Evaluation of an Online Relapse Prevention Program for Bipolar Disorder
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Bipolar disorder is a chronic relapsing remitting illness affecting 1–2% of the general adult population. Awareness of the limitations of pharmacological treatment for this disorder has encouraged the development of psychological treatments and a large body of evidence now exists demonstrating the effectiveness of several types of psychosocial interventions in the treatment and prevention of relapse for bipolar disorder. Unfortunately, it is difficult for many individuals with bipolar disorder to access such programs due to financial constraints and restricted roll-out. One solution to this difficulty is to use Internet-based delivery of targeted psychoeducation, cognitive behavior management and online medication monitoring to improve relapse prevention for those with bipolar disorder.
The focus of this article is to discuss the aims and methodology of this unique, collaborative randomized control trial that evaluates the effectiveness of an Internet-based disease management program (termed Recovery Road [RR]). The RR program incorporates both symptom monitoring with feedback, and targeted psychosocial treatment for adults with bipolar disorder delivered over a 12-month period. The overall aim was to determine whether this web-based adjunctive relapse prevention program can improve mental health outcomes. Upon successful enrolment, participants were automatically randomized into either the intervention (RR) or control group. The control group received some relevant information but did not include program components considered to be active parts of the experimental intervention.
This article also describes a recruitment, enrolment and randomization process that maximizes the potential of the Internet for research and data collection purposes. At the time of writing full results were not yet available and, thus, were not reported in this article. Interim outcomes indicate that the online enrolment has been successful and participants are making full use of all online features of the active program included by the support facility. The difficulties with maintaining individuals on the control program are described and samples of typical anecdotal comments provided by participants to the research group via the support facility are presented.
KeywordsBipolar Disorder Mental Health Service Cognitive Behavioral Therapy Mental Health Difficulty Sheehan Disability Scale
The authors wish to thank the following individuals: Gavin Pinto, IT Architect and designer of web-based platform, Sentiens Pty Ltd, Perth, Western Australia; Dr Dennis Tannenbaum, Consulting Psychiatrist and Executive Chair, Sentiens Pty Ltd, Perth, Western Australia; Professor Gordon Parker, Executive Director, Black Dog Institute, Sydney, New South Wales; and Sue Grdovic, Project Manager Community and Consumer Programs, Black Dog Institute, Sydney, New South Wales, Australia.
Dr Barnes has received a scholarship grant from the University of New South Wales. Professors Mitchell and Wilhelm have received a NH&MRC program grant 230802 and NSW Centre for Mental Health Infrastructure grant. Dr Barnes was a past employee of Sentiens Pty Ltd (formally Infrapsych). Dr Harvey is employed as the Research and Development Manager for Sentiens Pty Ltd. Mr Smith is employed as a research officer at Sentiens Pty Ltd. Professors Mitchell and Wlihelm have no conflicts of interest relevant to the content of this article.
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