A randomized head to head trial of MoodSwings.net.au: An internet based self-help program for bipolar disorder
- Lauder, Sue, Chester, Andrea, Castle, David, Dodd, Seetal, Gliddon, Emma, Berk, Lesley, Chamberlain, James, Klein, Britt, Gilbert, Monica, Austin, David, Berk, Michael
- Authors: Lauder, Sue , Chester, Andrea , Castle, David , Dodd, Seetal , Gliddon, Emma , Berk, Lesley , Chamberlain, James , Klein, Britt , Gilbert, Monica , Austin, David , Berk, Michael
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 171, no. (2014), p. 13-21
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- Description: Background Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. Method 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. Results 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 scores at 12 months (p=0.02) but not on the incidence of recurrence. Limitations The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. Conclusion This 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. © 2014 Elsevier B.V. All rights reserved.
- Authors: Lauder, Sue , Chester, Andrea , Castle, David , Dodd, Seetal , Gliddon, Emma , Berk, Lesley , Chamberlain, James , Klein, Britt , Gilbert, Monica , Austin, David , Berk, Michael
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 171, no. (2014), p. 13-21
- Full Text:
- Reviewed:
- Description: Background Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. Method 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. Results 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 scores at 12 months (p=0.02) but not on the incidence of recurrence. Limitations The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. Conclusion This 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. © 2014 Elsevier B.V. All rights reserved.
The diagnostic validity and reliability of an internet-based clinical assessment program for mental disorders
- Nguyen, David, Klein, Britt, Meyer, Denny, Austin, David, Abbott, Jo-Anne
- Authors: Nguyen, David , Klein, Britt , Meyer, Denny , Austin, David , Abbott, Jo-Anne
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 17, no. 9 (2015), p.
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- Description: Background: Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective: The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods: Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results: With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder:kappa=.37) to strong (eg, panic disorder:kappa=.62). Although the e-PASS' sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia:kappa=.54) to substantial (eg, bulimia nervosa:kappa=.87). Conclusions: The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders.
- Authors: Nguyen, David , Klein, Britt , Meyer, Denny , Austin, David , Abbott, Jo-Anne
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 17, no. 9 (2015), p.
- Full Text:
- Reviewed:
- Description: Background: Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders. Objective: The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system. Methods: Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion. Results: With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder:kappa=.37) to strong (eg, panic disorder:kappa=.62). Although the e-PASS' sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia:kappa=.54) to substantial (eg, bulimia nervosa:kappa=.87). Conclusions: The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders.
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