A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder

Sue Lauder; Andrea Chester; David Castle; Seetal Dodd; Emma Gliddon; Lesley Berk; James Chamberlain; Britt Klein; Monica Gilbert; David W Austin; Michael Berk

doi:10.1016/j.jad.2014.08.008

A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder

J Affect Disord. 2015 Jan 15;171:13-21. doi: 10.1016/j.jad.2014.08.008. Epub 2014 Sep 22.

Authors

Sue Lauder¹, Andrea Chester², David Castle³, Seetal Dodd⁴, Emma Gliddon⁴, Lesley Berk⁵, James Chamberlain⁶, Britt Klein⁷, Monica Gilbert⁶, David W Austin⁸, Michael Berk⁹

Affiliations

¹ The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia. Electronic address: suela@barwonhealth.org.au.
² RMIT University, Building 6, Level 5 Bowen Street, Melbourne 3000, Australia.
³ The University of Melbourne, Department of Psychiatry, St Vincent׳s Hospital, P.O. Box, 2900, Fitzroy 3065, Australia.
⁴ The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia.
⁵ The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia.
⁶ Healthmaps Pty Ltd, PO Box 2501, Fitzroy, 3065 Melbourne, Australia.
⁷ DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia; National Institute for Mental Health Research, The Australian National University, Building 63, Canberra 2000, Australia; National eTherapy Center, Swinburne University of Technology, Hawthorn, Victoria, Australia.
⁸ Deakin University, School of Psychology, Faculty of Health, Burwood Campus, 221 Burwood Highway, Burwood 3125, Victoria Australia.
⁹ The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052 Parkville, Victoria, Australia.

PMID: 25282145
DOI: 10.1016/j.jad.2014.08.008

Abstract

Background: Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design.

Method: Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence.

Results: Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence.

Limitations: The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline.

Conclusion: This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.

Keywords: Bipolar disorder; CBT; Internet; Online; Psychoeducation; Psychological.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Bipolar Disorder / psychology
Bipolar Disorder / therapy*
Cognitive Behavioral Therapy / methods*
Female
Follow-Up Studies
Health Behavior
Humans
Internet*
Male
Medication Adherence / psychology
Medication Adherence / statistics & numerical data
Middle Aged
Patient Education as Topic / methods*
Program Evaluation / methods*
Program Evaluation / statistics & numerical data
Quality of Life / psychology
Recurrence
Self Care / methods*
Self Care / psychology
Self Care / statistics & numerical data
Social Support
Therapy, Computer-Assisted / methods*
Treatment Outcome
Young Adult

Associated data

ANZCTR/12607000118404