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Intensive Follow-Up Care Helped Some: In a random-assignment study of 441 bipolar adults receiving usual care or usual care plus a systematic care management program including: initial assessment and care planning, monthly telephone monitoring including brief symptom assessment and medication monitoring, feedback to and coordination with the mental health treatment team, and a structured group psychoeducational program--all provided by a nurse care manager, the intervention group had lower mania ratings averaged across the 12-month follow-up period (p=0.015) and one-third less time in hypomanic or manic episode (2.59 weeks v. 1.69 weeks or 6 days less). Mean depression ratings across the entire follow-up period did not differ significantly between the two groups, but the intervention group showed a greater decline in depression ratings over time (p = 0.048). Preliminary results suggest a growing effect on depression over time, but longer follow-up will be needed. Randomized trial of a population-based care program for people with bipolar disorder. Simon GE, Ludman EJ, et al. Group Health Cooperative, Seattle, WA. Psychol Med. 2005 Jan;35(1):13-24. Neither of Two Family Therapy Interventions Helped: In a study of 92 bipolar I patients randomly assigned to family therapy plus pharmacotherapy, multifamily psychoeducational group therapy plus pharmacotherapy, or pharmacotherapy alone, neither adjunctive family therapy nor adjunctive multifamily psychoeducational group therapy significantly improved the rate of recovery from mood episodes. Does adjunctive family therapy enhance recovery from bipolar I mood episodes? Miller IW, Solomon DA, et al. Brown University, Providence, RI. J Affect Disord. 2004 Nov 1;82(3):431-6. |