Mobile Acceptance and Commitment Therapy in Bipolar Disorder: Microrandomized Trial

Area of Science:

• Digital mental health
• Psychiatry
• Behavioral science

Background:

• Mobile interventions offer scalable solutions for mental healthcare delivery.
• Acceptance and commitment therapy (ACT) is a transdiagnostic approach to psychological suffering.
• Bipolar disorder (BP) presents unique challenges for consistent treatment engagement.

Purpose of the Study:

• To evaluate the feasibility and impact of a mobile ACT intervention for individuals with bipolar disorder (BP).
• To assess the effect of mobile ACT on mood symptoms and valued living in BP patients.

Main Methods:

• A 6-week microrandomized trial involving 30 participants with BP.
• Twice-daily symptom logging and randomized delivery of ACT interventions via a mobile app.
• Measurement of mood (depressive 'd' and manic 'm' scores) and valued living (toward/away energy).

Main Results:

• Participants completed an average of 66% of in-app assessments.
• Mobile ACT did not significantly alter energy devoted to valued domains or away from distress.
• A significant increase in manic (m) and depressive (d) scores was observed, linked to increased irritability and fidgeting.

Conclusions:

• The study does not support a large-scale trial of mobile ACT for BP at this time.
• Findings highlight the need for careful adaptation of mobile interventions for BP to avoid exacerbating symptoms.
• Implications for future mobile therapy design for individuals with BP are significant, emphasizing symptom-specific considerations.