11):28–33, 2006.

    PubMed  Google Scholar 

  3. Morriss R, Mohammed F, Bolton C, McCarthy J, Williamson P, Jones A: Interventions for helping people recognize early signs of recurrence in bipolar disorder: Full review. Cochrane Collaboration 24(1):CD004854, 2007.

    Google Scholar 

  4. Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfeld RMA: The National MDA survey of bipolar members. Journal of Affective Disorders 31:281–294, 1994.

    Article  PubMed  CAS  Google Scholar 

  5. Hill RG, Shepard GPH. A Survey of the Manic Depression Fellowship. London, Sainsbury Centre for Mental Health, 1996.

    Google Scholar 

  6. Scott J, Colom F, Vieta E. A meta-analysis of relapse rates with adjunctive psychological therapies compared to usual psychiatric treatment for bipolar disorders. The International Journal of Neuropsychopharmacology 10(1):123–129, 2007.

    Article  PubMed  CAS  Google Scholar 

  7. Lam DH, Wong G. Prodromes, coping strategies and psychological interventions in bipolar disorders. Clinical Psychology Review 25:1028–1042, 2005.

    Article  PubMed  Google Scholar 

  8. Barnes E, Simpson S, Griffiths E, Hood K, Craddock N, Smith D: Developing an online psychoeducation package for bipolar disorder. Journal of Mental Health 20(1):21–31, 2011.

    Article  PubMed  Google Scholar 

  9. Frank E, Kupfer DJ, Thase ME, Mallinger AG, Swartz HA, Fagiolini AM, Grochocinski V, Houck P, Scott J, Thompson W, Monk T: Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry 62(9):996–1004, 2005.

    Article  PubMed  Google Scholar 

  10. Sierra P, Livianos L, Arques S, Castello J, Rojo L: Prodromal symptoms to relapse in bipolar disorder. Australian and New Zealand Journal of Psychiatry 41:385–391, 2007.

    Article  PubMed  Google Scholar 

  11. Miklowitz DJ and Johnson SL: Social and familial factors in the course of bipolar disorder: Basic processes and relevant interventions. Clinical Psychology (New York) 16(2):281–296, 2009.

    Google Scholar 

  12. Parikh SV, Zaretsky A, Beaulieu S, Yatham LN, Young LT, Patelis-Siotis I, Macqueen GM, Levitt A, Arenovich T, Cervantes P, Velyvis V, Kennedy SH, Streiner DL: A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: A Canadian network for mood and anxiety treatments (CANMAT) study [CME]. Journal of Clinical Psychiatry 73(6):803–810, 2012.

    Article  PubMed  Google Scholar 

  13. Prasko J, Ociskova M, Kamaradova D, Sedlackova Z, Cerna M, Mainerova B, Sandoval A: Bipolar affective disorder and psychoeducation. Neuro Endocrinology Letters 34(2):83–96, 2013.

    PubMed  Google Scholar 

  14. Smith DJ, Griffiths E, Poole R, DiFlorio A, Barnes E, Kelly M, Craddock N, Hood K, Simpson S: Beating Bipolar: Exploratory trial of a novel internet-based psychoeducational treatment for bipolar disorder. Bipolar Disorders 13(5–6):571–577, 2011.

    Article  PubMed  Google Scholar 

  15. Zaresky A, Lancee W, Miller C, Harris A, Parikh SV: Is cognitive-behavioural therapy more effective than psychoeducation in bipolar disorder? Canadian Journal of Psychiatry 53(7):441–448, 2008.

    Google Scholar 

  16. Podawiltz A: A review of current bipolar disorder treatment guidelines. Journal of Clinical Psychiatry 73(3):e12, 2012.

    Article  PubMed  Google Scholar 

  17. NICE: Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents in Primary and Secondary Care. London, National Institute for Clinical Excellence, 2006.

    Google Scholar 

  18. Perlick DA, Hohenstein JM, Clarkin JF, Kaczynski R, Rosenheck RA: Use of mental health and primary care services by caregivers of patients with bipolar disorder: A preliminary study. Bipolar Disorders 7(2):126–135, 2005.

    Article  PubMed  Google Scholar 

  19. Woods SW: The economic burden of bipolar disease. Journal of Clinical Psychiatry 61(Suppl 13):38–41, 2000.

    PubMed  Google Scholar 

  20. Gupta R, Guest JF: Annual cost of bipolar disorder to UK society. The British Journal of Psychiatry 180:227–233, 2002.

    Article  PubMed  Google Scholar 

  21. Jones S, McGrath E, Hampshire K, Owen R, Riste L, Roberts C, Davies L, Mayes D: A randomised controlled trial of time limited CBT informed psychological therapy for anxiety in bipolar disorder. BMC Psychiatry 13:54, 2013. doi:10.1186/1471-244X-13-54.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Lam D, Bright J, Jones S: Cognitive therapy for bipolar illness—A pilot study of relapse prevention. Cognitive Therapy and Research 24:503–520, 2000.

    Article  Google Scholar 

  23. Todd NJ, Solis-Trapala I, Jones SH, Lobban FA: An online randomized controlled trial to assess the feasibility, acceptability and potential effectiveness of ‘Living with Bipolar’: A web-based self-management intervention for bipolar disorder: Trial design and protocol. Contemporary Clinical Trials 33(4):679–688, 2012.

    Article  PubMed  Google Scholar 

  24. Spek V, Cuijpers P, Nyklícek I, Riper H, Keyzer J, Pop V: Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: A meta-analysis. Psychological Medicine 37(8):37, 2007.

    Google Scholar 

  25. Poole R, Simpson SA, Smith DJ: Internet-based psychoeducation for bipolar disorder: A qualitative analysis of feasibility, acceptability and impact. BMC Psychiatry 12:139, 2012. http://www.biomedcentral.com/1471-244X/12/139.

  26. Carlbring P, Nilsson-Ihrfelt E, Waara J, Kollenstam C, Buhrman M, Kaldo V, Söderberg M, Ekselius L, Andersson G: Treatment of panic disorder. Live therapy vs. self-help via the Internet. Behavior Research and Therapy 43:1321–1333, 2005.

    Article  Google Scholar 

  27. Clarke G, Eubanks D, Reid E, Kelleher C, O’Connor E, DeBar LL, Lynch F, Nunley S, Gullion C: Overcoming depression on the Internet (ODIN) (2): A randomized trial of a self-help depression skills program with reminders. Journal of Medical Internet Research 7(2):e16, 2005.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Mackinnon A, Griffiths KM, Christensen H: Comparative randomized trial of online cognitive-behavioural therapy and an information website for depression: 12-Month outcomes. The British Journal of Psychiatry 192(2):130–134, 2008.

    Article  PubMed  Google Scholar 

  29. O’Kearney R, Gibson M, Christensen H, Griffiths KM: Effects of a cognitive-behavioural internet program on depression, vulnerability to depression and stigma in adolescent males: A school-based controlled trial. Cognitive Behavior Therapy 35(1):43–54, 2006.

    Article  Google Scholar 

  30. Van Voorhees BW, Ellis JM, Gollan JK, Bell CC, Stuart SS, Fogel J, Corrigan PW, Ford DE: Development and process evaluation of a primary care internet-based intervention to prevent depression in emerging adults. The Primary Care Companion Journal of Clinical Psychiatry 9(5):346–355, 2007.

    Article  Google Scholar 

  31. Van Straten A, Cuijpers P, Smits N: Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: Randomized controlled trial. Journal of Medical Internet Research 10(1):e7, 2008.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Kenwright M and Marks IM: Computer-aided self-help for phobia/panic via internet at home: A pilot study. The British Journal of Psychiatry 184:448–449, 2004.

    Article  PubMed  Google Scholar 

  33. Gega L, Norman IJ, Marks IM: Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: Randomized controlled trial with pre-registration nursing students. International Journal of Nursing Studies 44(3):397–405, 2007.

    Article  PubMed  CAS  Google Scholar 

  34. Carlbring P, Bohman S, Brunt S, Buhrman M, Westling BE, Ekselius L, Andersson G. Remote treatment of panic disorder: A randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. American Journal of Psychiatry 163(12):2119–2125, 2006.

    Article  PubMed  Google Scholar 

  35. Kiropoulos LA, Klein B, Austin DW, Gilson K, Pier C, Mitchell J, Ciechomski L: Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders 22(8):1273–1284. 2008.

    Article  PubMed  Google Scholar 

  36. Riper H, Kramer J, Smit F, Conijn B, Schippers G, Cuijpers P: Web-based self-help for problem drinkers: A pragmatic randomized trial.Addiction 103(2):218–227, 2008.

    Article  PubMed  Google Scholar 

  37. Knaevelsrud C and Maercker A: Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: A randomized controlled clinical trial. BMC Psychiatry 19(7):13, 2007.

    Article  Google Scholar 

  38. Wagner B, Knaevelsrud C, Maercker A. Post-traumatic growth and optimism as outcomes of an internet-based intervention for complicated grief. Cognitive Behavioral Therapy 36(3):156–61, 2007.

    Article  Google Scholar 

  39. Barlow JH, Ellard DR, Hainsworth JM, Jones FR, Fisher A: A review of selfmanagement interventions for panic disorders, phobias and obsessive-compulsive disorders. Acta Psychiatrica Scandinavica 111(4):272–285, 2005.

    Article  PubMed  CAS  Google Scholar 

  40. Klein B, Richards JC, Austin DW: Efficacy of internet therapy for panic disorder. Journal of Behavior Therapy and Experimental Psychiatry 37(3):213–238, 2006.

    Article  PubMed  Google Scholar 

  41. Standley K, Austin DW, Klein B, Pier C, Schattner P, Pierce D, Wade V: Therapist-assisted, Internet-based treatment for panic disorder: Can general practitioners achieve comparable patient outcomes to psychologists? Journal of Medical Internet Research 10(2):e14, 2008.

    Article  Google Scholar 

  42. Liwowsky I, Cebulla M, Fichter M: New ways to combat eating disorders-evaluation of an internet-based self-help program in bulimia nervosa. MMW Fortschr Med 148(31–32):31–33, 2006.

    PubMed  CAS  Google Scholar 

  43. Latalova K, Prasko J, Diveky T, Velartova H: Cognitive impairment in bipolar disorder. Biomedical Papers-Olomouc 155(1): 19–26, 2011.

    Article  Google Scholar 

  44. Latalova K, Prasko J, Diveky T, Kamaradova D, Grambal A, Velartova H: Prodromes, precipitants, and risk factors for relapse in bipolar disorder. Neuroendocrinology Letters 33(6):619–625, 2012.

    PubMed  Google Scholar 

  45. Lam DH, Wong G: Prodromes, coping strategies, insight and social functioning in bipolar affective disorders. Psychological Medicine 27:1091–1100, 1997.

    Article  PubMed  CAS  Google Scholar 

  46. Latalova K: Insight in bipolar disorder. Psychiatr Quarterly 83(3):293–310, 2011.

    Article  Google Scholar 

  47. Basco MR: The Bipolar Workbook. Tools for Controlling your Mood Swings. New York, The Guilford Press, 2006.

    Google Scholar 

  48. Perlick, D.A., Rosenheck, R.A., Clarkin, J.F., Sirey, J.A., Salahi, J., Struening, E.L.,Link, B.G: Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatric Services 52(12):1627–1632, 2001.

    Article  PubMed  CAS  Google Scholar 

  49. Latalova K, Ociskova M, Praško J, Kamaradova D, Jelenova D, Sedlackova Z: Bipolar disorder and stigmatization. Neuroendocrinology Letters 34(4):265–272, 2013a.

    PubMed  Google Scholar 

  50. Berk M, Berk L, Castle D: A collaborative approach to the treatment alliance in bipolar disorder. Bipolar Disorders 6(6):504–518, 2004.

    Article  PubMed  Google Scholar 

  51. Sahoo MK, Chakrabarti S, Kulhara P: Detection of prodromal symptoms of relapse in mania & unipolar depression by relatives & patients. Indian Journal of Medical Research 135(2):177–183, 2012.

    PubMed Central  PubMed  CAS  Google Scholar 

  52. Leclerc E, Mansur RB, Brietzke E: Determinants of adherence to treatment in bipolar disorder: A comprehensive review. Journal of Affective Disorders. 149(1–3):247–252, 2013.

    Article  PubMed  Google Scholar 

  53. Molnar GJ, Feeney MG, Fava GA: Duration and symptoms of bipolar prodromes. American Journal of Psychiatry 145:1576–1578, 1988.

    PubMed  CAS  Google Scholar 

  54. Berk L, Hallam KT, Colom F, Vieta E, Hasty M, Macneil C, Berk M: Enhancing medication adherence in patients with bipolar disorder. Human Psychopharmacology 25:1–16, 2010.

    Article  PubMed  Google Scholar 

  55. Devulapalli KK, Ignacio RV, Weiden P, Cassidy KA, Williams TD, Safavi R, Blow FC, Sajatovic M: Why do persons with bipolar disorder stop their medication? Psychopharmacology Bulletin 43(3):5–14, 2010.

    PubMed  Google Scholar 

  56. Gonzalez-Pinto A, Reed C, Novick D, Bertsch J, Haro JM: Assessment of medication adherence in a cohort of patients with bipolar disorder. Pharmacopsychiatry 43:263–270, 2010.

    Article  PubMed  CAS  Google Scholar 

  57. Hong J, Reed C, Novick D, Haro JM, Aguado J: Clinical and economic consequences of medication non-adherence in the treatment of patients with a manic/mixed episode of bipolar disorder: Results from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) Study. Psychiatry Research 190:110–114, 2011.

    Article  PubMed  Google Scholar 

  58. Colom F: Achieving remission and recovery in bipolar disorder. Journal of Clinical Psychiatry 71(11):e32, 2010;

    Article  PubMed  Google Scholar 

  59. Mansour HA, Talkowski ME, Wood J, Chowdari KV, McClain L, Pprasad K, Montrose D, Fagioline A, Friedman ES, Aleen MH, Bowden CL, Calabrese J, El-Mallakh RS, Escamilla M, Faraona SV, Fossey MD, Gyulai L, Loftis JM, Hauser P, Ketter TS, Marangell LB, Miklowitz DJ, Nierenberg AA, Patel J, Sachs GS, Sklar P, Smoller JW, Laird N, Keshavan M, Thase ME, Axelson D, Birmaher B, Lewis D, Monk T, Frank E, Kupfer DJ, Devlin B, Nimgaonkar VL: Association study of 21 circadian genes with bipolar I disorder, schizoaffective disorder, and schizophrenia. Bipolar Disorders 11(7):701–710, 2009.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  60. Dallaspezia S, Benedetti F: Chronobiological therapy for mood disorders. Expert Review of Neurotherapeutics 11(7):961–970, 2011.

    Article  PubMed  Google Scholar 

  61. Sylvia LG, Alloy LB, Hafner JA, Gauger MC, Verdon K, Abramson LY: Life events and social rhythms in bipolar spectrum disorders: A prospective study. Behavior Therapy 40(2):131–141, 2009.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Frank E, Swartz HA, Boland E: Interpersonal and social rhythm therapy: An intervention addressing rhythm dysregulation in bipolar disorder. Dialogues in Clinical Neurosciences 9(3):325–332, 2007.

    Google Scholar 

  63. Depp CA, Moore DJ, Patterson TL, Lebowitz BD, Jeste DV: Psychosocial interventions and medication adherence in bipolar disorder. Dialogues in Clinical Neurosciences 10(2):239–250, 2008.

    Google Scholar 

  64. Latalova K, Prasko J, Pastucha P, Grambal A, Kamaradova D, Diveky T, Jelenova D, Mainerova B, Vrbova K: Bipolar affective disorder and dissociation—Comparison with healthy controls. Biomedical Papers 155(2):181–186, 2011.

    Article  Google Scholar 

  65. Mantere O, Suominen K, Valtonen HM, Arvilommi P, Isometsa E: Only half of bipolar I and II patients report prodromal symptoms. Journal of Affective Disorders 111:366–371, 2008.

    Article  PubMed  Google Scholar 

  66. Colom F and Vieta E: Improving the outcome of bipolar disorder through non-pharmacological strategies: The role of psychoeducation. Revista Brasileira de Psiquiatria 26(Suppl III):47–50, 2004.

    Article  PubMed  Google Scholar 

  67. Goossens PJ, Kupka RW, Beentjes TA, van Achterberg T: Recognising prodromes of manic or depressive recurrence in outpatients with bipolar disorder: A cross-sectional study. International Journal of Nursing Studies 47:1201–1207, 2010.

    Article  PubMed  CAS  Google Scholar 

  68. Jackson A, Cavanagh J, Scott J: A systematic review of manic and depressive prodromes. Journal of Affective Disorders 74:209–217, 2003.

    Article  PubMed  Google Scholar 

  69. Lex C, Meyer TD, Marquart B, Thau K: No strong evidence for abnormal levels of dysfunctional attitudes, automatic thoughts, and emotional information-processing biases in remitted bipolar I affective disorder. Psychology Psychotherapy 81(1):1–13, 2008.

    Article  PubMed  Google Scholar 

  70. Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N, et al.: A randomised controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: Outcome of the first year. Archives of General Psychiatry 60:145–152, 2003.

    Article  PubMed  Google Scholar 

  71. Lomax CL, Lam D: Investigation into activation of dysfunctional schemas in euthymic bipolar disorder following positive mood induction. British Journal of Clinical Psychology 50(2):115–126, 2011.

    Article  PubMed  Google Scholar 

  72. Prasko J, Grambal A, Kamaradova D, Jelenova D: Imagery rescripting of traumatic or distressing stories from childhood. Acta Nervosa Superior Rediviva 54(3):113–120, 2012.

    Google Scholar 

  73. Latalova K, Prasko J, Kamaradova D, Sedlackova J, Ociskova M: Comorbidity bipolar disorder and personality disorders. Neuro Endocrinology Letters 34(1):1–8, 2013.

    PubMed  CAS  Google Scholar 

  74. Segrin C: Social Skills Training. In: O′Donohue WT & Fisher JE, (Eds) Cognitive Behavioral Therapy: Applying Empirically Supported Techniques in your Practice, 2nd edn., Wiley, New Jersey 502–509, 2008.

    Google Scholar 

  75. Lam DH, Burbeck R, Wright K, Pilling S. Psychological therapies in bipolar disorder: The effect of illness history on relapse prevention—A systematic review. Bipolar Disorders 11(5):474–482, 2009.

    Article  PubMed  Google Scholar 

  76. Scott J, Colom. Psychosocial treatments for bipolar disorders. Psychiatric Clinics of North America 28(2):371–384, 2005.

    Article  PubMed  Google Scholar 

  77. Soares-Weiser K, Bravo Vergel Y, Beynon S, Dunn G, Barbieri M, Duffy S, et al.: A systematic review and economic model of the clinical effectiveness and cost-effectiveness of interventions for preventing relapse in people with bipolar disorder. Health Technology Assess. 11(39):iii–iv, ix–206, 2007.

  78. Zaretsky AE, Rizvi S, Parikh SV: How well do psychosocial interventions work in bipolar disorder? Canadian Journal of Psychiatry 52(1):14–21, 2007.

    Google Scholar 

  79. McMurrich SL, Johnson SL: The role of depression, shame-proneness, and guilt-proneness in predicting criticism of relatives towards people with bipolar disorder. Behavior Therapy 40(4):315–324, 2009.

    Article  PubMed Central  PubMed  Google Scholar 

  80. Yan LJ, Hammen C, Cohen AN, Daley SE, Henry RM: Expressed emotion versus relationship quality variables in the prediction of recurrence in bipolar patients. Journal of Affective Disorders 83:199–206, 2004.

    Article  PubMed  Google Scholar 

  81. Kim EY, Miklowitz DJ: Expressed emotion as a predictor of outcome among bipolar patients undergoing family therapy. Journal of Affective Disorders 82:343–352, 2004.

    PubMed  Google Scholar 

  82. Barrowclough C, Johnston M, Tarrier N: Attributions, expressed emotion, and patient relapse: An attributional model of relatives’ response to schizophrenic illness. Behavior Therapy 25:67–88, 1994.

    Article  Google Scholar 

  83. Hooley JM, Campbell C: Control and controllability. Beliefs and behaviour in high and low expressed emotion relatives. Psychological Medicine 32:1091–1099, 2002.

    Article  PubMed  Google Scholar 

  84. Eisner LR and Johnson SL: An acceptance-based psychoeducation intervention to reduce expressed emotion in relatives of bipolar patient. Behavior Therapy 39(4):375–385, 2008.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Project IGA MZ CR NT 11047-2010/4.

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Correspondence to Klara Latalova.

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Latalova, K., Prasko, J., Kamaradova, D. et al. Internet Psychoeducation for Bipolar Affective Disorder: Basis for Preparation and First Experiences. Psychiatr Q 85, 241–255 (2014). https://doi.org/10.1007/s11126-013-9286-y

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