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Mobile Acceptance and Commitment Therapy in Bipolar Disorder: Microrandomized Trial.

Amy Cochran^1,2, Jacob M Maronge³, Amanda Victory⁴

¹Department of Population Health Sciences, University of Wisconsin Madison, Madison, WI, United States.

JMIR Mental Health

|April 20, 2023

Summary

This summary is machine-generated.

A mobile version of acceptance and commitment therapy (ACT) for bipolar disorder (BP) did not improve mood energy but increased manic and depressive symptoms. Findings suggest caution for future mobile therapy development in BP.

Keywords:

acceptance and commitment therapy bipolar disorder micro-randomized trial mindfulness mobile applications precision medicine randomized controlled trials

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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.