Bipolar I disorder (BP-I) is a chronic disorder with recurrent depressed and/or manic mood episodes. Recurrent episodes of depression constitute the most functionally debilitating aspect for individuals with bipolar I disorder (BP-I). Mood stabilizers are the first line of treatment for patients with bipolar disorder in a depressive episode. However, these treatments fail to bring sustained remission for most patients. For example, despite the use of mood-stabilizing agents, longitudinal data suggests relapse rates as high as 40% in one year, 60% in two years, and 73% in five or more years. Thus, despite advances in the pharmacologic treatment of bipolar disorder, it has become clear that additional strategies are needed to provide patients with longer-term mood stability. Cognitive-Behavior Therapy (CBT) has been shown to enhance medication compliance as well as to reduce rates of relapses in patients with bipolar disorder. Although there is substantial evidence that CBT is an effective treatment for depressive episodes in major depression, surprisingly few studies have investigated the efficacy of CBT for depressive episodes in bipolar disorder. In addition, existing CBT studies suffer from several short-comings including small sample sizes, the lack of control groups and active control treatments. The present application addresses this gap by proposing to conduct a randomized controlled treatment trial of CBT compared to supportive psychotherapy (the most widely available type of psychotherapy in the community) in depressed patients with bipolar I disorder and to investigate moderators and mediators of treatment response to CBT.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH074895-04
Application #
7741195
Study Section
Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
Program Officer
Hill, Lauren D
Project Start
2006-12-07
Project End
2011-11-30
Budget Start
2009-12-01
Budget End
2010-11-30
Support Year
4
Fiscal Year
2010
Total Cost
$184,248
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Stange, Jonathan P; Kleiman, Evan M; Sylvia, Louisa G et al. (2016) SPECIFIC MOOD SYMPTOMS CONFER RISK FOR SUBSEQUENT SUICIDAL IDEATION IN BIPOLAR DISORDER WITH AND WITHOUT SUICIDE ATTEMPT HISTORY: MULTI-WAVE DATA FROM STEP-BD. Depress Anxiety 33:464-72
Stange, Jonathan P; Sylvia, Louisa G; da Silva Magalhães, Pedro Vieira et al. (2016) Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment. Br J Psychiatry 208:352-8
Gold, Alexandra K; Montana, Rebecca E; Sylvia, Louisa G et al. (2016) Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders. Curr Behav Neurosci Rep 3:340-349
Peters, Amy T; Peckham, Andrew D; Stange, Jonathan P et al. (2014) Correlates of real world executive dysfunction in bipolar I disorder. J Psychiatr Res 53:87-93
Deckersbach, Thilo; Peters, Amy T; Sylvia, Louisa et al. (2014) Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD. Am J Psychiatry 171:178-86
Stange, Jonathan P; Sylvia, Louisa G; da Silva Magalhães, Pedro Vieira et al. (2013) Extreme attributions predict the course of bipolar depression: results from the STEP-BD randomized controlled trial of psychosocial treatment. J Clin Psychiatry 74:249-55
Stange, Jonathan P; Sylvia, Louisa G; Magalhães, Pedro Vieira da Silva et al. (2013) Extreme attributions predict transition from depression to mania or hypomania in bipolar disorder. J Psychiatr Res 47:1329-36
Deckersbach, Thilo; Hölzel, Britta K; Eisner, Lori R et al. (2012) Mindfulness-based cognitive therapy for nonremitted patients with bipolar disorder. CNS Neurosci Ther 18:133-41
Ellard, Kristen K; Deckersbach, Thilo; Sylvia, Louisa G et al. (2012) Transdiagnostic treatment of bipolar disorder and comorbid anxiety with the unified protocol: a clinical replication series. Behav Modif 36:482-508
Stange, Jonathan P; Eisner, Lori R; Hölzel, Britta K et al. (2011) Mindfulness-based cognitive therapy for bipolar disorder: effects on cognitive functioning. J Psychiatr Pract 17:410-9

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