Abstract
Objective: This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Methods: Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Results: Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. Conclusions: These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
Original language | English (US) |
---|---|
Pages (from-to) | 453-461 |
Number of pages | 9 |
Journal | Australian and New Zealand Journal of Psychiatry |
Volume | 49 |
Issue number | 5 |
DOIs | |
State | Published - May 6 2015 |
Keywords
- Bipolar disorder
- medication use
- psychotherapy
- service utilization
ASJC Scopus subject areas
- Psychiatry and Mental health
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Psychotherapy use in bipolar disorder : Association with functioning and illness severity. / Sylvia, Louisa G.; Thase, Michael E.; Reilly-Harrington, Noreen A. et al.
In: Australian and New Zealand Journal of Psychiatry, Vol. 49, No. 5, 06.05.2015, p. 453-461.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Psychotherapy use in bipolar disorder
T2 - Association with functioning and illness severity
AU - Sylvia, Louisa G.
AU - Thase, Michael E.
AU - Reilly-Harrington, Noreen A.
AU - Salcedo, Stephanie
AU - Brody, Benjamin
AU - Kinrys, Gustavo
AU - Kemp, David
AU - Shelton, Richard C.
AU - Mcelroy, Susan L.
AU - Kocsis, James H.
AU - Bobo, William V.
AU - Kamali, Masoud
AU - Mcinnis, Melvin
AU - Friedman, Edward
AU - Tohen, Mauricio
AU - Bowden, Charles L.
AU - Ketter, Terence A.
AU - Singh, Vivek
AU - Calabrese, Joseph
AU - Nierenberg, Andrew A.
AU - Rabideau, Dustin J.
AU - Elson, Constance M.
AU - Deckersbach, Thilo
N1 - Funding Information: Dr Calabrese has received federal funding from the Department of Defense, Health Resources Services Administration, and the National Institute of Mental Health. He has received research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Cephalon, Cleveland Foundation, Eli Lilly, GlaxoSmithKline, Janssen, Lundbeck, NARSAD, Repligen, Stanley Medical Research Institute, Takeda, and Wyeth. He has consulted to or served on advisory boards of Abbott, AstraZeneca, Bristol-Meyers Squibb, Cephalon, Dainippon Sumitomo, EPI-Q, Inc., Forest, France Foundation, GlaxoSmithKline, Janssen, Johnson and Johnson, Lundbeck, Merck, Neurosearch, OrthoMcNeil, Otsuka, Pfizer, Repligen, Schering-Plough, Servier, Solvay, Supernus, Synosia, Takeda, and Wyeth. Dr. Calabrese has provided CME lectures supported by AstraZeneca, Bristol-Myers Squibb, France Foundation, GlaxoSmithKline, Janssen, Johnson and Johnson, Merck, Sanofi Aventis, Schering-Plough, Pfizer, Solvay, and Wyeth. Funding Information: Dr Kinrys has received research support from Astra-Zeneca, Bristol-Myers Squibb Company, Cephalon, Elan Pharmaceuticals, Eli Lilly & Company, Forest Pharmaceuticals Inc., GlaxoSmithkline, Sanofi/Synthelabo, Sepracor Inc., Pfizer Inc, UCB Pharma, and Wyeth-Ayerst Laboratories. He has been an advisor or consultant for Astra-Zeneca, Cephalon, Eli Lilly & Company, Forest Pharmaceuticals Inc., GlaxoSmithkline, Janssen Pharmaceutica, Pfizer Inc, Sepracor Inc., UCB Pharma, and Wyeth-Ayerst Laboratories. Dr. Kinrys has been a speaker for Astra-Zeneca, Forest Pharmaceuticals Inc., GlaxoSmithkline, Sepracor Inc., and Wyeth-Ayerst Laboratories. Funding Information: Dr Friedman received grant support from NIMH, AHRQ, Novartis, St. Jude Medical, Medtronics, Repligen, Astra-Zeneca, Roche, and Takeda. He receives royalties from Springer. He has been a consultant for PamLab. Funding Information: Dr Shelton has been a consultant for Bristol-Myers Squibb Company; Cerecor, Inc.; Cyberonics, Inc.; Eli Lilly and Company; Forest Pharmaceuticals; Janssen Pharmaceutica; Medtronic, Inc.; Pamlab, Inc.; Pfizer, Inc.; Ridge Diagnostics; and Takeda Pharmaceuticals. He has grant support from Assures Health; Bristol-Myers Squibb; Eli Lilly and Company; Elan, Corp.; Euthymics Bioscience; Forest Pharmaceuticals; Janssen Pharmaceutica; Jazz Pharmaceuticals; Naurex, Inc.; Novartis Pharmaceuticals; Otsuka Pharmaceuticals; Pamlab, Inc.; Pfizer, Inc.; Repligen, Corp.; Ridge Diagnostics; St. Jude Medical, Inc.; Takeda Pharmaceuticals. Funding Information: Dr Deckersbach has received research support from NIMH, NARSAD, TSA, IOCDF, Tufts University, NIH, NIA, DBDAT, Janssen Pharmaceuticals, the Forest Research Institute, Shire Development Inc., Medtronic, Cyberonics, Northstar. He has received honoraria, consultation fees and/or royalties from the following: Medacorp, MGH Psychiatry Academy, BrainCellsInc.,Clintara, LLC., Systems Research and Applications Corporation, Boston University, Tufts University, the Catalan Agency for Health Technology Assessment and Research, the National Association of Social Workers Massachusetts, Massachusetts Medical Society, and Oxford University Press. Funding Information: Dr McInnis has received grants for research support from NIMH, the Heinz C Prechter Research Fund, and the Michigan Institute for Clinical Health Research (MICHR). MM has received consulting income from the Qatar National Research Foundation and Merck Pharmaceuticals. Funding Information: Dr Thase has been an advisor/consultant: to Alkermes, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Janssen Pharmaceuticals, Lundbeck, MedAvante, Merck, Mylan, Neuronetics, Otsuka, Pamlab, PharmaNeuroboost, Pfizer, Rexahn, Roche, Shire, Sunovion, Supernus, Takeda, Teva, Cerecor, Inc, Dey Pharma, LP, Gerson Lehman Group, Guidepoint Global, Novartis, Ortho-McNeil Pharmaceuticals, and Transcept Pharmaceuticals as well as the US Food and Drug Administration and the National Institute of Mental Health. During the same time frame, Dr. Thase has received honoraria for talks from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Merck, and Pfizer and he has received research grants from Alkermes, AstraZeneca, Eli Lilly, Forest, GlaxoSmithKline, Otsuka, PharmaNeuroboost, and Roche, as well as the National Institute of Mental Health and the Agency for Healthcare Research and Quality. Dr. Thase has also received royalties from the American Psychiatric Association, Guilford Publications, Herald House, and W.W. Norton & Company, Inc. He has equity holdings in MedAvante, Inc. Funding Information: Dr Kocsis has received research grants and contracts from AHRQ, NIMH, NIDA, Burroughs Wellcome Trust, Pritzker Consortium, Elan, Takeda, Forest, Astra Zeneca, Roche. He is on the speaker’s bureau at Pfizer and Merck and on the advisory board at Corcept. Funding Information: Dr Nierenberg is a consultant for Abbott Laboratories, Astra Zeneca, Basilea, BrainCells Inc., Brandeis University, Bristol-Myers Squibb, Cephalon, Corcept, Eli Lilly & Co., Forest, Genaissance, GlaxoSmithKline, Innapharma, Janssen Pharmaceutica, Jazz Pharmaceuticals, Lundbeck, Merck, Novartis, PamLabs, PGx Health, Pfizer, Ridge Diagnostics, Roche, Sepracor, Schering-Plough, Shire, Somerset, Sunovion, Takeda, Targacept, and Teva. He is a stakeholder in Appliance Computing, Inc. (MindSite); Brain Cells, Inc., InfoMed (potential share of income). He receives research support from AHRQ, Bristol-Myers Squibb, Cederroth, Cyberonics, Elan, Forest Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceutica, LichtwerPharma, Eli Lilly, Mylin (formerly Dey Pharmaceuticals), NARSAD, NIMH, Pamlabs, Pfizer, Shire, Stanley Foundation, and Wyeth-Ayerst. Honoraria include MGH Psychiatry Academy in the past 3 years (Prior to 3 years ago, honoraria from Bristol-Myers Squibb, Cyberonics, Forest Pharmaceuticals, GlaxoSmithKline, Eli Lilly, Shire, Wyeth-Ayerst). Dr. Nierenberg receives other income from legal case reviews for CRICO, MBL Publishing for past services as Editor-in-chief of CNS Spectrums, Slack Inc. for services as Associate Editor of Psychiatric Annals, and Editorial Board, Mind Mood Memory, Belvior Publications. He has copyright joint ownership with MGH for Structured Clinical Interview for MADRS and Clinical Positive Affect Scale and additional honoraria from ADURS, American Society for Clinical Psychopharmacology and Zucker Hillside Hospital and Forest and Janssen, Biomedical Development, Boston Center for the Arts, University of Pisa, University of Wisconsin at Madison, University Texas Southwest at Dallas, Health New England and Harold Grinspoon Charitable Foundation and Eli Lilly and AstraZeneca, Brandeis University, International Society for Bipolar Disorder, 2 East Asian Bipolar Forum, Mid-Atlantic Permanente Research Institute, Up-to-Date. nd Funding Information: Dr Brody has received salary support over the past 3 years from grants funded by Forrest, Agency for Healthcare Quality and Research, and Pritzker neuropsychiatric disorders research consortium. Publisher Copyright: © The Royal Australian and New Zealand College of Psychiatrists 2014.
PY - 2015/5/6
Y1 - 2015/5/6
N2 - Objective: This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Methods: Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Results: Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. Conclusions: These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
AB - Objective: This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Methods: Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Results: Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. Conclusions: These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
KW - Bipolar disorder
KW - medication use
KW - psychotherapy
KW - service utilization
UR - http://www.scopus.com/inward/record.url?scp=84930591179&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930591179&partnerID=8YFLogxK
U2 - 10.1177/0004867415569803
DO - 10.1177/0004867415569803
M3 - Article
C2 - 25680360
AN - SCOPUS:84930591179
VL - 49
SP - 453
EP - 461
JO - Australian and New Zealand Journal of Psychiatry
JF - Australian and New Zealand Journal of Psychiatry
SN - 0004-8674
IS - 5
ER -