The 6-month attrition rate of the programme was high. Positive outcomes regarding satisfaction were found predominantly among completers. The optimal dosage and retention of IBP mental health programmes remain challenging issues that need further research.
BackgroundNew technologies have recently been used for monitoring signs and symptoms of mental health illnesses and particularly have been tested to improve the outcomes in bipolar disorders. Web-based psychoeducational programs for bipolar disorders have also been implemented, yet to our knowledge, none of them have integrated both approaches in one single intervention. The aim of this project is to develop and validate a smartphone application to monitor symptoms and signs and empower the self-management of bipolar disorder, offering customized embedded psychoeducation contents, in order to identify early symptoms and prevent relapses and hospitalizations.Methods/designThe project will be carried out in three complementary phases, which will include a feasibility study (first phase), a qualitative study (second phase) and a randomized controlled trial (third phase) comparing the smartphone application (SIMPLe) on top of treatment as usual with treatment as usual alone. During the first phase, feasibility and satisfaction will be assessed with the application usage log data and with an electronic survey. Focus groups will be conducted and technical improvements will be incorporated at the second phase. Finally, at the third phase, survival analysis with multivariate data analysis will be performed and relationships between socio-demographic, clinical variables and assessments scores with relapses in each group will be explored.DiscussionThis project could result in a highly available, user-friendly and not costly monitoring and psychoeducational intervention that could improve the outcome of people suffering from bipolar disorders in a practical and secure way.Trial registrationClinical Trials.gov: NCT02258711 (October 2014).
ObjectiveCyberbullying involvement carries mental health risks for adolescents, although post-traumatic stress (PTS) symptoms have not received strong attention in the UK. This study aimed to assess the overlap between cyber and traditional (ie, face-to-face) bullying, and the relationship to PTS symptoms in UK adolescents.DesignA cross-sectional survey.SettingFour secondary schools in London,UK.Participants2218 secondary school students (11–19 years).Main outcome measuresThe Olweus Bully/Victim Questionnaire and the Children Revised Impact of Events Scale.ResultsThere was a significant overlap between traditional bullying and cyberbullying. However, cyberperpetrators were less frequently involved in concurrent traditional bullying. Of 2218 pupils, 46% reported a history of any kind of bullying (34% were involved in traditional bullying and 25% in cyberbullying), 17% as victims, 12% as perpetrators, and 4% as both victims and perpetrators. A significant proportion of those who were cybervictims (n=280; 35%), cyberbullies (n=178; 29.2%) or cyberbully-victims (n=77; 28.6%) presented clinically significant PTS symptoms. Cybervictims (both cyber-only and cyberbully-victims) suffered more intrusion (p=0.003; p<0.001) and avoidance (p=0.005; p<0.001) than cyberbullies. However, cyberbullies still suffered more PTS symptoms than the non-involved (intrusion: z=−3.67, p=0.001; avoidance: z=−3.57, p=0.002). Post-traumatic stress symptoms were significantly predicted (R2=13.6) by cyber and traditional victimisation.ConclusionsCyberbullying, as victim only or as a victim-perpetrator, seems to be associated with multiple types of PTS symptoms. Cyber and traditional victimisation significantly predicted intrusion and avoidance. Paediatricians, general practitioners and mental health professionals need to be aware of possible PTS symptoms in young people involved in cyberbullying. Screening and early cost-effective treatments could be implemented.
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