The Effect of Resilience on Bipolar Mood During Specialty Clinic Treatment

Overview

Journal J Affect Disord

Date 2023 Nov 10

PMID 37949240

Authors

Karl Chiang

Teresa Lanza di Scalea

Tawny Smith

David Spelber

Jennifer Siegel-Ramsay

Charles B Nemeroff

Stephen M Strakowski

Jorge Almeida

Affiliations

Soon will be listed here.

Abstract

Background: Limitations in mental health resources behoove exploration of factors that may enhance treatment response. One such factor, resilience, has been minimally examined in bipolar disorder.

Methods: With multi-level modeling of clinical care data, we examined associations among longitudinal measurements of resilience and mood rating trajectories in a sample of 100 individuals with bipolar disorder during 6 weeks of evidence-based pharmacotherapy and psychotherapy.

Results: Individuals with high self-care subscale scores from the Resilience Questionnaire for Bipolar Disorder exhibited an improving rate of depression change -0.18 (SE = 0.04, p < .001) completing treatment with a subthreshold depression rating of 3.1 (SE = 1.39, p < .05). In contrast, treatment recipients who disagreed or were neutral towards self-care experienced worsening or no change in depression, respectively. This subscale also decreased mood elevation. Each one-point increase yielded a -0.27 (SE = 0.13 p < .05) point decrease in mania.

Limitations: Resilience may develop longitudinally. In this study, it was examined during active treatment which was a relatively brief period of time.

Conclusions: Higher bipolar resilience could identify individuals more likely to exhibit improvement in mood during bipolar specialty clinic treatment.

References

Frank E, Kupfer D, Thase M, Mallinger A, Swartz H, Fagiolini A . Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry. 2005; 62(9):996-1004. DOI: 10.1001/archpsyc.62.9.996. View

Michalak E, Murray G . Development of the QoL.BD: a disorder-specific scale to assess quality of life in bipolar disorder. Bipolar Disord. 2010; 12(7):727-40. DOI: 10.1111/j.1399-5618.2010.00865.x. View

Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea J, Benabarre A . A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry. 2003; 60(4):402-7. DOI: 10.1001/archpsyc.60.4.402. View

Prendes-Alvarez S, Nemeroff C . Personalized medicine: Prediction of disease vulnerability in mood disorders. Neurosci Lett. 2016; 669:10-13. DOI: 10.1016/j.neulet.2016.09.049. View

Bauer M, Vojta C, Kinosian B, Altshuler L, GLICK H . The Internal State Scale: replication of its discriminating abilities in a multisite, public sector sample. Bipolar Disord. 2001; 2(4):340-6. DOI: 10.1034/j.1399-5618.2000.020409.x. View

Murray G, Suto M, Hole R, Hale S, Amari E, Michalak E . Self-management strategies used by 'high functioning' individuals with bipolar disorder: from research to clinical practice. Clin Psychol Psychother. 2010; 18(2):95-109. DOI: 10.1002/cpp.710. View

Masten A, Lucke C, Nelson K, Stallworthy I . Resilience in Development and Psychopathology: Multisystem Perspectives. Annu Rev Clin Psychol. 2021; 17:521-549. DOI: 10.1146/annurev-clinpsy-081219-120307. View

Adler M, Brodin U . An IRT validation of the Affective Self Rating Scale. Nord J Psychiatry. 2011; 65(6):396-402. DOI: 10.3109/08039488.2011.577187. View

Yatham L, Kennedy S, Parikh S, Schaffer A, Bond D, Frey B . Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018; 20(2):97-170. PMC: 5947163. DOI: 10.1111/bdi.12609. View

10.

Miklowitz D, Otto M, Frank E, Reilly-Harrington N, Wisniewski S, Kogan J . Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program. Arch Gen Psychiatry. 2007; 64(4):419-26. PMC: 3579612. DOI: 10.1001/archpsyc.64.4.419. View

11.

Echezarraga A, Hayas C, Gonzalez-Pinto A, Jones S . The Resilience Questionnaire for Bipolar Disorder: Development and validation. Arch Psychiatr Nurs. 2017; 31(4):376-385. DOI: 10.1016/j.apnu.2017.04.010. View

12.

Gitlin M, Miklowitz D . The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment. J Affect Disord. 2016; 209:147-154. PMC: 7213058. DOI: 10.1016/j.jad.2016.11.021. View

13.

Choi J, Cha B, Jang J, Park C, Kim B, Lee C . Resilience and impulsivity in euthymic patients with bipolar disorder. J Affect Disord. 2014; 170:172-7. DOI: 10.1016/j.jad.2014.08.056. View

14.

Mizuno Y, Hofer A, Suzuki T, Frajo-Apor B, Wartelsteiner F, Kemmler G . Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study. Schizophr Res. 2016; 175(1-3):148-153. DOI: 10.1016/j.schres.2016.04.047. View

15.

Sheehan D, Raj B . The measurement of disability. Int Clin Psychopharmacol. 1996; 11 Suppl 3:89-95. DOI: 10.1097/00004850-199606003-00015. View

16.

Perry A, Tarrier N, Morriss R, McCarthy E, Limb K . Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. BMJ. 1999; 318(7177):149-53. PMC: 27688. DOI: 10.1136/bmj.318.7177.149. View

17.

Goldstein T, Krantz M, Fersch-Podrat R, Hotkowski N, Merranko J, Sobel L . A brief motivational intervention for enhancing medication adherence for adolescents with bipolar disorder: A pilot randomized trial. J Affect Disord. 2020; 265:1-9. PMC: 8713513. DOI: 10.1016/j.jad.2020.01.015. View

18.

Jones S, Mulligan L, Higginson S, Dunn G, Morrison A . The bipolar recovery questionnaire: psychometric properties of a quantitative measure of recovery experiences in bipolar disorder. J Affect Disord. 2012; 147(1-3):34-43. DOI: 10.1016/j.jad.2012.10.003. View

19.

Echezarraga A, Calvete E, Gonzalez-Pinto A, Las Hayas C . Resilience dimensions and mental health outcomes in bipolar disorder in a follow-up study. Stress Health. 2017; 34(1):115-126. DOI: 10.1002/smi.2767. View

20.

Miklowitz D, Efthimiou O, Furukawa T, Scott J, McLaren R, Geddes J . Adjunctive Psychotherapy for Bipolar Disorder: A Systematic Review and Component Network Meta-analysis. JAMA Psychiatry. 2020; 78(2):141-150. PMC: 7557716. DOI: 10.1001/jamapsychiatry.2020.2993. View