Online and Mobile Technologies for Self-Management in Bipolar Disorder: A Systematic Review

Objective: Internet (eHealth) and smartphone-based (mHealth) approaches to self-management for bipolar disorder are increasingly common. Evidence-based self-management strategies are available for bipolar disorder and provide a useful framework for reviewing existing eHealth/mHealth programs to determine whether these strategies are supported by current technologies. This review assesses which self-management strategies are most supported by technology. Method: Based on 3 previous studies, 7 categories of self-management strategies related to bipolar disorder were identified, followed by a systematic literature review to identify existing eHealth and mHealth programs for this disorder. Searches were conducted by using PubMed, CINAHL, PsycINFO, EMBASE, and the Cochrane Database of Systematic Reviews for relevant peer-reviewed articles published January 2005 to May 2015. eHealth and mHealth programs were summarized and reviewed to identify which of the 7 self-management strategy categories were supported by eHealth or mHealth programs. Results: From 1,654 publications, 15 papers were identified for inclusion. From these, 9 eHealth programs and 2 mHealth programs were identified. The most commonly supported self-management strategy categories were “ongoing monitoring,” “maintaining hope,” “education,” and “planning for and taking action”; the least commonly supported categories were “relaxation” and “maintaining a healthy lifestyle.” eHealth programs appear to provide more comprehensive coverage of self-management strategies compared with mHealth programs. Conclusions and Implications for Practice: Both eHealth and mHealth programs present a wide range of self-management strategies for bipolar disorder, although individuals seeking comprehensive interventions might be best served by eHealth programs, while those seeking more condensed and direct interventions might prefer mHealth programs.

[1]  K. Griffiths,et al.  Mindfulness-Based Cognitive Therapy for Couples , 2016 .

[2]  P. Mitchell,et al.  Evaluation of an Online Relapse Prevention Program for Bipolar Disorder , 2007 .

[3]  Steven H. Jones,et al.  An online randomised controlled trial to assess the feasibility, acceptability and potential effectiveness of 'Living with Bipolar': a web-based self-management intervention for bipolar disorder: trial design and protocol. , 2012, Contemporary clinical trials.

[4]  J. Aubry,et al.  Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial , 2010, European Psychiatry.

[5]  J. Savarino,et al.  An online recovery plan program: can peer coaching increase participation? , 2011, Psychiatric services.

[6]  L. Pbert,et al.  Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. , 1992, The American journal of psychiatry.

[7]  G. Sándor,et al.  Point of care. , 2020, Journal.

[8]  C. Depp,et al.  Mobile Interventions for Severe Mental Illness: Design and Preliminary Data From Three Approaches , 2010, The Journal of nervous and mental disease.

[9]  M. Berk,et al.  Net-effect? Online psychological interventions , 2007, Acta Neuropsychiatrica.

[10]  A. John Rush,et al.  Cognitive-behavioral therapy for bipolar disorder. , 1996 .

[11]  G. Murray,et al.  Self-management strategies used by 'high functioning' individuals with bipolar disorder: from research to clinical practice. , 2011, Clinical psychology & psychotherapy.

[12]  G. Andersson,et al.  Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials , 2017, Cognitive behaviour therapy.

[13]  G. Parker,et al.  The Ins and Outs of an Online Bipolar Education Program: A Study of Program Attrition , 2010, Journal of medical Internet research.

[14]  K. Gao,et al.  Mindfulness-based Cognitive Therapy for Bipolar Disorder , 2015 .

[15]  Mark Tomlinson,et al.  Point of care in your pocket: a research agenda for the field of m-health. , 2012, Bulletin of the World Health Organization.

[16]  Mark Erik Larsen,et al.  Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality , 2015, Journal of medical Internet research.

[17]  G Eysenbach,et al.  What is e-health? , 2001, Encyclopedia of Social Network Analysis and Mining. 2nd Ed..

[18]  N. Craddock,et al.  Beating Bipolar: exploratory trial of a novel Internet-based psychoeducational treatment for bipolar disorder. , 2011, Bipolar disorders.

[19]  W. Mansell,et al.  The process of recovery from bipolar I disorder: a qualitative analysis of personal accounts in relation to an integrative cognitive model. , 2010, The British journal of clinical psychology.

[20]  M. Berk,et al.  A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder. , 2015, Journal of affective disorders.

[21]  M. Keshavan,et al.  Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics , 2014, JMIR mental health.

[22]  M. Tohen,et al.  Does stage of illness impact treatment response in bipolar disorder? Empirical treatment data and their implication for the staging model and early intervention. , 2011, Bipolar disorders.

[23]  A. Mykletun,et al.  Diet quality in bipolar disorder in a population-based sample of women. , 2011, Journal of affective disorders.

[24]  G. Murray,et al.  Development of an online intervention for bipolar disorder. www.moodswings.net.au , 2013, Psychology, health & medicine.

[25]  Amy N. Cohen,et al.  Effects of stress and social support on recurrence in bipolar disorder. , 2004, Journal of affective disorders.

[26]  Britta K. Hölzel,et al.  Mindfulness-Based Cognitive Therapy for Bipolar Disorder: Effects on Cognitive Functioning , 2011, Journal of psychiatric practice.

[27]  M. Alda,et al.  Online information seeking by patients with bipolar disorder: results from an international multisite survey , 2016, International Journal of Bipolar Disorders.

[28]  C. Depp,et al.  A Pilot Study of Mood Ratings Captured by Mobile Phone Versus Paper-and-Pencil Mood Charts in Bipolar Disorder , 2012, Journal of dual diagnosis.

[29]  K. Jamison,et al.  Life events and the course of bipolar disorder. , 1990, The American journal of psychiatry.

[30]  L. Pollack.  Inpatient self-management of bipolar disorder. , 1996, Applied nursing research : ANR.

[31]  Steven H. Jones,et al.  Self-management in bipolar disorder: The story so far , 2011, Journal of mental health.

[32]  Steven H. Jones,et al.  What do service users with bipolar disorder want from a web-based self-management intervention? A qualitative focus group study. , 2013, Clinical psychology & psychotherapy.

[33]  Lori Wozney,et al.  A Systematic Review of Cognitive Behavioral Therapy and Behavioral Activation Apps for Depression , 2016, PloS one.

[34]  P. Mitchell,et al.  A web-based preventive intervention program for bipolar disorder: outcome of a 12-months randomized controlled trial. , 2015, Journal of affective disorders.

[35]  A. Kilbourne,et al.  Nutrition and exercise behavior among patients with bipolar disorder. , 2007, Bipolar disorders.

[36]  A. Matic,et al.  Internet-based psychological interventions for bipolar disorder: Review of the present and insights into the future. , 2015, Journal of affective disorders.

[37]  Sona Dimidjian,et al.  A Pilot Study of Mindfulness-Based Cognitive Therapy for Bipolar Disorder , 2009 .

[38]  M. Humble,et al.  Internet-Based Cognitive Behavioral Therapy for Residual Symptoms in Bipolar Disorder Type II: A Single-Subject Design Pilot Study , 2015, JMIR research protocols.

[39]  Michael F. Armey,et al.  Feasibility and Acceptability of a Mobile Intervention to Improve Treatment Adherence in Bipolar Disorder , 2014, Behavior modification.

[40]  Gordon Parker,et al.  Next Generation of Self-Management Education: Web-based Bipolar Disorder Program , 2007, The Australian and New Zealand journal of psychiatry.

[41]  M. Crowe,et al.  Staying well with bipolar disorder: A qualitative analysis of five-year follow-up interviews with young people. , 2018, Journal of psychiatric and mental health nursing.

[42]  F. Goodwin,et al.  An automated Internet application to help patients with bipolar disorder track social rhythm stabilization. , 2011, Psychiatric services.

[43]  C. Depp,et al.  Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial. , 2015, Journal of affective disorders.

[44]  I. Patelis-Siotis,et al.  Cognitive-behavioral therapy: applications for the management of bipolar disorder. , 2001, Bipolar disorders.

[45]  Britta K. Hölzel,et al.  Mindfulness‐Based Cognitive Therapy for Nonremitted Patients with Bipolar Disorder , 2012, CNS neuroscience & therapeutics.

[46]  J. Krupnick.  An Automated Internet Application to Help Patients With Bipolar Disorder Track Social Rhythm Stabilization , 2013 .

[47]  Adrian H. Taylor,et al.  The effects of physical activity on physical and mental health among individuals with bipolar disorder: A systematic review , 2009 .

[48]  Steven H. Jones,et al.  A web-based self-management intervention for Bipolar Disorder 'living with bipolar': a feasibility randomised controlled trial. , 2014, Journal of affective disorders.

[49]  Danny J. Smith,et al.  Internet-based psychoeducation for bipolar disorder: a qualitative analysis of feasibility, acceptability and impact , 2012, BMC Psychiatry.

[50]  E. Michalak,et al.  Self-management techniques for bipolar disorder in a sample of New Zealand Chinese , 2009 .

[51]  G. Goodwin,et al.  Mindfulness-based Cognitive Therapy (MBCT) in bipolar disorder: Preliminary evaluation of immediate effects on between-episode functioning , 2008, Journal of affective disorders.

[52]  G. Murray,et al.  What works for people with bipolar disorder? Tips from the experts. , 2010, Journal of affective disorders.

[53]  Kathleen M. Griffiths,et al.  Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: a systematic review , 2016, J. Am. Medical Informatics Assoc..

[54]  G. Parker,et al.  Effects of adjunctive peer support on perceptions of illness control and understanding in an online psychoeducation program for bipolar disorder: a randomised controlled trial. , 2012, Journal of affective disorders.

[55]  Sheri L. Johnson,et al.  Online mindfulness-based intervention for late-stage bipolar disorder: pilot evidence for feasibility and effectiveness. , 2015, Journal of affective disorders.

[56]  Venet Osmani,et al.  Smartphones in Mental Health: Detecting Depressive and Manic Episodes , 2015, IEEE Pervasive Computing.

[57]  G. Murray,et al.  Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study. , 2016, Journal of affective disorders.

[58]  G. Murray,et al.  Optimizing delivery of recovery‐oriented online self‐management strategies for bipolar disorder: a review , 2015, Bipolar disorders.