A Successful, Internet Based Self-Help Program For Bipolar Illness

In the great tradition of Aussie online mental health services, researchers from the University of Melbourne and Royal Melbourne Hospital performed a comparative evaluation of two online programs, hosted on a single website (www.moodswings.net.au), to help treat bipolar illness.

A basic version, called MoodSwings (MS), containing psycho-education material and asynchronous discussion boards was compared to a more interactive program, MoodSwings Plus (MS-Plus), combining the basic psycho-education material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design.

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.

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 and scores at 12 months (p=0.02) but not on the incidence of recurrence.

The investigators note the limitations of this study: there was no attention control group and therefore it could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline.

The 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.

Citation: Lauder S1, Chester A2, Castle D3, Dodd S4, Gliddon E4, Berk L5, Chamberlain J6, Klein B7, Gilbert M6, Austin DW8, Berk M9. A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder. Journal of Affective Disorders 2015 Jan 15;171:13-21. doi: 10.1016/j.jad.2014.08.008. Epub 2014 Sep 22. [email protected]