Title: A Pilot Randomised Controlled Trial of CBT for People with Bipolar Disorders and Current Symptoms: Think Effectively About Mood Swings (TEAMS)
Funder: Department of Health (England)

Abstract: Background Despite treatment, people with bipolar disorder remain depressed for the majority of time when outside an episode. The cost of bipolar disorders annually in the UK is £5.2 billion, projected to rise to £8.2 billion by 2026. There is a clear need for a more effective, cost-efficient intervention such as CBT. Currently, CBT for bipolar disorder shows significant, but modest, effects. Our group has developed and piloted a case series for a new CBT approach known as TEAMS (Think Effectively About Mood Swings) based on an empirically supported model (Mansell et al., 2007). It involves a new integrative treatment approach which has the potential to benefit those people whose symptoms of depression, hypomania and anxiety have otherwise remained treatment resistant and with reduced functioning. Aims We will assess whether the TEAMS approach is feasible and acceptable to patients and services, can be trained to a good level of adherence, and has the potential to be effective and cost-effective for people with bipolar disorders who experience persistent symptoms We predict that TEAMS will reduce depression, hypomanic symptoms and anxiety, improve social functioning, and promote recovery in comparison to treatment as usual at post-treatment and follow-up. We will also obtain in depth feedback from service users regarding their treatment preferences, and their suggestions for improvements to TEAms We will also utilise the data to inform the design of a larger clinical trial of the TEAMS approach. Plan of Investigation Adults with bipolar disorders will be recruited from clinical services and service user groups. They will be interviewed concerning their treatment preferences and asked to complete measures of symptoms, functioning and cognitive style on two occasions over the two weeks prior to random allocation to TEAMS or treatment-as-usual. Clients will be offered 16 treatment sessions over a period of up to 6 months. Outcome measures will be repeated at 3, 6 and 12 months post-randomisation. At 6 months, a combination of anonymised feedback and interviews with treated participants will be analysed to judge the acceptability of the treatment and inform potential modifications to improve future developments of the TEAMS approach and its application within services. Potential Impact This project will have immediate benefit to patients with bipolar disorders suffering persistent symptoms of depression. These people form the majority of all individuals diagnosed with the disorder and for whom there are no currently available psychological treatments specific to these particular problems We aim to (a) evaluate the effectiveness of an intervention which has the potential for direct benefits for patients (b) assess feasibility and outcomes including acceptability, uptake, service barriers, and attrition, and (c) the research team are both committed to, and ideally placed to carry out, widespread dissemination within the NHS. This research will provide valuable data for commissioners and service users.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH