Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment

Stange, Jonathan P., Sylvia, Louisa G, da Silva Magalhães, Pedro Vieira, Miklowitz, David J., Otto, Michael W., Frank, Ellen, Yim, Christine, Berk, Michael, Dougherty, Darin D., Nierenberg, Andrew A. and Deckersbach, Thilo 2016, Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment, British journal of psychiatry, vol. 208, no. 4, pp. 352-358, doi: 10.1192/bjp.bp.114.162073.

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Title Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment
Author(s) Stange, Jonathan P.
Sylvia, Louisa G
da Silva Magalhães, Pedro Vieira
Miklowitz, David J.
Otto, Michael W.
Frank, Ellen
Yim, Christine
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Dougherty, Darin D.
Nierenberg, Andrew A.
Deckersbach, Thilo
Journal name British journal of psychiatry
Volume number 208
Issue number 4
Start page 352
End page 358
Total pages 9
Publisher Royal College of Psychiatrists
Place of publication London, Eng.
Publication date 2016-04
ISSN 1472-1465
Summary BACKGROUND: Little is known about predictors of recovery from bipolar depression. AIMS: We investigated affective instability (a pattern of frequent and large mood shifts over time) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychosocial treatment for acute depression. METHOD: A total of 252 out-patients with DSM-IV bipolar I or II disorder and who were depressed enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and were randomised to one of three types of intensive psychotherapy for depression (n = 141) or a brief psychoeducational intervention (n = 111). All analyses were by intention-to-treat. RESULTS: Degree of instability of symptoms of depression and mania predicted a lower likelihood of recovery and longer time until recovery, independent of the concurrent effects of symptom severity. Affective instability did not moderate the effects of psychosocial treatment on recovery from depression. CONCLUSIONS: Affective instability may be a clinically relevant characteristic that influences the course of bipolar depression.
Language eng
DOI 10.1192/bjp.bp.114.162073
Field of Research 110319 Psychiatry (incl Psychotherapy)
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Royal College of Psychiatrists
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082047

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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