Bipolar Disorder
Conditions
Keywords
mindfulness, older age bipolar disorder, tai chi, qigong, randomized controlled trial
Brief summary
It is expected that by 2030, the percentage of patients with bipolar disorder (BD) in Canada over 60 years of age will exceed 50%. In this population, poor cognition and persistent sub-threshold depressive symptoms are particularly common, difficult to treat, associated with increased mood episodes, and poor daily functioning. Mind-body interventions have increasingly been found to be effective in treating several psychiatric condition including BD. A few pilot studies examining mindfulness-based intervention in younger adult BD have been promising for depressive symptoms, but some pilot research suggest that patients with older age bipolar disorder (OABD) may benefit more from moving mindfulness. The investigators will conduct a 12-week randomized controlled trial to assess whether tai-chi/qigong will be associated with 1) greater reduction in depressive symptoms, and 2) greater improved cognition, in comparison to a light exercise active control condition, 12- and 24-weeks from baseline, in BD patients aged 40+.
Interventions
BEHAVIORALTai Chi/Qigong vs. Walking/Stretching
Both interventions can be thought of as a form of movement and exercise.
Sponsors
Lady Davis Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* aged greater than or equal to 40 years * history of diagnosis of bipolar I or II disorder * access to a computer with a functioning camera, microphone, and ability to run Zoom software * English or French speaking * ability to give informed consent
Exclusion criteria
* Young Mania Rating Scale score \> 5 * current clinician diagnosis of substance abuse, unless currently in complete remission * risk of suicide as assessed by a score above 3 on item 10 of Montgomery Asberg Depression Rating Scale * participation or plan to participate in any other concurrent psychosocial group program during course of study * unstable psychiatric medication (less than 4-weeks since commencement)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Depression | Baseline, 12-weeks, 24-weeks | Level of depression as measured by the Montgomery-Asberg Depression Rating Scale, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-60, higher score indicates worse outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Processing Speed | Baseline, 12-weeks, 24-weeks | Processing speed as measured by the Animal Fluency Test at 12-weeks and 24-weeks. Scored by number of animals named, higher score indicates better outcome. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in Generalized Anxiety | Baseline, 12-weeks, 24-weeks | Generalized anxiety as measured by the Generalized Anxiety Disorder 7-item scale, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-21, higher score indicates worse outcome |
| Change in Mindfulness | Baseline, 12-weeks, 24-weeks | Mindfulness as measured by the Five Factor Mindfulness Questionnaire Short Form at 12-weeks and 24-weeks post-intervention. Possible score range = 49-110, higher score indicates worse outcome |
| Change in Self-Compassion | Baseline, 12-weeks, 24-weeks | Self-compassion as measured by the Self Compassion Scale Short Form at 12-weeks and 24-weeks post-intervention. Possible score range: 0-130, higher score indicates worse outcome |
| Change in Quality of Life | Baseline, 12-weeks, 24-weeks | Quality of life as measured by the Quality of Life in Bipolar Disorder Questionnaire - Short Form, at 12-weeks and 24-weeks post-intervention. Possible score range: 12-60, higher score indicates worse outcome |
| Change in Self-Reported Depression | Baseline, weekly throughout 12-weeks, 24-weeks | Level of depression as measured by the Quick Inventory of Depressive Symptomatology - Self Report, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-45, higher score indicates worse outcome |
| Change in Self-Reported Mania | Baseline, weekly throughout 12-weeks, 24-weeks | Level of mania as measured by the Altman Self-Rating Mania Scale, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-25, higher score indicates worse outcome |
| Change in Mania | Baseline, 12-weeks, 24-weeks | Mania as measured by the Young Mania Rating Scale at 12-weeks and 24-weeks post-intervention. Possible score range: 0-60, higher score indicates worse outcome |
| Change in Daily Functioning | Baseline, 12-weeks, 24-weeks | Daily functioning as measured by the Functional Assessment Short Test, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-72, higher score indicates worse outcome |
Countries
Canada
Outcome results
None listed