Can a targeted psychological intervention be effective for young people following a first manic episode? Results from an 18‐month pilot study

Macneil, Craig A.; Hasty, Melissa K.; Cotton, Sue; Berk, Michael; Hallam, K; Kader, Linda; McGorry, Patrick D.; Conus, Philippe

doi:10.1111/j.1751-7893.2011.00336.x

Cited by 37 publications

(43 citation statements)

References 54 publications

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“…Psychoeducation and cognitive-behavioural therapy (CBT) have been shown to be effective in BPD particularly if undertaken early in the course of the illness (Scott et al 2006;Colom, 2008;Macneil et al 2012) and in young people (Pavuluri et al 2004). Adding CBT to medication is associated with fewer relapses and cost savings of £1400 per patient (Lam et al 2008).…”

Section: Psychological Interventionsmentioning

confidence: 98%

Intervening early in bipolar disorder in young people: a review of the clinical staging model

Power

2015

Ir. j. psychol. Med.

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Bipolar disorder (BPD) essentially has its onset during adolescence and early adulthood. It has the capacity to be highly disruptive, dislocating individuals from their normal developmental trajectory and potentially causing significant long-term co-morbidity and chronicity. At a societal level the burden created is greater than schizophrenia. This is not helped by the very substantial delays in its diagnosis and appropriate treatment. Thus, there is a clear rationale for intervening earlier and at a younger age. However, the field of early intervention in BPD is in its infancy. One approach that conceptually provides a basis for early intervention is the Clinical Staging Model (used widely in general medicine). This article outlines how this model helps in an understanding of the emerging stages of BPD. It also summarises the interventions that might be appropriately introduced if a person progresses from an early to a late stage of the illness. Early intervention has a well-established record in psychotic disorders. If it can be realised for BPDs, then it may hold out hope of better outcomes for the next generation of young people at risk.

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Section: Psychological Interventionsmentioning

confidence: 98%

Intervening early in bipolar disorder in young people: a review of the clinical staging model

Power

2015

Ir. j. psychol. Med.

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“…39,40 For example, IPSRT showed a strong trend in improving the sleep profile of young adults, but showed no significant benefits for mood disorders (eg, three patients met depression criteria at baseline and four patients met depression criteria at follow-up). 37 CBT showed only weak effects on manic symptoms.…”

Section: Overview Of Outcomesmentioning

confidence: 99%

“…Five studies have been reported in individuals with first episode bipolar disorder: four case series 39,41–43 and one clinical controlled trial (CCT) 40 . In two studies, 39,41 CBT was provided in adult mental health settings, whereas in the other three studies, 40,42,43 CBT was given as an early intervention in psychosis settings.…”

Section: Overview Of Outcomesmentioning

confidence: 99%

“…In two studies, 39,41 CBT was provided in adult mental health settings, whereas in the other three studies, 40,42,43 CBT was given as an early intervention in psychosis settings.…”

Section: Overview Of Outcomesmentioning

confidence: 99%

“…One CCT 40 offered therapy to 40 individuals with first-episode mania who were concurrently enrolled in a large open-label medication trial. 20 participants identified as controls (who received fewer than four of eight therapy modules) were matched on key demographic characteristics with participants who completed four or more modules (intervention group).…”

Section: Overview Of Outcomesmentioning

confidence: 99%

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An evidence map of psychosocial interventions for the earliest stages of bipolar disorder

Vallarino

Henry

Étain

et al. 2015

The Lancet Psychiatry

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Depression, schizophrenia, and bipolar disorder are three of the four most burdensome problems in people aged under 25 years. In psychosis and depression, psychological interventions are effective, low-risk, and high-benefit approaches for patients at high risk of first-episode or early-onset disorders. We review the use of psychological interventions for early-stage bipolar disorder in patients aged 15–25 years. Because previous systematic reviews had struggled to identify information about this emerging sphere of research, we used evidence mapping to help us identify the extent, distribution, and methodological quality of evidence because the gold standard approaches were only slightly informative or appropriate. This strategy identified 29 studies in three target groups: ten studies in populations at high risk for bipolar disorder, five studies in patients with a first episode, and 14 studies in patients with early-onset bipolar disorder. Of the 20 completed studies, eight studies were randomised trials, but only two had sample sizes of more than 100 individuals. The main interventions used were family, cognitive behavioural, and interpersonal therapies. Only behavioural family therapies were tested across all of our three target groups. Although the available interventions were well adapted to the level of maturity and social environment of young people, few interventions target specific developmental psychological or physiological processes (eg, ruminative response style or delayed sleep phase), or offer detailed strategies for the management of substance use or physical health.

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The Early Burden of Disability in Individuals With Mood and Other Common Mental Disorders in Ontario, Canada

et al. 2020

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Key Points Question What is the risk of receiving disability services after a first (ie, incident) diagnosis of mood or common mental disorder? Findings This cohort study included 1 902 792 individuals and found that an incident diagnosis of mood disorder or common mental disorder was associated with high rates of receiving disability services, indicating that mood and common mental disorders are associated with an elevated risk of disability early in the course of illness. Meaning The findings of this study suggest that the receipt of disability services occurs early in the trajectory of mood and common mental disorders, indicating that the development of preventative and early intervention strategies focused on functional impairment should be priorities.

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Can a targeted psychological intervention be effective for young people following a first manic episode? Results from an 18‐month pilot study

Abstract: This study suggests that a manualized psychological intervention targeted to a first-episode population can be effective in reducing depression and overall symptom severity, and can improve functional outcome following a first episode of psychotic mania.

Cited by 37 publications

References 54 publications

Intervening early in bipolar disorder in young people: a review of the clinical staging model

Intervening early in bipolar disorder in young people: a review of the clinical staging model

An evidence map of psychosocial interventions for the earliest stages of bipolar disorder

The Early Burden of Disability in Individuals With Mood and Other Common Mental Disorders in Ontario, Canada

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