Internet-based psychological interventions for bipolar disorder: Review of the present and insights into the future

Hidalgo‐Mazzei, Diego; Mateu, Ainoa; Reinares, María; Matic, Aleksandar; Vieta, Eduard; Colom, Francesc

doi:10.1016/j.jad.2015.08.005

Cited by 90 publications

(54 citation statements)

References 74 publications

(80 reference statements)

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“…While many patients will agree with the value of completing a mood diary, and this strategy has been shown to improve treatment, regular completion can be a burden 65. Online solutions such as mobile apps may improve adherence,66 such as the Self‐Monitoring and Psychoeducation In Bipolar Patients smartphone app (SIMPLE) which provides weekly and daily mood tests, with reminders to take medication or see their doctor 67, 68, 69…”

Section: Foundations Of Managementmentioning

confidence: 99%

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Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Foundations Of Managementmentioning

confidence: 99%

“…In reviews, such internet and mobile health interventions have shown good adherence to validated psychological health principles, good acceptability to patients, ease of access, and ease of use. However, research is mostly limited to pilot studies and the relatively few larger studies have not shown unequivocal benefit 68, 121…”

Section: Foundations Of Managementmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…The growth of Internet-connected technologies opens new pathways to overcome these limitations (Emmelkamp, 2005;Glenn and Monteith, 2014;Hidalgo-Mazzei et al, 2015a), especially given the proven accuracy smartphone-based interventions when it comes to evaluate and potentially alter biological rhythms. In this regard, Murnane et al found that smartphones usage in healthy controls is closely correlated to chronotype, alertness, and sleep (Murnane et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, some of the remaining questions that need to be solved regarding online interventions are the long-term engagement and the sustained effect of these approaches; especially, whether self-monitoring is modifying behaviour per se -as has been shown with other psychosocial interventions-or whether it is just a short-term Hawthorne like artefact (Colom et al, 2009;Depp et al, 2014;Hidalgo-Mazzei et al, 2015a;McCambridge et al, 2014;Torous et al, 2016). For instance, Depp et al evaluated an add-on psychoeducation program using a mobile intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, people diagnosed with BD often use internet to gather information about their condition (Bauer et al, 2016). Hence, there is an increasing number of initiatives aimed to adapt psychotherapeutic treatments to Internet platforms (Hidalgo-Mazzei et al, 2015a). Most of them, attempted to provide psychoeducational contents and programs over web-based platforms, showing high levels of feasibility but mixed results regarding its efficacy (Hidalgo-Mazzei et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Is a SIMPLe smartphone application capable of improving biological rhythms in bipolar disorder?

Hidalgo‐Mazzei

Reinares

Mateu

et al. 2017

Journal of Affective Disorders

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Effects of a Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder on Relapse, Symptom Burden, and Quality of Life

et al. 2023

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ImportanceBipolar disorder–specific psychotherapy combined with pharmacotherapy improves relapse risk, symptom burden, and quality of life, but psychotherapy is not easily accessible.ObjectiveTo determine if a smartphone-based self-management intervention (LiveWell) can assist individuals with bipolar disorder to maintain wellness.Design, Setting, and ParticipantsAn assessor-blind randomized clinical trial enrolled participants from March 20, 2017, to April 25, 2019, with 48-week follow-up ending on April 10, 2020. Participants were randomly assigned to usual care or usual care plus the smartphone intervention stratified by relapse risk based on initial clinical status (low risk: asymptomatic recovery; high risk: continued symptomatic, prodromal, recovering, symptomatic recovery). Participants with bipolar disorder I were recruited from clinics in the Chicago and Minneapolis-Saint Paul areas. Data were analyzed from June 19, 2020, to May 25, 2022.InterventionsThe smartphone-based self-management intervention consisted of an application (app), coach, and website. Over 16 weeks, participants had a coach visit followed by 6 phone calls, and they completed daily and weekly app check-ins. The app provided adaptive feedback and information for developing a personalized wellness plan, the coach provided support, and the website provided summary data and alerts.Main Outcomes and MeasuresThe primary outcome was time to relapse. Secondary outcomes were percentage-time symptomatic, symptom severity, and quality of life.ResultsOf the 205 randomized participants (mean [SD] age, 42 [12] years; 125 female individuals [61%]; 5 Asian [2%], 21 Black [10%], 13 Hispanic or Latino [6%], 7 multiracial [3%], 170 White [83%], 2 unknown race [1%]), 81 (40%) were randomly assigned to usual care, and 124 (60%) were randomly assigned to usual care plus the smartphone intervention. This clinical trial did not detect a reduction in relapse risk for the smartphone intervention (hazard ratio [HR], 0.65; 95% CI, 0.39-1.09; log-rank P = .08). However, decreased relapse was observed for low-risk individuals (HR, 0.32; 95% CI, 0.12-0.88; log-rank P = .02) but not high-risk individuals (HR, 0.86; 95% CI, 0.47-1.57; log-rank P = .62). Reduced manic symptom severity was observed for low-risk individuals (mean [SE] difference, −1.4 [0.4]; P = .001) but not for high-risk individuals (mean [SE] difference, 0 [0.3]; P = .95). The smartphone-based self-management intervention decreased depressive symptom severity (mean [SE] difference, −0.80 [0.34]; P = .02) and improved relational quality of life (mean [SE] difference, 1.03 [0.45]; P = .02) but did not decrease percentage-time symptomatic (mean [SE] difference, −5.6 [4.3]; P = .20).Conclusions and RelevanceThis randomized clinical trial of a smartphone-based self-management intervention did not detect a significant improvement in the primary outcome of time to relapse. However, a significant decrease in relapse risk was observed for individuals in asymptomatic recovery. In addition, the intervention decreased depressive symptom severity and improved relational quality of life. These findings warrant further work to optimize the smartphone intervention and confirm that the intervention decreases relapse risk for individuals in asymptomatic recovery.Trial RegistrationClinicalTrials.gov Identifier: NCT03088462

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Internet-based psychological interventions for bipolar disorder: Review of the present and insights into the future

Cited by 90 publications

References 74 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Is a SIMPLe smartphone application capable of improving biological rhythms in bipolar disorder?

Effects of a Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder on Relapse, Symptom Burden, and Quality of Life

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