The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) ran from 1998 to 2005, with over 4,000 sufferers of Bipolar Disorder (BD) taking part in various trials and assessments over a two-year period.
Researchers were looking at how BD progresses through a person's life, how related it is to other psychiatric disorders, and how related it is to suicidality.
It found that few treatments alone were successful in treating BD, however psycho-social interventions (such as Cognitive Behaviour Therapy) and psycho-education interventions combined with mood stabilizers showed the most positive results.
BD was also shown to be strongly related to substance abuse and smoking, both of which affected the success or otherwise of chemical and psychological treatments.
Interestingly, paroxetine or bupropion were shown to be no more effective than a placebo in achieving sustained recovery (in this instance, determined as eight weeks of 'stable' behavior). So, too, were lamotrigine, risperidone, and inositol found to deliver minimal positive effects.
To the vexed, 'hidden', taboo subject of suicide -- the 'S' word not spoken of by the media (although thankfully that is slowly changing, at least in Australia). Suicidality persists with BD, even when treatment outcomes are good. The biggest predictor of suicidality being previous attempts.
The authors' conclusions
The authors of this review paper note seven contributions of the STEP-BD program:
1. Antidepressants remain poorly effective in treating BD;
2. BD is particularly disabling (tell me about it), and frequently doesn't respond to medications;
3. BD does respond modestly to intensive psycho-social interventions;
4. Other psychiatric disorders are common and destabilizing, yet anxiety disorders and smoking are able to be treated and when treated positively impact on BD;
5. An early age on onset of BD usually results in a more severe course of the illness, but rapid-cycling usually diminishes;
6. The sub-syndrome of Depression may be so strong as to mask the manic pole of BD, therefore careful symptom appraisal by psychiatrists is essential;
7. Suicidal thoughts persist in BD sufferers, and a previous attempt is a good indicator of a future event. However, by reducing feelings of 'hopelessness' in particular, there is the possibility of reducing the risk of suicide.
Source: Parikh, S.V., LeBlanc, S.R., & Ovanessian, M.M. 2010. Advancing Bipolar Disorder: Key Lessons From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). The Canadian Journal of Psychiatry, Vol. 55, No 3, p.p. 136-143.
Please see our medical disclaimer.
Query: can the ‘alts’ of Second Life and other virtual worlds be akin to ‘alters’, the various alternative states of sufferers of Dissociative Identity Disorder and Multiple Personality Disorder?
Is the act of having several ‘alts’ a quasi-therapeutic way of dealing with those ‘alters’?
Prompted by listening to an episode of ABC Radio National’s superb show, ‘All in the Mind’.
Subscribe to receive each post on this blog in your email AND get a free copy of the ebook, Boosting Your Self Esteem
Follow me on twitter
Book of the Week
"the author achieves something difficult in a memoir: she remembers feelings from a period of her life, while still providing distance and perspective. Williamson's analysis of the mental health field and mental health professionals is insightful without being preachy, and she presents her story with grace and humor." - Publishers Weekly
- Vickie l. Rogers on Facebook Therapy: Emotional self-disclosure issues for young adults
- Kate Singleton on Today is World Suicide Day
- induchhibber on Psychoeducation intervention for bipolar sufferers
- Tina on Psychological Effects of Dog Ownership
- Isla Watson on Facebook Therapy: Emotional self-disclosure issues for young adults
- Bipolar disorder from the clinician’s perspective
- I’m back
- When to suspect bipolar disorder
- Today is World Suicide Day
- A review of findings from the world’s largest study of Bipolar Disorder
- BeyondBlue Australian depression organisation with great resources
- Defeating bipolar Pick up the latest books and dvds on bipolar
- Inspire Foundation Set up in 1996 in response to escalating rates of youth suicide in Australia
- The Black Dog Institute Australia’s premiere online resource for bipolar sufferers and those who love them
- The Mental Health Service Australia-wide organisation whose annual conference is a must attend, bringing over 1,000 mental health specialists together