Maintenance treatment for bipolar disorder

Addressing priority 8: NIHR Health Technology Assessment Programme commissioning brief advertised to researchers. 

Cognitive Remediation in Bipolar (CRiB2): a randomised trial assessing efficacy and mechanisms

Addressing a range of the prioritiesNIHR research in progress

This project will recruit 200 people from a range of sources (e.g. health services and places in the community) and randomly allocate them to receive 12 weeks of either evidence-based Cognitive Remediation Therapy (CRT) (100 people) or continue usual care without CRT (100 people). The team will test their cognitive skills and everyday functioning before and after the 12 week program, then 3 months later. The two groups will be compared to see whether CRT is better than usual treatment at improving everyday (including work-related) and cognitive functioning. To explore what makes the therapy effective, the project will also test whether CRT affects peoples' knowledge about their cognitive skills, stress hormones and mood instability and whether these changes relate to improved functioning. This may help increase future benefits that CRT could provide. 

Cognitive behavioural therapy in comparison to treatment as usual in young adults at high risk of developing bipolar disorder (Bipolar At Risk): A randomised controlled trial to investigate the efficacy of a treatment approach targeted at key appraisal change (BART II)

Addressing a range of the prioritiesNIHR research in progress

This research team has conducted a successful study to see whether a psychological therapy (cognitive behavioural therapy, CBT) can be given to individuals who meet criteria for Bipolar at risk (BAR), and whether it would be a potentially useful treatment. Their pilot work showed that CBT (CBT-BAR) is an acceptable (as shown by feedback from people who took part) and feasible treatment option (as shown by people agreeing to take part and attending the therapy sessions) for people meeting Bipolar at risk criteria. They successfully recruited 76 people to take part in the study, provided therapy to those allocated to therapy and followed up over 85% of people 12 months later. The study showed promising findings e.g. improved mood, functioning and those who took part were positive about their experiences and the impact it had on their life.  They would now like to repeat this study to understand if this therapy works in a larger group of people, across 5 different sites in the UK

Aripiprazole/ sertraline combination: Clinical and cost-effectiveness in comparison with quetiapine for the treatment of bipolar depression. An open label randomised controlled trial. (ASCEnD)

Addressing priority 16NIHR research in progress

A combination of aripiprazole with an antidepressant may be expected to be as effective in bipolar depression as olanzapine with fluoxetine but, importantly, with a reduced burden of side-effects. This combination is starting to be used clinically in this way and a small trial in bipolar depression found some benefit.  This research plans is to examine the combination of aripiprazole and a standard antidepressant (sertraline) in patients with bipolar depression. The team wants to understand whether 135 patients who will be prescribed the combination do better than the 135 who will be started on the most widely used recommended treatment, quetiapine. 

Clinical and cost effectiveness of an online integrated bipolar parenting intervention: A randomised controlled trial 

Addressing a range of the priorities:  NIHR research in progress

This research aims to assess whether providing parents with bipolar disorder (BD) with online parenting support leads to their children having fewer behaviour problems. The team also wants to know whether this helps parents feel less stressed and more confident about their parenting. They will also explore whether the intervention leads to parents having fewer mood or anxiety problems.