Nutrition, Exercise, and Wellness Treatment (NEW Tx) for Bipolar Disorder



Status:Completed
Conditions:Psychiatric, Bipolar Disorder
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - 65
Updated:6/9/2018
Start Date:May 21, 2012
End Date:February 28, 2017

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Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in bipolar
disorder, yet no empirically validated psychosocial interventions to manage risk factors for
CVD in BD have been developed. The purpose of this study is to develop and test the
feasibility of an integrated treatment to decrease CVD risk factors, while exploring whether
the intervention improves overall functioning and mood symptoms. The designed treatment
integrates theories on Nutrition strategies, Exercise interventions, and Wellness Treatment
(NEW Tx) to address risk factors for CVD that co-occur with bipolar disorder. NEW Tx includes
novel intervention strategies in each of these three modules, as well as modified and
tailored empirically-supported strategies for bipolar disorder. The primary hypotheses are
that NEW Tx will be feasible to deliver, acceptable to this population, and associated with
improvements in CVD risk factors (i.e., waist circumference). Exploratory analyses will
examine predictors of treatment response and the effect of NEW Tx on mood symptoms and
overall functioning.

The purpose of the Nutrition, Exercise, and Wellness Treatment (NEW Tx) research is to
develop and test the feasibility and acceptance of a theoretically integrated treatment to
address the impact of medical comorbidity of individuals with bipolar disorder (BD), while
exploring its efficacy, whether it improves overall functioning and symptoms, as well as
examine a potential moderator and mediator of treatment response.

A.Primary Aims

Aim 1: Feasibility and Acceptance of NEW Tx in the Nonrandomized Trial.

Hypothesis 1a: A preliminary study of whether NEW Tx will be feasible with regards to
recruitment, retention, blinded assessments, and therapist adherence to NEW Tx.

Hypothesis 1b: Participants will report high satisfaction with the treatment and
acceptability over the study duration in a nonrandomized trial.

Aim 2: Feasibility and Acceptance of NEW Tx and its Evaluation in the Randomized Pilot Trial.

Hypothesis 2a: A pilot study of whether NEW Tx will be feasible with regards to recruitment,
randomization, retention, blinded assessments, and therapist adherence to NEW Tx.

Hypothesis 2b: Participants will report high satisfaction with the treatment and
acceptability over the study duration in the randomized pilot trial.

B. Exploratory Aims

Aim 3a: Reducing Medical Burden in the Randomized Pilot Trial. Pilot test the efficacy of NEW
Tx in improving medical burden using the Framingham Risk Score (FRS).

Hypothesis 3a: Over the course of 20-weeks (18 sessions) the NEW Tx group will have a lower
FRS compared to treatment as usual (TAU) in the randomized pilot trial.

Aim 3b: Symptoms and Functioning in the Randomized Pilot Trial. Examine the efficacy of NEW
Tx in improving functioning and symptoms of BD.

Hypothesis 3b: Over the course of 20-weeks (18 sessions) the NEW Tx group will improved
functioning and mood symptoms compared to TAU in the randomized pilot trial.

Aim 3c: Moderator and Mediator of NEW Tx in the Randomized Pilot Trial. Investigate a
potential moderator and mediator of treatment response.

Hypothesis 3c.1: Individuals with higher baseline Body Mass Index (BMI) > 30 will moderate
the between treatment effect size for medical burden (FRS) in the randomized pilot trial,
such that of NEW Tx will have lower FRSs.

Hypothesis 3c.2: Mastery of the diet and exercise modules of NEW Tx will mediate the
association of NEW Tx and improvement in medical burden (FRS).

Inclusion Criteria:

- Diagnosis of Bipolar Disorder (Type I or II), which is the primary focus of treatment

- Ability to give informed consent

- Currently ill (CGI-BP ≥ 3)

- Age > 18 years and < 65 years

- Overweight individuals (BMI > 25)

Exclusion Criteria:

- Unwilling/unable to comply with study procedures

- Endorsed item, confirmed by patient's physician, on the PAR-Q

- Euthymic (CGI-BP < 3)

- Diagnosis of an eating disorder (e.g., anorexia nervosa, bulimia nervosa) in the past
month

- Diagnosis of substance dependence in the past month

- Active suicidality (MADRS item 9 score > 4)

- Pregnant (as analyzed by a urine pregnancy test)

- Currently receiving another psychosocial treatment

- Exercising regularly (i.e., 5 days per week for 30 min)

- Neurologic disorder or history of head trauma

- Contraindications to exercise or diet interventions (e.g., co-morbid nutritional and
metabolic diseases, physical injuries)
We found this trial at
1
site
185 Cambridge Street
Boston, Massachusetts 02114
617-724-5200
Principal Investigator: Louisa Sylvia, PhD
Phone: 617-726-0360
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mi
from
Boston, MA
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