Page 34 - e-book CPG - Bipolar Disorder
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CLINICAL PRACTICE GUIDELINES MANAGEMENT OF BIPOLAR DISORDER (2ND ED.)
Overall, the quality of studies was low, other than for studies examining psychoeducation vs
placebo in which the quality was moderate based on GRADE.
Overall, the quality of studies was low, other than for studies examining psychoeducation vs
Overall, the quality of studies was low, other than for studies examining psychoeducation vs
placebo in which the quality was moderate based on GRADE.
placebo in which the quality was moderate based on GRADE.
However, in a large network meta-analysis on adjunctive psychotherapy vs TAU on adults with
However, in a large network meta-analysis on adjunctive psychotherapy vs TAU on adults with
However, in a large network meta-analysis on adjunctive psychotherapy vs TAU on adults with
BD, evidence showed that CBT (individual and group) was more effective compared with TAU
at 12 months follow-up in reducing depressive symptoms (SMD= -0.32, 95% CI -0.64 to -0.01).
BD, evidence showed that CBT (individual and group) was more effective compared with TAU
BD, evidence showed that CBT (individual and group) was more effective compared with TAU
at 12 months follow-up in reducing depressive symptoms (SMD= -0.32, 95% CI -0.64 to -0.01).
78, level I
The overall quality of studies was mixed based on Cochrane RoB assessment.
at 12 months follow-up in reducing depressive symptoms (SMD= -0.32, 95% CI -0.64 to -0.01).
The overall quality of studies was mixed based on Cochrane RoB assessment.
The overall quality of studies was mixed based on Cochrane RoB assessment. 78, level I
78, level I
Another meta-analysis of three RCTs on adults with BD explored the effectiveness of group
Another meta-analysis of three RCTs on adults with BD explored the effectiveness of group
Another meta-analysis of three RCTs on adults with BD explored the effectiveness of group
CBT vs TAU/individualised therapy in reducing depressive and manic symptoms. The study
revealed that group CBT was not effective in reducing depressive or manic symptoms. The
CBT vs TAU/individualised therapy in reducing depressive and manic symptoms. The study
CBT vs TAU/individualised therapy in reducing depressive and manic symptoms. The study
revealed that group CBT was not effective in reducing depressive or manic symptoms. The
79, level I
overall RoB 2 of the primary studies was of some concern.
revealed that group CBT was not effective in reducing depressive or manic symptoms. The
In a meta-analysis of five RCTs on adults with BD using IPSRT as an adjunct treatment vs
overall RoB 2 of the primary studies was of some concern. 79, level I
overall RoB 2 of the primary studies was of some concern.
79, level I
In a meta-analysis of five RCTs on adults with BD using IPSRT as an adjunct treatment vs
80, level I
control, evidence found that IPSRT was more effective in improving:
In a meta-analysis of five RCTs on adults with BD using IPSRT as an adjunct treatment vs
control, evidence found that IPSRT was more effective in improving:tion (LIFE)] (Hedge’s g=
control, evidence found that IPSRT was more effective in improving: 80, level I
depressive symptoms [Longitudinal Interval Follow-up Evalua 80, level I
-0.23, 95% CI -0.62 to 0.16)
depressive symptoms [Longitudinal Interval Follow-up Evaluation (LIFE)] (Hedge’s g=
depressive symptoms [Longitudinal Interval Follow-up Evaluation (LIFE)] (Hedge’s g=
-0.23, 95% CI -0.62 to 0.16)
recovery rate of depression (MADRS) (Hedge’s g= -0.29, 95% CI -0.55 to -0.03)
-0.23, 95% CI -0.62 to 0.16)
stability of social rhythm [Social Rhythm Metrics (SRM)] (Hedge’s g= -0.69, )
recovery rate of depression (MADRS) (Hedge’s g= -0.29, 95% CI -0.55 to -0.03) 95% CI
recovery rate of depression (MADRS) (Hedge’s g= -0.29, 95% CI -0.55 to -0.03
-1.33 to -0.04)
stability of social rhythm [Social Rhythm Metrics (SRM)] (Hedge’s g= -0.69, 95% CI
stability of social rhythm [Social Rhythm Metrics (SRM)] (Hedge’s g= -0.69, 95% CI
occupational,
-1.33 to -0.04)
-1.33 to -0.04) social and impaired functioning score (UCLA Social Attainment Scale,
Social Adjustment Scale (SAS) and Longitudinal Interval Follow-Up Evaluation-Range
occupational, social and impaired functioning score (UCLA Social Attainment Scale,
occupational, social and impaired functioning score (UCLA Social Attainment Scale,
of Impaired Functioning Tool (LIFE-RIFT) respectively] (Hedge’s g= -0.34, 95% CI
Social Adjustment Scale (SAS) and Longitudinal Interval Follow-Up Evaluation-Range
Social Adjustment Scale (SAS) and Longitudinal Interval Follow-Up Evaluation-Range
of Impaired
-0.55 to -0.14) Functioning Tool (LIFE-RIFT) respectively] (Hedge’s g= -0.34, 95% CI
of Impaired Functioning Tool (LIFE-RIFT) respectively] (Hedge’s g= -0.34, 95% CI
The overall quality of the primary papers was mixed based on RoB.
-0.55 to -0.14)
-0.55 to -0.14)
The overall quality of the primary papers was mixed based on RoB.
The overall quality of the primary papers was mixed based on RoB.
The above findings were supported by a recent RCT on adults with BD receiving IPSRT as an
adjunct treatment. It showed that compared with control, IPSRT reported a significant
The above findings were supported by a recent RCT on adults with BD receiving IPSRT as an
The above findings were supported by a recent RCT on adults with BD receiving IPSRT as an
81, level I
improvement in:
adjunct treatment. It showed that compared with control, IPSRT reported a significant
adjunct treatment. It showed that compared with control, IPSRT reported a significant
improvement in:
81, level I
improvement in: 81, level I s [Hamilton Rating Scale for Anxiety (HAM-A)]
anxiety symptom
anxiety symptoms [Hamilton Rating Scale for Anxiety (HAM-A)]
manic symptoms [Mania Rating Scale (MRS)]
anxiety symptoms [Hamilton Rating Scale for Anxiety (HAM-A)]
depressive symptoms [Inventory of Depressive Symptomatology Self-Report (IDS-SR)
manic symptoms [Mania Rating Scale (MRS)]
manic symptoms [Mania Rating Scale (MRS)]
depressive symptoms [Inventory of Depressive Symptomatology Self-Report (IDS-SR)
global functioning [Global Assessment of Functioning (GAF)]
depressive symptoms [Inventory of Depressive Symptomatology Self-Report (IDS-SR)
global functioning [Global Assessment of Functioning (GAF)] erm Treatment Response
response to mood stabilisers [Retrospective Criteria of Long-t
global functioning [Global Assessment of Functioning (GAF)]
response to mood stabilisers [Retrospective Criteria of Long-term Treatment Response
response to mood stabilisers [Retr
in Bipolar Disorder (ALDA Scale)] ospective Criteria of Long-term Treatment Response
in Bipolar Disorder (ALDA Scale)]
psychological functioning [Affective Morbidity Index (AMI)]
in Bipolar Disorder (ALDA Scale)]
psychological functioning [Affective Morbidity Index (AMI)]
psychological functioning [Affective Morbidity Index (AMI)]
A meta-analysis on adults with BD compared MBCT vs TAU/waitlist and found NS difference
A meta-analysis on adults with BD compared MBCT vs TAU/waitlist and found NS difference
in improvement of depressive and anxiety symptoms. The three related RCTs had mixed
A meta-analysis on adults with BD compared MBCT vs TAU/waitlist and found NS difference
in improvement of depressive and anxiety symptoms. The three related RCTs had mixed
RoB.
82, level I
in improvement of depressive and anxiety symptoms. The three related RCTs had mixed
82, level I
RoB. 82, level I
RoB.
The evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) in
managing BD is limited. A single-group clinical trial of adults with BD receiving group ACT as
The evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) in
The evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) in
an adjunct treatment showed significant change in the following outcomes compared with
managing BD is limited. A single-group clinical trial of adults with BD receiving group ACT as
managing BD is limited. A single-group clinical trial of adults with BD receiving group ACT as
83, level II-3
an adjunct treatment showed significant change in the following outcomes compared with
baseline:
an adjunct treatment showed significant change in the following outcomes compared with
83, level II-3
decrease in
baseline: 83, level II-3 anxiety symptoms [Beck Anxiety Inventory (BAI)]
baseline:
decrease in depressive symptoms [Beck Depression Inventory (BDI-II)]
decrease in anxiety symptoms [Beck Anxiety Inventory (BAI)]
decrease in anxiety symptoms [Beck Anxiety Inventory (BAI)]
increase in QoL [The Quality of Life Inventory (QOLI)]
decrease in depressive symptoms [Beck Depression Inventory (BDI-II)]
decrease in depressive symptoms [Beck Depression Inventory (BDI-II)]
increase in QoL [The Quality of Life Inventory (QOLI)]
increase in psychological flexibility [The Acceptance and Action Questionnaire (AAQ-2)]
increase in QoL [The Quality of Life Inventory (QOLI)]
increase in psychological flexibility [The Acceptance and Action Questionnaire (AAQ-2)]
increase in psychological flexibility [The Acceptance and Action Questionnaire (AAQ-2)]
In a narrative review on the management of BD based on well-established guidelines,
In a narrative review on the management of BD based on well-established guidelines,
In a narrative review on the management of BD based on well-established guidelines,
adjunctive psychosocial interventions and psychotherapies that had been recommended in
In the
84, level III
acute depression and maintenance were CBT, IPSRT, FFT ± psychoeducation.
adjunctive psychosocial interventions and psychotherapies that had been recommended in
adjunctive psychosocial interventions and psychotherapies that had been recommended in
acute depression and maintenance were CBT, IPSRT, FFT ± psychoeducation. incorporated
In the
first edition of local CPG, psychosocial interventions were recommended to be 84, level III
acute depression and maintenance were CBT, IPSRT, FFT ± psychoeducation. 84, level III In the
into patients’ care in addition to pharmacological treatment in BD. The CPG DG opines that
first edition of local CPG, psychosocial interventions were recommended to be incorporated
6
first edition of local CPG, psychosocial interventions were recommended to be incorporated
into patients’ care in addition to pharmacological treatment in BD. The CPG DG opines that
6 6
into patients’ care in addition to pharmacological treatment in BD. The CPG DG opines that
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