Medical burden, body mass index and the outcome of psychosocial interventions for bipolar depression

Peters, Amy T., Shesler, Leah W., Sylvia, Louisa, Da Silva Magalhaes, Pedro Vieira, Miklowitz, David J., Otto, Michael W., Frank, Ellen, Berk, Michael, Dougherty, Darin D., Nierenberg, Andrew A. and Deckersbach, Thilo 2016, Medical burden, body mass index and the outcome of psychosocial interventions for bipolar depression, Australian and New Zealand journal of psychiatry, vol. 50, no. 7, pp. 667-677, doi: 10.1177/0004867415616694.

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Title Medical burden, body mass index and the outcome of psychosocial interventions for bipolar depression
Author(s) Peters, Amy T.
Shesler, Leah W.
Sylvia, Louisa
Da Silva Magalhaes, Pedro Vieira
Miklowitz, David J.
Otto, Michael W.
Frank, Ellen
Berk, MichaelORCID iD for Berk, Michael
Dougherty, Darin D.
Nierenberg, Andrew A.
Deckersbach, Thilo
Journal name Australian and New Zealand journal of psychiatry
Volume number 50
Issue number 7
Start page 667
End page 677
Total pages 11
Publisher Sage
Place of publication London, Eng.
Publication date 2016-07
ISSN 0004-8674
Keyword(s) bipolar disorder
medical burden
body mass index
Summary Objective: Individuals with bipolar disorder experience a disproportionately high incidence of medical co-morbidity and obesity. These health-related problems are a barrier to recovery from mood episodes and have been linked with unfavorable responses to pharmacological treatment. However, little is known about whether and how these characteristics affect responses to adjunctive psychotherapy. Method: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy plus pharmacotherapy with collaborative care (a three-session psycho-educational intervention) plus pharmacotherapy. We conducted a post-hoc analysis to evaluate whether medical burden and body mass index predicted and/or moderated the likelihood of recovery and time until recovery from a depressive episode among patients in the two treatments. Results: Participants who had medical co-morbidity and body mass index data constituted 199 of the 293 patients in the original Systematic Treatment Enhancement Program for Bipolar Disorder trial. Higher medical burden predicted a lower likelihood of recovery from depression in both treatment conditions (odds ratio = 0.89), but did not moderate responses to intensive psychotherapy vs collaborative care. Intensive psychotherapy yielded superior recovery rates for individuals of normal body mass index (odds ratio= 2.39) compared with collaborative care, but not among individuals who were overweight or obese. Conclusion: Medical co-morbidity and body weight impacts symptom improvement and attention to this co-morbidity may inform the development of more personalized treatments for bipolar disorder.
Language eng
DOI 10.1177/0004867415616694
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Royal Australian and New Zealand College of Psychiatrists
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