The CREST.BD Bipolar Wellness Centre: What’s New in 2016

Erin Michalak

Associate Professor Department of Psychiatry

University of British Columbia Network Lead, CREST.BD

erin.michalak@ubc.ca

@erin_michalak @crest_bd

www.crestbd.ca

Objectives

1. Explore:

- QoL assessment in BD

- Self-management in BD

2. Introduce CREST.BD’s:

- QoL Tool

- Bipolar Wellness Centre

QoL in BD publications Publications referencing QoL as a proportion of publications referencing BD (Scopus database, terms in abstract, title or keywords), past 20 years

Source: Murray G, Michalak EE. Bipolar Disord. 2012;14(8):793-6.

Exponential growth (F (1,18) = 136.76,

p < .001, Adj R2 = .88)

But...

Sheer numbers still small

N for QoL publications = 140

Vs.

N for symptom measure publications = 1576

Methods STOP-EM project, UBC Hospital, longitudinal naturalistic study of FEM patients

- N=63, majority FEM, N=3 mixed episodes

- Mean age 22.8 yrs (±4.3)

- N=30 (48%) male

- Duration of illness 3.0 yrs (±3.5)

- N=41 (65%) psychosis in index manic episode

- Comorbid substance/alcohol misuse⁄dependence, N=17 (27%)

Michalak et al., Bipolar Disorders, 2013: 15: 188–198.

QoL in first-episode mania

0102030405060708090

100

0 Mths 6 Mths 12 Mths 18 Mths

Mean Q-LES-QScore

QoL (mean Q-LES-Q) and HRQOL (SF-36) baseline - 18 months in FEM patients (N=63)

* *

Q-LES-Q at 12 and 18 mths sig. improved over baseline

SF-36 PHC and MHC summary scores sig. improved at 6, 12 and 18 mths

*

* * *

* *

Michalak E.E. et al., Bipolar Disord 2013: 15: 188–198.

QoL (mean Q-LES-Q) scores compared to STEP-BD sample and never mentally ill controls

• STEP-BD range 47.7 (±3.0) (depressed) to 61.5 (±4.3) (manic)

• Schechter study 81.8 (±13) NMI normal controls

Zhang H. et al., Compr Psychiatry. 2006: 47(3):161-8. Schechter D, et al., Psychiatry Res. 2007: 30;152(1):45-54. Michalak E.E. et al., Bipolar Disord 2013: 15: 188-198.

Gaps in the BD QoL field

Condition-specific measurement of QoL in BD

56-item 14 Domain

QoL.BD Scale

Full QoL.BD Version

QoL.BD Scale

PHYSICAL

SLEEP

MOOD

COGNITION

LEISURE

RELATIONSHIPS

WORK

STUDY

12 Basic Scales

2 Optional Scales (full QoL.BD version only)

SPIRITUALITY

MONEY

HOME

SELF-ESTEEM

INDEPENDENCE

IDENTITY

Chinese, Tamil English, Spanish

English, French-CN Afrikaans, Zulu, Xhosa, Sotho/Sesotho

QoL.BD Translations

Gaps in the BD QoL field

Online version of the QoL.BD

Gaps in the BD self-management field

Data on BD-specific self-management strategies

Integration of QoL assessment and supported self-management

Self-management in BD

Study Aim – To identify self-management strategies used by people living well with BD

Methods - Purposeful sampling used to identify:

~ People with BD Type I/II (N = 32) ~ Median Age: 41±13 yrs ~ 63% female ~ 78% BD I ~ Functioning well Individual interviews or focus groups, thematic analysis.

Suto et al. (2010) JAD, 124 (1-2):76-84; Murray et al (2011) Clinical Psychology and Psychotherapy, 18:95-109.

.

Sleep, rest, diet and exercise

Regular monitoring and adjustment

Reflective, meditative, spiritual practices

Understanding BD, educating others

Connecting with others

Enacting a plan

Results: Categories of self-management

Delphi Consensus Study results

• Stopping progression into hypomania/mania

• Maintaining balance in mood

Bipolar Wellness Centre Design:

• 15-20 min • 1 QoL domain covered per webinar • CREST.BD expert covers science and strategies

Bipolar Wellness Centre

Design: • 2-4 min • 1 QoL domain

covered per video • Featuring Victoria

Maxwell • Show concrete

self-management strategies in daily life

Bipolar Wellness Centre

Design:

• 2.5 hrs in length, 2 QoL domains covered per workshop • Delivered by CREST.BD academic and peer-researchers • Combination of didactic, role-play, small group work • Delivered in Ottawa, Kingston, Toronto in June 2015

Workshops being delivered in Vancouver Fall 2016

Bipolar Wellness Centre

Design:

• 1x 45 min session

• Delivered by CREST.BD peer living well with BD

• Content individually tailored according to QoL Tool profile

ORBIT (online, recovery-focused, bipolar individual therapy) project.

ORBIT recruiting early 2017!