Healthy Lifestyles in Bipolar Disorder: Bay Area Study
Time-restricted Eating as an Adjunctive Intervention for Bipolar Disorder
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sheri L Johnson, PhD
- Phone Number: (510) 519-4305
- Email: calmprogram@berkeley.edu
Study Contact Backup
- Name: Nandini A Rajgopal, BS
- Phone Number: (510) 519-4305
- Email: calmprogram@berkeley.edu
Study Locations
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California
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Berkeley, California, United States, 94720-2010
- Recruiting
- University of California Berkeley
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Contact:
- Sheri L Johnson, PhD
- Phone Number: (510) 519-4305
- Email: calmprogram@berkeley.edu
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Contact:
- Nandini Rajgopal, BS
- Phone Number: (510) 519-4305
- Email: calmprogram@berkeley.edu
-
Principal Investigator:
- Sheri L Johnson, PhD
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Meets diagnostic criteria for bipolar I disorder or bipolar II disorder (but not cyclothymia, bipolar disorder Not otherwise specified or bipolar disorder due to another medical condition) assessed by the Diagnostic Interview for Anxiety, Mood, and Obsessive-compulsive and Related Neuropsychiatric Disorders [DIAMOND])
- current sleep (insomnia, hypersomnolence) or circadian sleep-wake (delayed phase, advanced phase, irregular sleep-wake, non-24-hour sleep-wake-type) concerns indicated by endorsement of at least some sleep or circadian-related impairment across the screening self-reports or interview
- Living in an English-speaking country (and one that the researchers have expertise in research procedures and diet)
- Has been speaking English for at least 10 years, speaks English in the home, or certifies that they are able to understand English well for the study and demonstrates this during the screening interview.
- Receiving medical care for bipolar disorder (referrals will be provided for those who would like to begin care)
- Mood-stabilizing medication regimens stable for at least one month
- < 5 kg weight change in the past 3 months
- Currently eating ≥ 12 hours per day at least twice per week
- Able to operate the camera function and respond to web-based surveys by phone (loaner phones will be provided as needed)
- Not engaged in current shift work or have other responsibilities such as providing care that would chronically disrupt their sleep (i.e., > 3 h between 22:00 and 05:00 h for at least 1 day/week)
- Able to complete 7 days of dietary logs adequately (e.g., at least 2 entries per day, covering at least a 5-hour eating window) during the baseline period
- Able to complete screening and baseline questionnaires adequately (e.g., not failing more than 1 attention check item with instructed responding; responding to standard multiple-choice items in a mean of < 2 seconds per item). Where individuals respond to more than 14 items in a row with the same response, their answers will be manually reviewed for possible invalidity.
Exclusion criteria include the following:
- Current episode of depression, hypomania or mania, or psychosis (assessed by the DIAMOND), Participants with acute mood disorder episodes will be encouraged to seek treatment and to consider the study when symptoms have remitted.
- Eating disorder diagnosis (by self-report of treatment or diagnosis at any point during their life, Short Eating Disorder Examination Questionnaire (EDE-QS) scores above clinical concern thresholds for eating disorders, or DIAMOND interview of symptoms during adulthood)
- Past 3-month alcohol use disorder or substance use disorder (assessed by DIAMOND)
- Active suicidal ideation coupled with plan, intent or attempt history as assessed by Columbia Suicide Severity Rating Scale
- Conditions that would interfere with ability to take part in the intervention, including pregnancy, breastfeeding, uncorrected hypo or hyperthyroidism, gastrointestinal conditions impairing nutrient absorption
- Conditions that would confound immune or other study measures, such as HIV, AIDS, lupus, or multiple sclerosis
- Medications contraindicated for fasting: clozapine, glucose-lowering medications, diabetes-related injections, medications requiring food early morning or late evening, corticosteroids; Glucagon-like peptide-1 (GLP-1) agonists will not be an exclusion criteria if weight stabilized
- Cognitive deficits as noted during the initial interview or as indicated by low performance on the Orientation Memory Concentration Test- Short Version (weighted score < 20)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Time Restricted Eating (TRE) for 8 weeks
Participants will receive an intro to TRE and then throughout 8 weeks they will receive brief online psychoeducation several times per week with optional weekly coaching sessions.
TRE involves restricting the window of eating to 10 hours/ day, most typically by avoiding eating in the first 1-2 hours after awakening and in the 2-4 before sleep.
Those with an eating window > 14 hours will be asked to restrict their eating to 12 hours in the first week, then 10 hours in week 2. To select the period, investigators will ask Ss to review baseline logs to consider sleep, eating, family meals and social commitment schedules, and any special energy demands, such as exercise.
During the eating window, no restrictions are placed on the type or quantity of food consumed.
The investigators will instruct participants to follow their habitual diet within their 10-hour eating window and to aim to consume the same number of calories per day as they did at baseline.
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limiting food intake to 10 hours per day
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mania
Time Frame: Lower YMRS at the end of intervention (10 weeks) as compared to baseline
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Young Mania Rating Scale (YMRS) total scores (minimum: 0, maximum: 60, high scores reflect higher manic symptom severity)
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Lower YMRS at the end of intervention (10 weeks) as compared to baseline
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Depression
Time Frame: Lower MADRS at the end of intervention (10 weeks) as compared to baseline
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Montgomery Asberg Depression Scale (MADRS) total scores (minimum: 0, maximum: 60, higher scores reflect higher depressive symptom severity)
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Lower MADRS at the end of intervention (10 weeks) as compared to baseline
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Self-rated Quality of Life (QOL)
Time Frame: Scores at 1.5-months post-intervention (16 weeks) as compared to baseline
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self-rated Brief Quality of Life in Bipolar Disorder (QoL.BD) (minimum: 12, maximum: 60, higher scores reflect better QOL)
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Scores at 1.5-months post-intervention (16 weeks) as compared to baseline
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Acceptability
Time Frame: immediately post-treatment (10 weeks after enrollment)
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Participant self-ratings of the acceptability of the intervention: The primary index of acceptability will be the percentage of individuals who endorse that they agree or strongly agree that they would recommend the food plan to a friend.
This single item has been used in previous trials of bipolar disorder.
Higher agreement will be considered a positive outcome.
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immediately post-treatment (10 weeks after enrollment)
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Mania at follow-up
Time Frame: YMRS and LIFE scores will be lower at 3 months post-intervention as compared to baseline
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YMRS (described above) and Longitudinal Interval Follow-up Evaluation (LIFE; minimum 0, maximum 6) scores across follow-up (higher scores reflect more severe symptoms)
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YMRS and LIFE scores will be lower at 3 months post-intervention as compared to baseline
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Depression at follow-up
Time Frame: MADRS scores will be lower at 3 months post-intervention as compared to baseline
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MADRS scores (described above) across follow-up
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MADRS scores will be lower at 3 months post-intervention as compared to baseline
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Self-rated mania
Time Frame: Lower PMQ scores at post-intervention (10 weeks) and at 1.5 and 3 months follow-ups post-intervention, as compared to baseline
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Patient Health Questionnaire (PMQ) Mania scores (minimum: 0, maximum: 27, higher scores reflect more severe mania)
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Lower PMQ scores at post-intervention (10 weeks) and at 1.5 and 3 months follow-ups post-intervention, as compared to baseline
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Self-rated depression
Time Frame: post-intervention (10 weeks) and at 1.5 and 3 months follow-ups post-intervention, as compared to baseline
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Patient Health Questionnaire (PHQ) Depression scores (minimum: 0, maximum: 27, higher scores reflect more severe depression)
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post-intervention (10 weeks) and at 1.5 and 3 months follow-ups post-intervention, as compared to baseline
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Weekly change in mania severity
Time Frame: Weekly scores from the end of the intervention through 3 months post-intervention
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Longitudinal Interval Follow-up Evaluation (LIFE) weekly mania scores post-treatment as compared to those at baseline.
The investigators will administer the LIFE interview at 6 months after study entry, and interviewers will record a mania severity rating for each week, to cover the time from the end of intervention until 6-month follow-up.
Better outcomes would be reflected in lower LIFE scores post-treatment.
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Weekly scores from the end of the intervention through 3 months post-intervention
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Daily emotional lability as assessed using ecological momentary assessment
Time Frame: 7 weeks post-study entry as compared to baseline
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Mean square of successive difference of negative affect scores within derived from the ecological momentary assessments at 7 weeks post-baseline as compared to baseline.
Participants will be asked to complete negative affect ratings 5 times per day for 7 days, at the baseline and mid-point of treatment.
The investigators will calculate scores to examine the degree of negative affect variability for each day, and then take the average across 7 days at baseline and at treatment mid-point.
Better outcomes would be indicated by lower scores.
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7 weeks post-study entry as compared to baseline
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sheri L Johnson, PhD, University of California, Berkeley
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TRE_Study2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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