Although bipolar disorder is the Axis I disorder associated with the highest risk of having a substance use disorder, little is known about the treatment of patients who are dually diagnosed with these two disorders. In particular, there have been no studies of behavioral treatment of this high-risk, poor-outcome patient population. The primary aim of this Phase one project is to develop a 12-session relapse prevention group therapy manual for patients with bipolar disorder and substance use disorder. This treatment manual will focus on practical themes that are relevant for both disorders; there will be an emphasis on educating patients about their two disorders, fostering manual support, discussing ambivalence about treatment, working on interpersonal relationships, and helping patients to accept their illnesses. The manual will combine therapist information and instructions with patient worksheets, handouts, and homework assignments. To accomplish this aim, the investigators will: a) Obtain outside review of the manual at two different stages of its development from experts in the treatment of bipolar disorder and substance use disorders. b) Develop and utilize a therapist """"""""self-test"""""""" to help therapists identify their competence and readiness to use the material. c) obtain monthly assessment of subjects' substance use, psychiatric symptoms, treatment utilization, and medication compliance during treatment and for 3 months afterwards. These assessments along with data from a group of subjects receiving """"""""treatment as usual,"""""""" will help us to revise the manual. d) Establish the acceptability of the manualized treatment intervention by obtaining session-by-session and overall patient and therapist satisfaction ratings. e) Develop and refine therapist competence and adherence measures for the treatment intervention, and develop instructions for their use by raters. f) Revise the manual in an ongoing way, based on information from elements a-e above, while conducting the group intervention twice in the pre-pilot phase, and twice again during a pilot study. The investigators will then conduct a pilot study in which outcomes among subjects receiving the treatment intervention will be compared with outcomes of subjects who receive """"""""treatment as usual.""""""""

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA009400-02
Application #
2122595
Study Section
Special Emphasis Panel (SRCD (52))
Project Start
1994-09-30
Project End
1997-07-31
Budget Start
1995-09-01
Budget End
1996-07-31
Support Year
2
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Mc Lean Hospital (Belmont, MA)
Department
Type
DUNS #
City
Belmont
State
MA
Country
United States
Zip Code
02478
Kolodziej, Monika E; Griffin, Margaret L; Bender, Rachel et al. (2008) Assessment of depressive symptom severity among patients with co-occurring bipolar disorder and substance dependence. J Affect Disord 106:83-9
Weiss, Roger D; Griffin, Margaret L; Kolodziej, Monika E et al. (2007) A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence. Am J Psychiatry 164:100-7
Trucco, Elisa M; Connery, Hilary Smith; Griffin, Margaret L et al. (2007) The relationship of self-esteem and self-efficacy to treatment outcomes of alcohol-dependent men and women. Am J Addict 16:85-92
Kolodziej, Monika E; Griffin, Margaret L; Najavits, Lisa M et al. (2005) Anxiety disorders among patients with co-occurring bipolar and substance use disorders. Drug Alcohol Depend 80:251-7
Weiss, Roger D; Kolodziej, Monika; Griffin, Margaret L et al. (2004) Substance use and perceived symptom improvement among patients with bipolar disorder and substance dependence. J Affect Disord 79:279-83
Weiss, Roger D (2004) Treating patients with bipolar disorder and substance dependence: lessons learned. J Subst Abuse Treat 27:307-12
Greenfield, Shelly F; Sugarman, Dawn E; Muenz, Larry R et al. (2003) The relationship between educational attainment and relapse among alcohol-dependent men and women: a prospective study. Alcohol Clin Exp Res 27:1278-85
Greenfield, Shelly F; Hennessy, Grace; Sugarman, Dawn E et al. (2003) What general psychiatrists ask addiction psychiatrists: a review of 381 substance abuse consultations in a psychiatric hospital. Am J Addict 12:18-28
Greenfield, Shelly F (2002) Women and alcohol use disorders. Harv Rev Psychiatry 10:76-85
Greenfield, Shelly F; Kolodziej, Monika E; Sugarman, Dawn E et al. (2002) History of abuse and drinking outcomes following inpatient alcohol treatment: a prospective study. Drug Alcohol Depend 67:227-34

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