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.
Optimizing prediction of binge eating episodes : A comparison approach to test alternative conceptualizations of the affect regulation model
- Fuller-Tyszkiewicz, Matthew, Richardson, Ben, Skouteris, Helen, Austin, David, Castle, David, Busija, Lucy, Klein, Britt, Holmes, Milllicent, Broadbent, Jaclyn
- Authors: Fuller-Tyszkiewicz, Matthew , Richardson, Ben , Skouteris, Helen , Austin, David , Castle, David , Busija, Lucy , Klein, Britt , Holmes, Milllicent , Broadbent, Jaclyn
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Eating Disorders Vol. 2, no. 1 (2014), p. 1-8
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- Description: Background: Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).Methods: A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.Results: As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.Conclusions: Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset. © 2014 Fuller-Tyszkiewicz et al.; licensee BioMed Central Ltd.
- Authors: Fuller-Tyszkiewicz, Matthew , Richardson, Ben , Skouteris, Helen , Austin, David , Castle, David , Busija, Lucy , Klein, Britt , Holmes, Milllicent , Broadbent, Jaclyn
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Eating Disorders Vol. 2, no. 1 (2014), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose-response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).Methods: A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.Results: As hypothesized, the threshold approach was a better predictor than the linear dose-response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.Conclusions: Present findings suggest that simple dose-response formulations for the association between negative mood and onset of binge episodes miss vital aspects of this relationship. Most notably, the impact of mood on binge eating appears to depend on whether a threshold value of negative mood has been breached, and elevation in mood beyond this point may be useful for clinicians and researchers to identify time to onset. © 2014 Fuller-Tyszkiewicz et al.; licensee BioMed Central Ltd.
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