Interventions for helping people recognise early signs of recurrence in bipolar disorder
- PMID: 40530762
- PMCID: PMC12175751
- DOI: 10.1002/14651858.CD015343.pub2
Interventions for helping people recognise early signs of recurrence in bipolar disorder
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of EWS plus TAU or EWS plus psychological therapy versus TAU alone or psychological treatment (without EWS) independently on time to recurrence of any bipolar episode and hospitalisation, and other clinically relevant outcome measures. To evaluate the effectiveness of intermittent medication used on recognition of EWS without continued mood-stabilising medication versus TAU involving continued mood-stabilising medication on time to recurrence of any bipolar episodes.
Copyright © 2025 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
Sumeet Gupta: no relevant interests; Consultant Psychiatrist, Tees, Esk and Wear Valleys NHS Foundation Trust, Harrogate, UK.
Laurence Astill Wright: no relevant interests, Clinical Research Fellow at University of Nottingham, Nottingham, UK.
Ogba Onwuchekwa: no relevant interests; Senior Registrar working at Minster Ward, Foss Park Hospital, York, UK.
Lakshmi Ramana Alla: no relevant interests; Consultant Forensic Psychiatrist at Stockton Hall Hospital, Priory Group, York, UK.
Richard K Morriss: Magstim Inc. (Grant/Contract), Electromedical Products Inc, Texas (Grant / Contract), Novartis (Independent Contractor – Data And Safety Monitoring); published randomized controlled trials, clinical guidelines, and meta‐analyses, Universities of Manchester, Liverpool, and Nottingham (funding sources: North West Regional Health Authority, Medical Research Council, National Institute for Health Research).
Rachel Steele: none known.
Nitin Gupta: no relevant interests; Consultant Psychiatrist, Gupta Mind Healing and Counselling Centre, Chandigarh, India.
Nicholas Meader: no relevant interests; Deputy Coordinating Editor for Cochrane Common Mental Disorders (closed in March 2023) and was not involved in the editorial decision‐making for this protocol.
Ryan PW Kenny: none known.
Update of
- doi: 10.1002/14651858.CD015343
Similar articles
-
Interventions for helping people recognise early signs of recurrence in bipolar disorder.Cochrane Database Syst Rev. 2007 Jan 24;2007(1):CD004854. doi: 10.1002/14651858.CD004854.pub2. Cochrane Database Syst Rev. 2007. PMID: 17253526 Free PMC article.
-
Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents.Cochrane Database Syst Rev. 2012 Nov 14;11:CD008324. doi: 10.1002/14651858.CD008324.pub2. Cochrane Database Syst Rev. 2012. Update in: Cochrane Database Syst Rev. 2014 Nov 30;(11):CD008324. doi: 10.1002/14651858.CD008324.pub3. PMID: 23152255 Updated.
-
Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder.Cochrane Database Syst Rev. 2013 Oct 17;2013(10):CD003196. doi: 10.1002/14651858.CD003196.pub2. Cochrane Database Syst Rev. 2013. PMID: 24132760 Free PMC article.
-
Interventions for self-harm in children and adolescents.Cochrane Database Syst Rev. 2015 Dec 21;2015(12):CD012013. doi: 10.1002/14651858.CD012013. Cochrane Database Syst Rev. 2015. PMID: 26688129 Free PMC article.
-
Training to recognise the early signs of recurrence in schizophrenia.Cochrane Database Syst Rev. 2013 Feb 28;2013(2):CD005147. doi: 10.1002/14651858.CD005147.pub2. Cochrane Database Syst Rev. 2013. PMID: 23450559 Free PMC article.
References
Additional references
Agren 2007
-
- Agren H, Backlund L. Bipolar disorder: balancing mood states early in course of illness effects long-term prognosis. Physiology & Behavior 2007;92(1-2):199-202. - PubMed
Al‐Janabi 2012
Altman 1997
-
- Altman EG, Hedeker D, Peterson JL, Davis JM. The Altman Self-Rating Mania Scale. Biological Psychiatry 1997;42(10):948-55. - PubMed
APA 2013
-
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th edition. Washington (DC): American Psychiatric Publishing, 2013.
Bauer 1991
-
- Bauer MS, Crits-Christoph P, Ball WA, Dewees E, McAllister T, Alahi P, et al. Independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania. Archive of General Psychiatry 1991;48(9):807-12. - PubMed
Bauer 2001
-
- Bauer MS, Kirk GF, Gavin C, Williford WO. Determinants of functional outcome and healthcare costs in bipolar disorder: a high-intensity follow-up study. Journal of Affective Disorder 2001;65:231-41. - PubMed
Bauer 2006
-
- Bauer MS, McBride L, Williford WO, Glick H, Kinosian B, Altshuler L, et al. Collaborative care for bipolar disorder: part II. Impact on clinical outcome, function, and costs. Psychiatric Services 2006;57(7):937-45. - PubMed
Bech 1978
-
- Bech P, Rafaelsen OJ, Kramp P, Bolwig TG. Mania Rating Scale: scale construction and interobserver agreement. Neuropharmacology 1978;17(6):430-1. - PubMed
Beck 1961
-
- Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry 1961;4:561-71. - PubMed
Bond 2015
-
- Bond K, Anderson IM. Psychoeducation for relapse prevention in bipolar disorder: a systematic review of efficacy in randomized controlled trials. Bipolar Disorder 2015;17(4):349-62. - PubMed
Brazier 2002
-
- Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics 2002;21(2):271-92. - PubMed
Camacho 2017
-
- Camacho EM, Ntais D, Jones S, Riste L, Morriss R, Lobban F, et al. Cost-effectiveness of structured group psychoeducation versus unstructured group support for bipolar disorder: results from a multi-centre pragmatic randomised controlled trial. Journal of Affective Disorders 2017;211:27-36. - PubMed
Candini 2013
-
- Candini V, Buizza C, Ferrari C, Caldera MT, Ermentini R, Ghilardi A, et al. Is structured group psychoeducation for bipolar patients effective in ordinary mental health services? A controlled trial in Italy. Journal of Affective Disorder 2013;151(1):149-55. - PubMed
Cardoso 2015
-
- Cardoso Tde A, Campos Mondin T, Reyes AN, Zeni CP, Souza LD, da Silva RA, et al. Biological rhythm and bipolar disorder: twelve-month follow-up of a randomized clinical trial. Journal of Nervous and Mental Disease 2015;203(10):792-7. - PubMed
Castle 2010
-
- Castle D, White C, Chamberlain J, Berk M, Berk L, Lauder S, et al. Group-based psychosocial intervention for bipolar disorder: randomised controlled trial. British Journal of Psychiatry 2010;196(5):383-8. - PubMed
Cates 2002
Colom 2003
-
- Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Archives of General Psychiatry 2003;60:402-7. - PubMed
Colom 2009
-
- Colom F, Vieta E, Sánchez-Moreno J, Palomino-Otiniano R, Reinares M, Goikolea JM, et al. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. British Journal of Psychiatry 2009;194(3):260-5. - PubMed
de Barros Pellegrinelli 2013
-
- Barros Pellegrinelli K, O Costa LF, Silval KI, Dias VV, Roso MC, Bandeira M, et al. Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder. Acta Psychiatrica Scandinavica 2013;127(2):153-8. - PubMed
Deeks 2001
-
- Deeks JJ, Altman DG. Effect measures for meta-analysis of trials with binary outcomes. In: Systematic Reviews in Health Care: Meta-analysis in Context. Vol. 2. London (UK): BMJ Publication Group, 2001:313-35.
Depp 2015
Egger 1997
Faurholt‐Jepsen 2015
Gelenberg 1989
-
- Gelenberg AJ, Kane JM, Keller MB, Lavori P, Rosenbaum JF, Cole K, et al. Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. New England Journal of Medicine 1989;321(22):1489-93. - PubMed
Gitlin 1995
-
- Gitlin MJ, Swendsen J, Heller TL, Hammen C. Relapse and impairment in bipolar disorder. American Journal of Psychiatry 1995;152:1635-40. - PubMed
Goldberg 1995
-
- Goldberg JF, Harrow M, Grossman LS. Course and outcome in bipolar affective disorder: a longitudinal follow-up study. American Journal of Psychiatry 1995;152(2):379-84. - PubMed
Goldman 1992
-
- Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: a review of measures of social functioning (Diagnostic and Statistical Manual of Mental Disorders) (special article). American Journal of Psychiatry 1992;149(9):1148-56. - PubMed
Goodwin 2016
Hamilton 1960
Higgins 2011
Higgins 2012
Higgins 2021
-
- Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from training.cochrane.org/handbook/archive/v6.2.
Hurry 1983
-
- Hurry J, Sturt E, Bebbington P, Tennant C. Socio-demographic associations with social disablement in a community sample. Social Psychiatry 1983;18(3):113-21. - PubMed
Husain 2017
Isasi 2010
Jackson 2003
-
- Jackson A, Cavanagh J, Scott J. A systematic review of manic and depressive prodromes. Journal of Affective Disorders 2003;74(3):209-17. - PubMed
Joas 2020
Jones 2013
-
- Jones S, Mulligan LD, Higginson S, Dunn G, Morrison AP. The bipolar recovery questionnaire: psychometric properties of a quantitative measure of recovery experiences in bipolar disorder. Journal of Affective Disorders 2013;147(1):34-43. - PubMed
Judd 2002
-
- Judd LL, Akiskal HS, Schlettler PJ, Endicott J, Maser J, Solomon DA, et al. The long-term natural history of the weekly symptomatic status of bipolar 1 disorder. Archives of General Psychiatry 2002;59(6):530-7. - PubMed
Judd 2003
-
- Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry 2003;60(3):261-9. - PubMed
Keck 1998
-
- Keck PE, McElroy SL, Strakowski SM, West SA, Sax KW. 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. American Journal of Psychiatry 1998;155:646-52. - PubMed
Keller 1987
-
- Keller MB, Lavori PW, Friedman B, Nielsen E, Endicott J, McDonald-Scott P, et al. The Longitudinal Interval Follow-up Evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry 1987;44(6):540-8. - PubMed
Kroenke 2001
Lauder 2015
-
- Lauder S, Chester A, Castle D, Dodd S, Gliddon E, Berk L, et al. A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder. Journal of Affective Disorder 2015;171:13-21. - PubMed
Lobban 2011
Lobban 2017
-
- Lobban F, Dodd AL, Sawczuk AP, Asar O, Dagnan D, Diggle PJ, et al. Assessing feasibility and acceptability of web-based enhanced relapse prevention for bipolar disorder (ERPonline): a randomized controlled trial. Journal of Medical Internet Research 2017;19(3):e85. [DOI: 10.2196/jmir.7008] - DOI - PMC - PubMed
Maczka 2010
-
- Maczka G, Grabski B, Gierowski JK, Dudek D. Group psychoeducation in the complex treatment of bipolar disorder – Cracow experiences. Psychiatria Polska 2010;44(1):89-100. - PubMed
Madigan 2012
McIntyre 2020
-
- McIntyre RS, Berk M, Brietzke E, Goldstein BI, López-Jaramillo C, Kessing LV, et al. Bipolar disorders. Lancet 2020;396(10265):1841-56. - PubMed
Montgomery 1979
-
- Montgomery SA, Asberg M. A new depression rating scale designed to be sensitive to change. British Journal of Psychiatry 1979;134:382-9. - PubMed
Morriss 2016
-
- Morriss R, Lobban F, Riste L, Davies L, Holland F, Long R. 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 2016;3(11):1029-38. - PubMed
Mundt 2002
-
- Mundt J, Marks I, Shear M, Greist J. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry 2002;180(5):461-4. - PubMed
NICE 2014
-
- National Institute for Health and Care Excellence (NICE). Bipolar disorder: assessment and management (clinical guideline CG185). www.nice.org.uk/guidance/cg185 (accessed 25 October 2021).
Nikolakopoulou 2020
Oud 2016
-
- Oud M, Mayo-Wilson E, Braidwood R, Schulte P, Jones SH, Morriss R, et al. Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis. British Journal of Psychiatry 2016;208(3):213-22. - PubMed
Perry 1999
Rabin 2001
-
- Rabin R, Charro F. EQ-5D: a measure of health status from the EuroQol Group. Annals of Medicine 2001;33(5):337-43. - PubMed
Review Manager Web 2020 [Computer program]
-
- Review Manager Web (RevMan Web). Version 3.11.1. The Cochrane Collaboration, 2020. Available at revman.cochrane.org.
Rush 2003
-
- Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, et al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry 2003;54(5):573-83. - PubMed
Rücker 2020
Scott 2007
-
- Scott J, Colom F, Vieta E. A meta-analysis of relapse rates with adjunctive psychological therapies compared to usual psychiatric treatment for bipolar disorders. International Journal of Neuropsychopharmacology 2007;10:123-9. - PubMed
Semahegn 2020
Sierra 2007
-
- Sierra P, Livianos L, Arques S, Castelló J, Rojo L. Prodromal symptoms to relapse in bipolar disorder. Australia and New Zealand Journal of Psychiatry 2007;41(5):385-91. - PubMed
Smith 2011
-
- Smith DJ, Griffiths E, Poole R, di Florio A, Barnes E, Kelly MJ, et al. Beating bipolar: exploratory trial of a novel Internet-based psychoeducational treatment for bipolar disorder. Bipolar Disorder 2011;13(5-6):571-7. - PubMed
Tierney 2007
Todd 2014
-
- Todd NJ, Jones SH, Hart A, Lobban FA. A web-based self-management intervention for bipolar disorder 'living with bipolar': a feasibility randomised controlled trial. Journal of Affective Disorder 2014;169:21-9. - PubMed
Treuer 2010
-
- Treuer T, Tohen M. Predicting the course and outcome of bipolar disorder: a review. European Psychiatry 2010;25(6):328-33. - PubMed
Ware 1992
-
- Ware JE Jr, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Medical Care 1992;30(6):473-83. - PubMed
Weissman 1978
-
- Weissman MM, Prusoff BA, Thompson WD, Harding PS, Myers JK. Social adjustment by self-report in a community sample and in psychiatric outpatients. Journal of Nervous and Mental Disease 1978;166(5):317-26. - PubMed
Whiteford 2013
-
- Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013;382(9904):1575-86. - PubMed
WHO 1992
-
- World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. International Classification of Diseases 10th Revision. Geneva (Switzerland): World Health Organization, 1992.
Wong 1999
-
- Wong G, Lam K. The development and validation of the coping inventory for prodromes of mania. Journal of Affective Disorder 1999;53:57-65. - PubMed
Young 1978
Zigmond 1983
-
- Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 1983;67(6):361-70. - PubMed
References to other published versions of this review
Morriss 2004
Morriss 2007
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical