New treatment model for bipolar disorder shows promise

A new model of treatment for bipolar disorder, similar to care given to diabetics and others with chronic diseases, improved patient outcomes without increasing costs, according to a new research by U.S. psychiatrists published on Thursday.

Results appear in two reports published in Psychiatric Services, a journal of the American Psychiatric Association.

The new care model for bipolar disorder tested in veterans across the nation reduced their manic episodes and improved their quality of life.

The randomized, controlled trial also showed that the model did not add to the treatment costs for bipolar disorder, which affects nearly 6 million American adults a year.

"We applied the same symptom management approaches found in interventions for diabetes and asthma to the treatment of bipolar disorder and found that people with serious mental illness can help take control of their care," said Mark S. Bauer, staff psychiatrist with the Providence Veterans Affairs Medical Center.

"This finding should reduce the stigma of helplessness that so often is associated with these disorders, and it will open new avenues for the treatment of bipolar disorder," the psychiatrist added.

Bauer, who oversaw the clinical trial, is the lead author of both journal articles.

The new model was developed and tested in veterans with bipolar disorder at the Providence V.A. Medical Center.

During the trial, 306 veterans were enrolled at 11 V.A. centers located in 10 U.S. states.

Each veteran was randomly assigned to a study group. One group got usual care through their psychiatrist. The other group received treatment under the new model.

The model brings together psychiatrists and nurses as a team to treat the patients. Psychiatrists monitored symptoms and handled medications. Nurse care coordinators worked with veterans during group education sessions.

During the weekly group sessions, nurses discussed topics such as medication side effects and early warning signs for symptoms, which in bipolar disorder range from bursts of optimism and impulsive behavior during manic episodes to fatigue, social withdrawal and suicidal thoughts during depressive episodes.

During the sessions, patients discussed coping skills, got feedback from the group and created personal action plans.

The intervention was tested for three years. The results: Under the new model, patients saw a significant reduction in symptoms, including five fewer weeks experiencing mania during the three-year study period.

Patients also felt happier and healthier, reporting more productive time at work, better relations with family, and more satisfaction with their care.

The new model was less expensive - an average of 61,398 U.S. dollars for three years of direct treatment costs compared with 64,379 dollars for usual care - although the difference was not statistically significant.

"The bottom line is that we saw improvements in patients' symptoms, function and quality of life with no change in net costs," Bauer said.

Source: Xinhua