Does smartphone based intervention decreases relapse risk in bipolar disorder?

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-17T09:45:06+05:30 | Updated On 17 Jan 2023 3:07 PM IST

Results of a recent study suggest published in JAMA Psychiatry suggests that further work is warranted to optimize the smartphone-based self-management intervention and confirm that the intervention decreases relapse risk for individuals in asymptomatic recovery

Bipolar disorder–specific psychotherapy combined with pharmacotherapy improves relapse risk, symptom burden, and quality of life, but psychotherapy is not easily accessible.

A study was conducted to determine if a smartphone-based self-management intervention (LiveWell) can assist individuals with bipolar disorder to maintain wellness.

An assessor-blind randomized clinical trial enrolled participants from March 20, 2017, to April 25, 2019, with 48-week follow-up ending on April 10, 2020. Participants were randomly assigned to usual care or usual care plus the smartphone intervention stratified by relapse risk based on initial clinical status (low risk: asymptomatic recovery; high risk: continued symptomatic, prodromal, recovering, symptomatic recovery). Participants with bipolar disorder I were recruited from clinics in the Chicago and Minneapolis-Saint Paul areas. Data were analyzed from June 19, 2020, to May 25, 2022. The smartphone-based self-management intervention consisted of an application (app), coach, and website. Over 16 weeks, participants had a coach visit followed by 6 phone calls, and they completed daily and weekly app check-ins. The app provided adaptive feedback and information for developing a personalized wellness plan, the coach provided support, and the website provided summary data and alerts.

The primary outcome was time to relapse. Secondary outcomes were percentage-time symptomatic, symptom severity, and quality of life.

Results

• Of the 205 randomized participants were randomly assigned to usual care, and 124 (60%) were randomly assigned to usual care plus the smartphone intervention.

• This clinical trial did not detect a reduction in relapse risk for the smartphone intervention

• However, decreased relapse was observed for low-risk individuals but not high-risk individuals

• Reduced manic symptom severity was observed for low-risk individuals but not for high-risk individuals

• The smartphone-based self-management intervention decreased depressive symptom but did not decrease percentage-time symptomatic

This randomized clinical trial of a smartphone-based self-management intervention did not detect a significant improvement in the primary outcome of time to relapse. However, a significant decrease in relapse risk was observed for individuals in asymptomatic recovery. In addition, the intervention decreased depressive symptom severity and improved relational quality of life. These findings warrant further work to optimize the smartphone intervention and confirm that the intervention decreases relapse risk for individuals in asymptomatic recovery.

Reference:

Goulding EH, Dopke CA, Rossom R, Jonathan G, Mohr D, Kwasny MJ. Effects of a Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder on Relapse, Symptom Burden, and Quality of Life: A Randomized Clinical Trial. JAMA Psychiatry. Published online December 21, 2022. doi:10.1001/jamapsychiatry.2022.4304

JAMA Psychiatrybipolar disordersmartphoneintervention

Source : JAMA Psychiatry

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751