Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Articles by Sajatovic, M. Articles by Calabrese, J. R. PubMed Citation Articles by Sajatovic, M. Articles by Calabrese, J. R. Treatment Compliance Bipolar Disorder Outcome and Process Assessment Education, Patient and Family Other Psychotherapy Related Article

A Comparison of the Life Goals Program and Treatment as Usual for Individuals With Bipolar Disorder

Dr. Sajatovic, Dr. Ganocy, Ms. Cassidy, Dr. Safavi, and Dr. Calabrese are affiliated with the Department of Psychiatry, Case Western Reserve University School of Medicine, 10524 Euclid Ave., Cleveland, OH 44106 (e-mail: martha.sajatovic{at}uhhospitals.org), with which Mr. Hays was affiliated at the time of the study. Dr. Davies is with the University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Dr. Bauer is with the Center for Organization, Leadership, and Management Research, Department of Veterans Affairs (VA) Boston Healthcare System, and the Department of Psychiatry, Harvard Medical School, Boston. Dr. Blow is with the Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor VA Healthcare System, and the Department of Psychiatry, University of Michigan, Ann Arbor. Portions of this study were presented at the Institute on Psychiatric Services, October 2–5, 2008, Chicago.

OBJECTIVE: This randomized controlled study of 164 outpatients with bipolar disorder in a community mental health center who received standardized psychoeducation (Life Goals Program [LGP]) or treatment as usual sought to determine whether there were differences between the groups in medication adherence attitudes and behaviors. METHODS: Patients were randomly assigned to treatment as usual (N=80) or treatment as usual plus LGP (N=84) and were assessed at baseline and at the three-, six-, and 12-month follow-up. Primary outcomes were change in score from baseline on the Drug Attitude Inventory (DAI) and on self-reported treatment adherence behaviors (SRTAB). RESULTS: At baseline, there were no significant differences between the two groups. Slightly less than half (N=41, 49%) of the LGP group participated in most or all (four to six) LGP sessions, 14% (N=12) participated in one to three sessions, and 37% (N=31) did not participate in any sessions. At the 12-month follow-up there was improvement among all patients, with no significant differences between the two groups, in DAI scores, SRTAB, symptoms, psychopathology, and functional status. Greater depressive severity at baseline was associated with more negative attitudes toward treatment over time, although this finding was not significant (p=.056). Secondary analysis of persons in the LGP group found that compared with those who did not go to any LGP sessions, those with partial or full participation in LGP sessions had improved attitudes toward medication at the three- and six-month follow-up, but no difference was found between the three LGP subgroups by the 12-month follow-up. CONCLUSIONS: There were no differences between two groups in treatment attitudes at the 12-month follow-up. Low attendance rates mitigated effects on primary outcomes. Effects of LGP may become lost over time without ongoing intervention, and individuals with depression may have reduced response to LGP.

Related Article:

September 2009: This Month's Highlights
Psychiatr Serv 2009 60: 1163. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2009 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us