Bipolar Disorder II
Conditions
Keywords
bipolar disorder II, interpersonal and social rhythm therapy
Brief summary
This project is based on the biphasic instability model and social timing theory, utilizing IPSRT to help regulate social interactions and establish regular daily habits, alleviate emotional symptoms, and prevent. The included patients with bipolar II disorder who did not take medication for the first time or relapsed within the past month were randomly divided into a medication only group (Q group), a only IPSRT group (I group). Group Q received treatment with quetiapine alone (starting at 50mg/day, with an additional 50mg to 300mg/day per week, and the dosage can be flexibly adjusted); Group I received 12 weeks of interpersonal and social rhythm therapy (12 sessions, once a week, 40 minutes each time, with relatively fixed tasks and agendas for each meeting). Compare the changes in various clinical evaluation scales and skin potential before and after treatment, explore the safety and effectiveness of drug therapy and psychotherapy for patients with bipolar II disorder with rhythm disorders, and investigate the potential biological mechanism of IPSRT by collecting data on salivary cortisol and melatonin, peripheral circadian rhythm genes (PER1/PER2/PER3/BMAL1), and magnetic resonance.
Interventions
Patients received treatment with quetiapine alone (starting at 50mg/day, with an additional 50mg to 300mg/day per week, and the dosage can be flexibly adjusted)
BEHAVIORALPsychopharmacological treatment
Patients received 12 weeks of interpersonal and social rhythm therapy (12 sessions, once a week, 40 minutes each time, with relatively fixed tasks and agendas for each meeting)
Sponsors
First Affiliated Hospital of Zhejiang University
Second Xiangya Hospital of Central South University
Brain Hospital Affiliated to Guangzhou Medical University
First Affiliated Hospital of Kunming Medical University
Brain Hospital Hunan Province
Hunan Mental Hospital
The Affiliated Hospital of Hangzhou Normal University
Zhejiang Provincial Tongde Hospital
Shanghai Mental Health Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* 1: a primary diagnosis of bipolar II disorder in accordance with DSM-V criteria, in a current major depressive episode; 2: scoring ≥17 on the 17-item Hamilton Rating Scale for Depression (HAMD-17) 3: scoring \<12 on the Young Mania Rating Scale (YMRS) 4: medication-free (≥4 weeks without psychotropics) 5: with rhythm disturbance, scoring \>26 on the Biological Rhythm Interview for Neuropsychiatry (BRIAN) 6: Understand written language and be able to conduct questionnaire survey 7: 18 to 60 years old, gender is not limited 8: the patient voluntarily participates, signs a written informed consent form, is willing to participate in the study and undergo evaluation 9: Han Chinese 10: Right-handedness
Exclusion criteria
* 1: diseases that may significantly increase research risks or interfere with the evaluation of results 2: patients with rapid-cycling bipolar disorder (with \>4 episodes within the past year); 3: any psychiatric or organic mental disorder, bipolar I disorder (BD I), current alcohol or drug dependence, borderline or antisocial personality disorder 4: patients currently receiving any psychological treatment or melatonin treatment intervention 5: patients with active suicidal ideation, HAMD-17 item 3 score ≥3 6: pregnant 7: patients with metal objects in the body (pacemaker, cochlear implant, implanted teeth, braces, metal foreign bodies, cardiac stent/intravascular coil, orthopedic steel plate, etc.) and other MRI examination contraindications (claustrophobia or inability to cooperate with the examination).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hamilton Depression Scale (17-items) Total Score Change | Baseline，4，8，12 weeks after treatment | The Hamilton Depression Scale (17-items), is a 17 item diagnostic questionnaire used to measure the severity of depressive episodes in patients with mood disorders. It's considered the gold standard for rating depression severity and used frequently in clinical trials. Higher HAM-D17 score indicates more severe depression. A reduction of 50% or more in total score from Baseline indicates clinical response. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) score | Baseline，4，8，12 weeks after treatment | The BRIAN comprises 18 items, which are divided in 3 areas: sleep and social rhythms, activities and eating pattern. The total score ranged from 18 to 72, a higher score suggested a more severe biological rhythm disturbance. |
| Neuroimaging | Baseline，12 weeks after treatment | MRI |
| Skin potential | Baseline，12 weeks after treatment | In a quiet environment, the subject's left hand was pre connected to a portable skin potential acquisition device to collect skin potential signals under different types of emotional stimulation task paradigms. After denoising, 10 time-domain eigenvalues and 8 time-frequency domain eigenvalues were obtained for each task. |
| Polysomnography | Baseline，12 weeks after treatment | overnight polysomnography |
| Change of the Brief Social Rhythm Scale (BSRS) score | Baseline，4，8，12 weeks after treatment | The BSRS assess the irregularity with which participants engage in basic daily activities during the workweek and on the weekend, using a scale ranging from 1 (very regularly) to 6 (very irregularly） |
| Neuropsychological tests | Baseline，12 weeks after treatment | Software testing (Prisoner's Dilemma game, Social searching task) |
| Change of Beck Scale of Suicidal Ideation score | Baseline，4，8，12 weeks after treatment | Beck Scale of Suicidal Ideation is a 21-item self-report instrument that detects and measures the intensity of a patient's specific attitudes, behaviors, and suicide plans during the past week. The BSI score ranges from 0 to 63, with higher scores indicating worse outcomes and lower scores indicating better outcomes. |
| Change of the Pittsburgh Sleep Quality Index (PSQI) score | Baseline，4，8，12 weeks after treatment | The PSQI is a validated self-report questionnaire assessing sleep quality and disturbance over 1 month, quantifying 7 sleep-related domains, with higher scores indicating worse sleep quality. |
| Change of the Young Mania Rating Scale (YMRS) score | Baseline，4，8，12 weeks after treatment | The Young Mania Rating Scale (YMRS) , is a 11 item diagnostic questionnaire used to measure the severity of mania symptom in patients with mood disorders. |
| Change of Hamilton Anxiety Scale score | Baseline，4，8，12 weeks after treatment | Hamilton Anxiety Scale is a 17 item diagnostic questionnaire used to measure the severity of anxiety episodes in patients. Each item on the scale is rated on a 5-point scale from 0 (not present) to 4 (severe), with the total score ranging from 0 to 68. The HAMA-17 is often used in clinical and research settings to assess the severity of anxiety symptoms and to evaluate the effectiveness of treatments for anxiety. |
| Change of the Sociaty Adaptive Scale score | Baseline，4，8，12 weeks after treatment | SAS is a self-rating scale used to assess an individual's social functioning in areas such as work, study, interpersonal communication, and family life. |
| blood | Baseline，12 weeks after treatment | Blood samples are collected to analyze the expression levels of peripheral circadian clock genes (PER1/PER2/PER3/BMAL1). |
| saliva samples | Baseline，12 weeks after treatment | Saliva is employed for the analysis of cortisol and melatonin |
Countries
China
Contacts
CONTACTHuang Manli, Professor
Outcome results
None listed