Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications. San Antonio, Texas: The Psychological Corporation; 2001. Inflammatory mediators of cognitive impairment in bipolar disorder. For the previous 10 years I hadbeen working on a long-term maintenance treatment study testing the prophylacticvalue of interpersonal psychotherapy for individuals with recurrent unipolar depres-sion. 2021;55(1):7117. Sato T. The Eysenck Personality Questionnaire Brief Version: factor structure and reliability. Palo Alto, CA: Consulting Psychologists Press; 1983. Department of Psychological Medicine, University of Otago, Christchurch, New Zealand, Katie M. Douglas,Maree L. Inder,Marie T. Crowe,Jennifer Jordan,Dave Carlye,Cameron Lacey,Ben Beaglehole,Roger Mulder,Kate Eggleston,Katherine A. Donovan,Christopher M. A. Frampton&Richard J. Porter, Specialist Mental Health Services, Canterbury District Health Board, Christchurch, New Zealand, Jennifer Jordan,Dave Carlye,Ben Beaglehole,Roger Mulder,Kate Eggleston,Katherine A. Donovan&Richard J. Porter, Mori Indigenous Health Institute, University of Otago, Christchurch, New Zealand, Department of Psychology, Queens University, Kingston, ON, Canada, You can also search for this author in This was a key factor in choosing a subjective, rather than objective, screen for cognitive impairment. BMJ. Utilising a non-active control intervention that does not produce behaviour change associated with a cognitively-enriched environment (e.g., treatment-as-usual) may result in stronger pro-cognitive effects. The current protocol therefore includes CR in the second half of the 12-month IPSRT course, giving patients the opportunity to learn strategies to stabilise circadian rhythms, routines, and mood symptoms prior to commencing CR. The trial was approved by the New Zealand Health and Disability Ethics Committees (Northern B) on 16 May 2019 (19/NTB/54). 2010;340:c332. Randomisation to the group-based CR intervention, or not, will occur at 6months. J Psychiatr Res. 2017;47(9):167889. (1997). Bradley AJ, Anderson KN, Gallagher P, McAllister-Williams RH. Groves SJ, Douglas KM, Milanovic M, Bowie CR, Porter RJ. Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice. IPSRT draws upon principles from interpersonal psychotherapy, an evidence-based treatment for depression and emphasizes the importance of daily routine (rhythm). J Psychiatr Ment Health Nurs. Computerised permuted block randomisation will be undertaken by the teams biostatistician (CF) prior to the commencement of the study and will be stratified according to mood disorder type (BD or MDD). It uses techniques that teach them vital skills to manage everyday stress, adhere to medication and reduce disturbances in their social rhythms. 2019;6(10):85161. Cognitive impairment in depression: a systematic review and meta-analysis. Action-based cognitive remediation for individuals with serious mental illnesses: Effects of real-world simulations and goal setting on functional and vocational outcomes. This article discusses the circadian basis of IPSRT and the importance of stable daily routines in the maintenance of the euthymic state, as well as the two large controlled trials which empirically support this intervention. Inflamed moods: a review of the interactions between inflammation and mood disorders. Interpersonal and Social Rhythm Therapy (IPSRT) is a modification of the Klerman and Weisman Interpersonal Therapy for Depression approach. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. 2014;56:1827. Essential Elements For the first 6months of the 12-month intervention period, all individuals will receive the same intervention; individual IPSRT. An ability to balance a focus on interpersonal problem areas and sources of interpersonal stressors with a focus on monitoring and regulating social activities An ability to work with the client to identify regular activities and patterns of social interactions that support and regulate sleep wake cycles and periods of activity and rest An abil. Porter RJ, Robinson LJ, Malhi GS, Gallagher P. The neurocognitive profile of mood disorders - a review of the evidence and methodological issues. IPSRT combines Interpersonal Psychotherapy with a focus on social rhythms or routines in a person's life. https://doi.org/10.1016/s0006-3223(96)00241-7, Frank, E., Swartz, H. A., & Boland, E. (2007). 2005;62(9):9961004. Aspects of cognitive impairment have also been associated with increased risk of relapse [12]. These cognitive domains are included based on recommendations from the ISBD Targeting Cognition Taskforce [5], as well as research showing these domains to be significantly impaired in acutely-unwell patients with mood disorders [6, 59] and to be sensitive to the effects of Cognitive Remediation interventions [60]. Consideration was given to when group-based CR should be commenced within the 12-month intervention period. Arch Gen Psychiatry. This will be the first RCT to combine group-based CR with an evidence-based psychotherapy for adults with mood disorders. In comparison with CR trials in BD, MDD trials have generally been smaller, shorter in CR duration, more variable in whether CR commences in the acute or remitted phase, and have often focused on short-term symptom reduction rather than longer-term functional outcomes. To assess the effect of IPSRT-CR versus IPSRT on secondary and exploratory outcomes, general linear models will be used. Interpersonal and Social Rhythm Therapy (ISRT) is a method of psychotherapy that was created to aid persons suffering from bipolar disorder. 44 reviews 23 ratings 15,005 10,000,000+ 303 100,000+ users Here's how it works 02. 2020;73(1):2934. [30]. Bourne C, Aydemir O, Balanza-Martinez V, Bora E, Brissos S, Cavanagh JT, et al. This is a prospectively-registered (Australian and New Zealand Clinical Trials Registry; ref ACTRN12619001080112; 6 August 2019), two-arm, single-blinded RCT comparing IPSRT-CR with IPSRT alone for individuals with mood disorders. Oliveira J, Oliveira-Maia AJ, Tamouza R, Brown AS, Leboyer M. Infectious and immunogenetic factors in bipolar disorder. *Although findings of two trials indicated that IPSRT lead to reduced depression, IPRST has been labeled as having modest research support due to null results in the maintenance phase of the Frank et al. Behav Res Ther. Several measures of subjective cognitive difficulties, as well as factors likely to be associated with subjective cognitive difficulties (rumination, metacognition, mood severity) are included in the current protocol to determine their impact on CR response in secondary and exploratory analyses. We therefore intend to explore the relation between objective and subjective cognitive impairment and treatment outcome in exploratory analyses of data. A semi-structured qualitative interview will be conducted at treatment-end (12months) by a trained research nurse. Effect of Action-Based Cognitive Remediation on cognitive impairment in patients with remitted bipolar disorder: A randomized controlled trial. 2023 BioMed Central Ltd unless otherwise stated. CB is a Consultant or Board Member for Takeda, Boehringer Ingelheim, Lundbeck, Otsuka and receives grant Support from Pfizer, Takeda. Interpersonal and social rhythm therapy combines SRT with interpersonal therapy. H., Flaherty, J. F., Frank, E., Hoskinson, K., & Kupfer, D. J. Data suggests a link between disrupted sleep and cognitive [25] and functional impairment [26] in BD. Bipolar Disord. Interpersonal and Social Rhythm Therapy. 2013;128(3):14962. Br J Psychiatry. Bowie CR, Grossman M, Gupta M, Holshausen K, Best MW. On the other hand, BD trials often recruit patients when euthymic, and include assessment of longer-term functional outcomes. The Social Measure Standard. Terms and Conditions, Interpersonal Psychotherapy of Depression. 2000;42(3):2417. Interpersonal and social rhythm therapy: Managing the chaos of bipolar disorder. These changes were made to reduce participant time burden, in the knowledge that many participants would be in full-time employment and many would still be attending fortnightly IPSRT sessions. Group-based CR will involve weekly 90-min sessions over 8weeks (i.e., 8 sessions). J Psychiatr Pract. This test uses role plays of everyday tasks focusing on communication skills and financial skills. Each exercise has several levels of difficulty that automatically adjust according to patients performance. Depp CA, Mausbach BT, Harmell AL, Savla GN, Bowie CR, Harvey PD, et al. Bipolar Disord. Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. At study intake, 43% of the sample were in episode, and thus, therapists often prioritised stabilisation of mood over CR. Interpersonal and social rhythm therapy (IPSRT) is used to explore how a person's social and daily routines impact their mood. Ann Intern Med. Targeting cognition in clinical research is thus considered a priority. We have recently completed a pragmatic RCT [30] which examined a novel combination of CR, IPSRT and medication management for people with mood disorders. IPSRT combines Interpersonal Psychotherapy with a focus on social rhythms or routines in a persons life. Qualitative interviews and treatment satisfaction questionnaires will be completed at 12-months only by a research nurse trained in qualitative methodology. 1971;24(4):45564. Porter RJ, Inder M, Douglas KM, Moor S, Carter JD, Frampton CM, et al. See Table 1 for a summary of study measures (primary, secondary, exploratory) at each time-point. The interpersonal piece of IPSRT refers to identifying how . Change z-scores on Global Cognition will be compared using general linear models, with an intention-to-treat (ITT) approach. Further, the ISBD Taskforce Targeting Cognition recommends screening for both objective and subjective cognitive impairment in clinical trials of cognitive interventions [5], and we agree that this is the most comprehensive approach for enriching CR trials. For example, in a group-CR session from the Learning and Memory module, a real-life task involves a hypothetical work orientation day in which every group member introduces themselves (using a blurb provided by the therapist) and is then required to use cognitive strategies to recall information about other group members and then to introduce them to the group.
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