Evidence map›Paper›PMID 28577505›Full record

ArticleJournal of affective disorders2017

Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial.

Kristen K Ellard, Emily E Bernstein, Casey Hearing, Ji Hyun Baek, Louisa G Sylvia, Andrew A Nierenberg, David H Barlow, Thilo Deckersbach

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In one paragraph

Article in Journal of affective disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  18. Transdiagnostic psychiatry: a systematic review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kristen K EllardDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Electronic address: kellard@mgh.harvard.edu.
Emily E BernsteinDepartment of Psychology, Harvard University, Cambridge, MA, USA.
Casey HearingDepartment of Psychology, George Washington University, USA.
Ji Hyun BaekDepartment of Psychiatry, Sungkyunkwan University Samsung Medical Centre, Gyeonggi-do, Republic of Korea.
Louisa G SylviaDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Andrew A NierenbergDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
David H BarlowDepartment of Psychology, Boston University, Boston, MA, USA.
Thilo DeckersbachDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Funding

Training Program in Recovery and Restoration of CNS health and functionT32NS100663 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI LEIGH R HOCHBERG, JONATHAN ROSAND · 2017 to 2026
$2.5M
Transdiagnostic Treatment for Anxiety and Bipolar I DisorderF32MH098490 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI ELLARD, KRISTEN K · 2012 to 2013
$99k
NIMH NIH HHS F32 MH098490NINDS NIH HHS T32 NS100663
6 · The paper itself

Abstract

backgroundComorbid anxiety in bipolar disorder (BD) is associated with greater illness severity, reduced treatment response, and greater impairment. Treating anxiety in the context of BD is crucial for improving illness course and outcomes. The current study examined the feasibility, acceptability and preliminary efficacy of the Unified Protocol (UP), a transdiagnostic cognitive behavioral therapy, as an adjunctive treatment to pharmacotherapy for BD and comorbid anxiety disorders.

methodsTwenty-nine patients with BD and at least one comorbid anxiety disorder were randomized to pharmacotherapy treatment-as-usual (TAU) or TAU with 18 sessions of the UP (UP+TAU). All patients completed assessments every four weeks to track symptoms, functioning, emotion regulation and temperament. Linear mixed-model regressions were conducted to track symptom changes over time and to examine the relationship between emotion-related variables and treatment response.

resultsSatisfaction ratings were equivalent for both treatment groups. Patients in the UP+TAU group evidenced significantly greater reductions over time in anxiety and depression symptoms (Cohen's d's>0.80). Baseline levels of neuroticism, perceived affective control, and emotion regulation ability predicted magnitude of symptom change for the UP+TAU group only. Greater change in perceived control of emotions and emotion regulation skills predicted greater change in anxiety related symptoms. LIMITATIONS: This was a pilot feasibility and acceptability trial; results should be interpreted with caution.

conclusionsTreatment with the UP+TAU was rated high in patient satisfaction, and resulted in significantly greater improvement on indices of anxiety and depression relative to TAU. This suggests that the UP may be a feasible treatment approach for BD with comorbid anxiety.

Indexed as

AdultAntipsychotic AgentsAnxietyBipolar DisorderClinical ProtocolsCognitive Behavioral TherapyCombined Modality TherapyComorbidityEmotionsFeasibility StudiesFemaleHumansMaleMiddle AgedPatient SatisfactionPilot ProjectsAntipsychotic AgentsAnxiety disordersBipolar disorderCognitive behavioral therapyEmotion regulationTransdiagnostic

Identifiers

PMID28577505
PMCPMC5571649

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.