There is a critical need for psychosocial interventions to help alleviate the stress and stress-related health and mental health problems experienced by family members caring for a relative with bipolar disorder, a recurrent and disabling mental disorder affecting 1% of the population. The proposed research aims to develop and test the first intervention to directly target the self-care deficits and compromised mental and physical health of caregivers of patients with bipolar illness, as well as the high perceived stress, and ineffective coping that help promote them. A Stage 1-3 treatment development study will create, manualize and pilot test a health-promoting intervention (HPI) that combines psychoeducation about caregiving stress and associated health and mental health risks with CBT techniques to identify and modify barriers to caregiver self-care. In Stages 1-2 a team of 3 clinical investigators from 3 research sites will develop the manual, adherence/competence and outcome measures, and run 6 feasibility cases. In Stage 3, 46 primary caregivers (PC's) of patients with SCID-diagnosed Bipolar I or II Disorder will be randomized to receive either the 15-session HPI delivered by the clinical investigators, or up to 4 sessions of a self-administered, videotaped psychoeducational control condition (CC). The efficacy of HPI vs. CC in reducing depression and poor physical health (primary outcomes) and caregiver burden, anxiety, self-care/prevention deficits, ineffective coping, and costs to caregivers (secondary outcomes) will be evaluated using multivariate regression and/or random effects models, in an intent-to-treat design. Training materials will be developed for a larger-scale study. ? ?
|Perlick, D A; Gonzalez, J; Michael, L et al. (2012) Rumination, gender, and depressive symptoms associated with caregiving strain in bipolar disorder. Acta Psychiatr Scand 126:356-62|
|Perlick, Deborah A; Miklowitz, David J; Lopez, Norma et al. (2010) Family-focused treatment for caregivers of patients with bipolar disorder. Bipolar Disord 12:627-37|