Individual experiences of psychological-based interventions for bipolar disorder: A systematic review and thematic synthesis

Kelly Davenport, Gillian Hardy, Sara Tai, Warren Mansell, Kelly Davenport, Gillian Hardy, Sara Tai, Warren Mansell

Abstract

Purpose: To conduct a thematic synthesis to evaluate qualitative studies exploring individuals' experiences of psychological-based interventions for bipolar disorder (BD).

Method: A systematic search of relevant databases (Web of Science, PsycINFO, MEDLINE, CINAHL) was conducted using predefined search terms related to 'Bipolar' 'Qualitative method', 'Psychological-based interventions' and 'Adults'. Studies meeting the inclusion criteria were selected and were then evaluated using established quality appraisal criteria. A thematic synthesis was used to synthesize the findings.

Results: From the thematic synthesis, nine analytical themes were derived from the 10 identified research studies. These were helpful and unhelpful aspects of the intervention, increased knowledge of BD, mood recognition, control of moods, change of perspective, mood stability, empowerment, improved relationships and lifestyle changes.

Conclusions: Findings from the review suggest there were characteristics of psychological-based interventions that individuals with BD valued and which helped facilitate areas of positive change, such as feeling empowered and in control of their moods and other aspects of their lives. However, there were also elements that individuals did not find as helpful and therefore reflects the challenge of a one-size-fits-all model or plan of interventions, compared to a wider recognition of the individuals as being the agent of their recovery. Future qualitative research is needed to explore individual experiences across a range of psychological interventions, in order to further understand the therapeutic processes, which may facilitate recovery.

Practitioner points: Psychological-based interventions for BD need to consider facilitating and measuring empowerment in individuals, rather than focusing just on mood stability. Clinicians with expertise and knowledge in BD should provide timely information to individuals and their families to help increase their understanding of the diagnosis.

Keywords: bipolar disorder; psychological interventions; qualitative research; systematic review; thematic synthesis; user perspectives.

© 2018 The British Psychological Society.

References

    1. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
    1. Barker, J. A. (2002). The service and illness experiences described by users of the Mood Swing Network. Journal of Mental Health, 11, 453-463.
    1. Barnett-Page, E., & Thomas, J. (2009). Methods for the synthesis of qualitative research: A critical review. BMC Medical Research Methodology, 9, 1-11.
    1. Billsborough, J., Mailey, P., Hicks, A., Sayers, R., Smith, R., Clewett, N., & Larsen, J. (2014). Listen, empower us and take action now!’: Reflexive-collaborative exploration of support needs in bipolar disorder when ‘going up’ and ‘going down. Journal of Mental Health, 23, 9-14.
    1. Castle, D., White, C., Chamberlain, J., Berk, M., Berk, L., Lauder, S., … Gilbert, M. (2010). Group-based psychosocial intervention for bipolar disorder: Randomised controlled trial. The British Journal of Psychiatry, 96, 383-388.
    1. *Chadwick, P., Kaur, H., Swelam, M., Ross, S., & Ellett, L. (2011). Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychotherapy Research, 21, 277-285.
    1. Coleman, S. J., Stevelink, S. A., Hatch, S. L., Denny, J. A., & Greenberg, N. (2017). Stigma-related barriers and facilitators to help seeking for mental health issues in the armed forces: A systematic review and thematic synthesis of qualitative literature. Psychological Medicine, 47, 1880-1892.
    1. Colom, F., Vieta, E., Sánchez-Moreno, J., Palomino-Otiniano, R., Reinares, M., Goikolea, J. M., … Martinez-Arán, A. (2009). Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. The British Journal of Psychiatry, 194, 260-265.
    1. Cook, T. & Camphell, D. T. (1979). Quasi-experimentation: Design and analysis issues for field settings. Boston, MA: Houghton Mifflin.
    1. Costa, R. T., Cheniaux, E., Rangé, B. P., Versiani, M., & Nardi, A. E. (2012). Group cognitive behavior therapy for bipolar disorder can improve the quality of life. Brazilian Journal of Medical and Biological Research, 45, 862-868.
    1. Critical Appraisal Skills Programme. (2010). Making sense of evidence about clinical effectiveness: 10 questions to help you make sense of qualitative research. Retrieved from
    1. Depp, C. A., Ceglowski, J., Wang, V. C., Yaghouti, F., Mausbach, B. T., Thompson, W. K., & Granholm, E. L. (2015). Augmenting psychoeducation with a mobile intervention for bipolar disorder: A randomized controlled trial. Journal of Affective Disorders, 174, 23-30.
    1. Devereux-Fitzgerald, A., Powell, R., Dewhurst, A., & French, D. P. (2016). The acceptability of physical activity interventions to older adults: A systematic review and meta-synthesis. Social Science and Medicine, 158, 14-23.
    1. Dixon-Woods, M., Agarwal, S., Jones, D., Young, B., & Sutton, A. (2005). Synthesising qualitative and quantitative evidence: a review of possible methods. Journal of Health Services Research and Policy, 10, 45-53.
    1. Dixon-Woods, M., Sutton, A., Shaw, R., Miller, T., Smith, J., Young, B., & Jones, D. (2007). Appraising qualitative research for inclusion in systematic reviews: A quantitative and qualitative comparison of three methods. Journal of Health Services Research and Policy, 12, 42-47.
    1. *Evans, M., Kellett, S., Heyland, S., Hall, J., & Majid, S. (2016). Cognitive analytic therapy for bipolar disorder: A pilot randomized controlled trial. Clinical Psychology and Psychotherapy, 24, 22-35.
    1. Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. Lancet Psychiatry, 381, 1672-1682.
    1. Goldstein, T. R., Fersch-Podrat, R. K., Rivera, M., Axelson, D. A., Merranko, J., Yu, H., … Birmaher, B. (2014). Dialectical behavior therapy for adolescents with bipolar disorder: Results from a pilot randomized trial. Journal of Child and Adolescent Psychopharmacology, 25, 140-149.
    1. Gomes, B. C., Abreu, L. N., Brietzke, E., Caetano, S. C., Kleinman, A., Nery, F. G., & Lafer, B. (2011). A randomized controlled trial of cognitive behavioral group therapy for bipolar disorder. Psychotherapy and Psychosomatics, 80, 144-150.
    1. Harper, D., & Thompson, A. R. (2012). Qualitative research methods in mental health and psychotherapy: A guide for student and practitioners. Chichester, UK: Wiley.
    1. Inder, M. L., Crowe, M. T., Luty, S. E., Carter, J. D., Moor, S., Frampton, C. M., & Joyce, P. R. (2015). Randomized, controlled trial of interpersonal and social rhythm therapy for young people with bipolar disorder. Bipolar Disorders, 17, 128-138.
    1. Jauhar, S., McKenna, P. J., & Laws, K. R. (2016). NICE guidance on psychological treatments for bipolar disorder: Searching for the evidence. Lancet Psychiatry, 3, 386-388.
    1. Jones, S. H., Smith, G., Mulligan, L. D., Lobban, F., Law, H., Dunn, G., … Morrison, A. P. (2015). Recovery-focused cognitive-behavioural therapy for recent-onset bipolar disorder: Randomised controlled pilot trial. The British Journal of Psychiatry, 206, 58-66.
    1. *Joyce, E., Tai, S., Gebbia, P., & Mansell, W. (2016). What are people's experiences of a novel cognitive behavioural therapy for bipolar disorders? A qualitative investigation with participants on the TEAMS trial. Clinical Psychology and Psychotherapy, 21, 1-15.
    1. Katsakou, C., & Pistrang, N. (2017). Clients’ experiences of treatment and recovery in borderline personality disorder: A meta-synthesis of qualitative studies. Psychotherapy Research, 31, 1-18.
    1. Madill, A., Jordan, A., & Shirley, C. (2000). Objectivity and reliability in qualitative analysis: Realist, contextualist and radical constructionist epistemologies. British Journal of Psychology, 91, 1-20.
    1. Maniglio, R. (2013). The impact of child sexual abuse on the course of bipolar disorder: A systematic review. Bipolar Disorders, 15, 341-358.
    1. Mansell, W., Morrison, A. P., Reid, G., Lowens, I., & Tai, S. (2007). The interpretation of, and response to, changes in internal states: An integrative cognitive model of mood swings and bipolar disorders. Behavioural and Cognitive Psychotherapy, 35, 515-539.
    1. Mansell, W., Powell, S., Pedley, R., Thomas, N., & Jones, S. A. (2010). The process of recovery from bipolar I disorder: A qualitative analysis of personal accounts in relation to an integrative cognitive model. British Journal of Clinical Psychology, 49, 193-215.
    1. McIntyre, R. S., Soczynska, J. K., Bottas, A., Bordbar, K., Konarski, J. Z., & Kennedy, S. H. (2006). Anxiety disorders and bipolar disorder: A review. Bipolar Disorders, 8, 665-676.
    1. Medical Research Council (2008). Developing and evaluating complex interventions: The new medical research council guidance. British Medical Journal, 337, 1-6.
    1. *Menezes, S. L., & Conceicao, M. (2012). The implications of a psychoeducation group on the everyday lives of individuals with bipolar affective disorder. Revista da Escola de Enfermagem da USP, 46, 120-127.
    1. Miklowitz, D. J., Axelson, D. A., Birmaher, B., George, E. L., Taylor, D. O., Beresford, B. A., … Brent, D. A. (2008). Family-focused treatment for adolescents with bipolar disorder: Results of a 2-year randomized trial. Archives of General Psychiatry, 65, 1053-1061.
    1. Miklowitz, D. J., O'Brien, M. P., Schlosser, D. A., Addington, J., Candan, K. A., Marshall, C., … Cannon, T. D. (2014). Family-focused treatment for adolescents and young adults at high risk for psychosis: Results of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 848-858.
    1. Miklowitz, D. J., Schneck, C. D., Singh, M. K., Taylor, D. O., George, E. L., Cosgrove, V. E., … Chang, K. D. (2013). Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 121-131.
    1. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group (2010). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. International Journal of Surgery, 8, 336-341.
    1. *Morriss, R., Lobban, F., Riste, L., Davies, L., Holland, F., Long, R., … Jones, S. (2016). Clinical effectiveness and acceptability of structured group psychoeducation versus optimised unstructured peer support for patients with remitted bipolar disorder (PARADES): A pragmatic, multicentre, observer-blind, randomised controlled superiority trial. Lancet Psychiatry, 3, 1029-1038.
    1. National Institute for Health and Clinical Excellence. (2015). Bipolar disorder in adults (QS95). Retrieved from
    1. Nivoli, A. M., Colom, F., Pacchiarotti, I., Murru, A., Scott, J., Valenti, M., … Vieta, E. (2013). Treatment strategies according to clinical features in naturalistic cohort study of bipolar patients: A principal component analysis of lifetime pharmacological and biophysic treatment option. European Neuropsychopharmacology, 23, 263-275.
    1. Noblit, J. W. & Hare, R. D. (1988). Meta-ethnography: synthesizing qualitative studies. London, UK: Sage.
    1. Novick, D., Haro, J. M., Suarez, D., Perez, V., Dittmann, R. W., & Haddad, P. M. (2010). Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia. Psychiatry Research, 176, 109-113.
    1. *O'Connor, C., Gordon, O., Graham, M., Kelly, F., & O'Grady-Walshe, A. (2008). Service user perspectives of a psychoeducation group for individuals with a diagnosis of bipolar disorder. The Journal of Nervous and Mental Disease, 196, 568-571.
    1. Oud, M., Mayo-Wilson, E., Braidwood, R., Schulte, P., Jones, S. H., Morriss, R., … Kendall, T. (2016). Psychological interventions for adults with bipolar disorder: Systematic review and meta-analysis. The British Journal of Psychiatry, 208, 213-222.
    1. Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: Systematic review and meta-analysis. The British Journal of Psychiatry, 209, 454-459.
    1. Perich, T., Manicavasagar, V., Mitchell, P. B., & Ball, J. R. (2013). The association between meditation practice and treatment outcome in Mindfulness-based Cognitive Therapy for bipolar disorder. Behaviour Research and Therapy, 51, 338-343.
    1. *Pontin, E., Peters, S., Lobban, F., Rogers, A., & Morriss, R. K. (2009). Enhanced relapse prevention for bipolar disorder: A qualiitative investigation of value for services users and care coordinators. Implementation Science, 4, 1-12.
    1. *Poole, R., Simpson, S. A., & Smith, D. J. (2012). Internet-based psychoeducation for bipolar disorder: A qualitative analysis of feasibility, acceptability and impact. BMC Psychiatry, 12, 1-10.
    1. *Poole, R., Smith, D., & Simpson, S. (2015). Patients’ perspectives of the feasibility, acceptability and impact of a group-based psychoeducation programme for bipolar disorder: A qualitative analysis. BMC Psychiatry, 15, 1-16.
    1. Proudfoot, J., Parker, G., Manicavasagar, V., Hadzi-Pavlovic, D., Whitton, A., Nicholas, J., … Burckhardt, R. (2012). Effects of adjunctive peer support on perceptions of illness control and understanding in an online psychoeducation program for bipolar disorder: A randomised controlled trial. Journal of Affective Disorders, 142, 98-105.
    1. Reinares, M., Sánchez-Moreno, J., & Fountoulakis, K. N. (2014). Psychosocial interventions in bipolar disorder: What, for whom, and when. Journal of Affective Disorders, 156, 46-55.
    1. Rosa, A., Reinares, M., Michalak, E., Bonnin, C., Sole, B., Franco, C., … Vieta, E. (2010). Functional impairment and disability across mood states in bipolar disorder. Value in Health, 13, 984-988.
    1. Royal College of Psychiatrists (2015). Bipolar disorder. Retrieved from
    1. Salcedo, S., Gold, A. K., Marcus, P. H., Nierenberg, A. A., Deckersbach, T., & Sylvia, L. G. (2016). Empirically supported psychosocial interventions for bipolar disorder: Current state of the research. Journal of Affective Disorders, 201, 203-214.
    1. Sayer, A. (2000). Realism and social science. London, UK: Sage.
    1. Scott, J., Paykel, E., Morriss, R., Bentall, R., Kinderman, P., Johnson, T., … Hayhurst, H. (2006). Cognitive-behavioural therapy for severe and recurrent bipolar disorders: Randomised controlled trial. The British Journal of Psychiatry, 188, 313-320.
    1. Shaw, R. L. (2010). Conducting literature reviews. In M. Forrester (Ed.), Doing qualitative research in psychology: A practical guide (pp. 40-49). London, UK: Sage.
    1. Shaw, R. L. (2012). Identifying and synthesizing qualitative literature. In D. Harper & A. R. Thompson (Eds.), Qualitative research methods in mental health and psychotherapy: A guide for students and practitioners (pp. 9-22). Chichester, UK: Wiley.
    1. *Straughan, H., & Buckenham, M. (2006). In-sight: An evaluation of user-led, recovery-based, holistic group training for bipolar disorder. Journal of Public Mental Health, 5, 29-43.
    1. Swartz, H. A., Levenson, J. C., & Frank, E. (2016). Psychotherapy for bipolar II disorder: The role of interpersonal and social rhythm therapy. Professional Psychology, Research and Practice, 43, 120-129.
    1. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 8-45.
    1. Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12, 1-8.
    1. Toye, F., Seers, K., Allcock, N., Briggs., M., Carr, E., & Barker, K. (2014). Meta-ethnography 25 years on: Challenges and insights for synthesising a large number of qualitative studies. BMC Medical Research Methodology, 14, 1-14.
    1. Van Dijk, S., Jeffrey, J., & Katz, M. R. (2013). A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder. Journal of Affective Disorders, 145, 386-393.
    1. Vieta, E., Langosch, J. M., Figueria, M. L., Souery, D., Blasco-Colmenares, E., Medina, E., … Bellivier, F. (2013). Clinical management and burden of bipolar disorder: Results from a multinational longitudinal study (WAVE-bd). International Journal of Neuropsychopharmacology, 16, 1719-1732.
    1. Williams, J. M., Russell, I., & Russell, D. (2008). Mindfulness-based cognitive therapy: Further issues in current evidence and future research. Journal of Consulting and Clinical Psychology, 76, 524-529.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit