Evidence map›Paper›PMID 29665518›Full record

Trial reportJournal of affective disorders2018

Early intervention for adolescents at-risk for bipolar disorder: A pilot randomized trial of Interpersonal and Social Rhythm Therapy (IPSRT).

Tina R Goldstein, John Merranko, Megan Krantz, Matthew Garcia, Peter Franzen, Jessica Levenson, David Axelson, Boris Birmaher, Ellen Frank

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of affective disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 6% of its field
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

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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  20. Sleep and Circadian Rhythm Disorder in Bipolar Affective Disorder.Current topics in behavioral neurosciences · 2021
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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

9 authors at 3 institutions in 1 country.

Tina R GoldsteinWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: goldsteintr@upmc.edu.
John MerrankoWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Megan KrantzWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Matthew GarciaWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Peter FranzenWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jessica LevensonWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
David AxelsonNationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Boris BirmaherWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ellen FrankWestern Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
University of Pittsburgh Medical Center · USNationwide Children's Hospital · USUPMC Health System · US

Funding

Early Assessment and Intervention for Adolescents at Risk for Bipolar DisorderR34MH091177 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI GOLDSTEIN, TINA R · 2011 to 2013
$673k
Targeted Intervention for Insufficient Sleep among Typically-Developing AdolescentsK23HD087433 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI LEVENSON, JESSICA C · 2017 to 2021
$670k
NICHD NIH HHS K23 HD087433NIMH NIH HHS R34 MH091177
6 · The paper itself

Abstract

objectiveTo conduct a pilot randomized trial of Interpersonal and Social Rhythm Therapy plus Data-Informed Referral (IPSRT + DIR) versus DIR-alone for adolescents at-risk for bipolar disorder (BP).

methodEligible participants included youth (12-18) with a BP parent; youth with BP were excluded. Participants (n = 42) were randomized to receive IPSRT + DIR to treat any psychiatric disorders present at baseline, or DIR-alone. A blind evaluator assessed outcomes at baseline, 3- and 6-months. Participants wore an actigraph to measure sleep/wake patterns for 7 days at baseline and 6-months. Primary outcomes included mood and non-mood symptoms and sleep disturbance.

resultsYouth randomized to IPSRT + DIR attended approximately half of scheduled IPSRT sessions. Although 33% of DIR-alone youth were referred for mental health services at intake (another 33% were already engaged in services), none initiated new services over follow-up. No youth developed new-onset mood disorder over follow-up. Self- and parent-reported mood and non-mood psychiatric symptoms did not distinguish the groups, although youth in DIR-alone tended to have higher baseline scores on most measures. Per clinician ratings, 1 youth receiving IPSRT + DIR displayed subthreshold hypo/manic symptoms, versus 2 receiving DIR-alone (OR = 14.7, p = 0.03), possibly signaling less subthreshold hypo/manic symptoms, and for fewer weeks (χ LIMITATIONS: Small sample size limits statistical power, and we are unable to definitively attribute group differences to IPSRT versus greater clinical contact. Ability to examine distal/rare (i.e., BP onset) outcomes was limited.

conclusionsAdolescents at-risk for BP present challenges to psychosocial treatment engagement and retention. IPSRT merits further study as an acceptable intervention for at-risk youth, though necessary frequency and intensity to affect outcomes should be examined. The potential to delay or prevent subthreshold hypo/manic symptoms via enhanced sleep continuity is an area for further examination. Future studies with larger samples and extended follow-up can help determine whether IPSRT may delay or prevent syndromal hypo/mania in youth at-risk.

Indexed as

ActigraphyAdolescentAffectBipolar DisorderChildFemaleHumansMaleParentsPilot ProjectsPsychiatric Status Rating ScalesPsychotherapyRiskSleep Wake DisordersBipolar disorderEarly interventionOffspringRisk

Identifiers

PMID29665518
PMCPMC5951768
OpenAlexW2795505895

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.