(Kellet, S & Evans, M) CATBiD: A phase one randomised controlled study of Cognitive Analytic Therapy for Bipolar Affective Disorder
Bipolar disorder is a severe and enduring mental disorder with a lifetime prevalence estimated at about 1% for which there is little clear evidence of the efficacy of psychological treatments.
This pilot project evaluated the acceptability of cognitive analytic therapy(CAT) as a treatment for patients with bipolar disorder as well as various secondary outcomes. The evidence for its efficacy in reducing relapse, service use and symptoms are presented.
Study design was a randomised controlled trial. Participants in the active treatment arm of the trial received treatment as usual (TAU) plus 24 weekly sessions of CAT followed by four review sessions( at 1, 2, 3 and 6 months post therapy). Participants in the control arm of the trial (TAU) received usual care from their clinical team consisting of psychiatric outpatient appointments and community team support when required.
Primary outcome measures included: total number of CAT sessions completed and acceptability of the therapy using qualitative methodology. Secondary outcome measures include: no of relapses, use of community and inpatient mental health services . and a variety of symptom measures (BDI,MADRS-Depression, Bech Rafaelson Mania Rating scale, CORE, Personality Structure Questionnaire) and a measure of work and social adjustment (WSAS).
The electronic health record system (AMIGOS ) was used to review number and length of any admissions to inpatient wards, crisis resolution and Home Treatment teams or Assertive Outreach Teams. This record was also used to gauge the number of community team and outpatient appointments.
The results of the acceptability of CAT as a potential treatment for Bipolar disorder together with results from secondary outcome measures was presented at the ICATA conference and is now in the review stage with the Psychotherapy Research Journal.
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