谁能从双相情感障碍的数字化干预中受益?预测生活质量变化的疾病阶段特征。

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY Bipolar Disorders Pub Date : 2024-11-01 Epub Date: 2024-07-23 DOI:10.1111/bdi.13462
Hailey Tremain, Kathryn Fletcher, Denny Meyer, Greg Murray
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引用次数: 0

摘要

研究目的本研究探讨了阶段相关变量在双相情感障碍(BD)干预结果中的潜在作用。具体而言,我们旨在确定哪些亚群最有可能在对躁狂症进行数字社会心理干预后生活质量得到改善:本研究对两项随机对照试验(RCT)的综合数据进行了二次分析。每项试验都评估了数字化干预对改善晚期(ORBIT RCT)或早期(BETTER RCT)BD患者生活质量的有效性。该研究进行了三次迭代聚类分析,根据(i)当前现象、(ii)病程和(iii)药物反应确定了个人亚组。通过重复测量方差分析,比较了由此产生的亚组在干预前和干预后生活质量的变化:结果:在每个聚类分析中都发现了两个聚类。目前的现象群组反映了两种障碍程度,即 "中度障碍 "和 "低度障碍"。病程聚类反映了 "慢性化程度较高 "和 "慢性化程度较低",药物反应聚类反映了 "药物反应良好 "和 "药物反应较差"。随着时间的推移,生活质量的变化在当前的两个现象群组和药物反应群组之间出现了差异,而病程亚群的反应并无不同:结论:至少有两类不同的已确诊 BD 患者寻求治疗,他们的疾病特征与先前确定的不同疾病阶段存在联系。在我们的干预措施下,当前现象学和药物反应领域中的分组随着时间的推移显示出明显不同的质量生活变化轨迹,这凸显了精准精神病学对治疗选择的潜在影响。
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Who benefits from digital interventions for bipolar disorder? Stage of illness characteristics as predictors of changes in quality of life.

Objectives: This study explored the potential role of stage-related variables in intervention outcomes in bipolar disorder (BD). Specifically, we aimed to identify which subgroups of individuals were most likely to experience improved quality of life following digitally delivered psychosocial interventions for BD.

Methods: The study involved a secondary analysis of combined data from two randomised control trials (RCTs). Each trial assessed the effectiveness of digitally delivered interventions for improving quality of life, in late-stage (ORBIT RCT) or early-stage (BETTER RCT) BD. Three iterations of cluster analyses were performed, identifying subgroups of individuals based on (i) current phenomenology, (ii) course of illness and (iii) medication response. The resultant subgroups were compared with regard to changes in quality of life pre-post intervention, via repeated measures ANOVAs.

Results: In each cluster analysis, two clusters were found. The current phenomenology clusters reflected two impairment levels, 'moderate impairment' and 'low impairment'. The course of illness clusters reflected 'more chronicity' and 'less chronicity' and the medication response clusters reflected 'good medication response' and 'poor medication response'. Differences in changes in quality of life over time were observed between the two current phenomenology clusters and between the medication response clusters, while the course of illness subgroups did not respond differently.

Conclusions: There are at least two distinct groups of treatment-seeking individuals with established BD, based on illness features with previously established links to different illness stages. Clusters within the current phenomenology and medication response domains demonstrated significantly different trajectories of QoL change over time in the context of our interventions, highlighting potential implications for treatment selection aligned with precision psychiatry.

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来源期刊
Bipolar Disorders
Bipolar Disorders 医学-精神病学
CiteScore
8.20
自引率
7.40%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.
期刊最新文献
Long-term management of a perpetual mixed state with minimal medication and sleep regulation. How to study psychological mechanisms of mania? A systematic review on the methodology of experimental studies on manic mood dysregulation of leading theories on bipolar disorder. Who benefits from digital interventions for bipolar disorder? Stage of illness characteristics as predictors of changes in quality of life. Behavioral skill practice as a predictor of mood and family functioning in adolescents with bipolar and depressive mood disorders: Results of a 6-month randomized trial of family-focused therapy. Cognitive predictors of response to interpersonal and social rhythm therapy in mood disorders.
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