A self-management intervention for bipolar disorder using a WeChat mini program (Mood Calm): study protocol for...

Bipolar disorder (BD) is a severe, chronic illness characterized by frequent relapses and persistent interepisode symptoms, even with standard pharmacological treatment. Digital self-management tools have the potential to broaden the reach of evidence-based approaches and improve healthcare delivery through immediate evaluation, tailored guidance, and notifications to healthcare providers, while collecting self-report and behavioral data to guide treatment decisions. This study describes the design, development, and a preliminary evaluation of "Mood Calm", a comprehensive self-management intervention for BD delivered via a WeChat mini-program.

The intervention protocol was developed through a multiphase process. First, guided by Cognitive Behavioral Theory, an initial protocol was constructed integrating six modules: symptom monitoring, medication management, crisis identification, healthy lifestyle support, psychoeducation, and cognitive functioning training. Plans for wearable device integration were also included to enable passive monitoring of sleep and activity. Second, a literature review identified core functional components of digital self-management interventions for BD, and the protocol was subsequently refined via a Delphi expert panel. Third, the "Mood Calm" mini-program was developed using an agile framework. Then, a four-week, single-arm preliminary trial was conducted with five remitted patients with BD to assess feasibility and usability of the digital self-management modules delivered through the "Mood Calm" mini-program. These modules included symptom monitoring, medication management, lifestyle tracking via wearable device, and cognitive functioning training, but excluded psychoeducation and crisis intervention components which are planned for future randomized controlled trial (RCT).

All participants completed the trial, reporting high satisfaction and describing the application as user-friendly and easy to operate. However, system data indicated suboptimal self-reported medication adherence for three participants, prompting an immediate design revision to implement a one-click reporting function.

Findings support the feasibility and acceptability of the "Mood Calm" mini-program as a potential digital adjunct for BD self-management in China. This study establishes a protocol for a comprehensive intervention and provides preliminary evidence for the mini-program-based components. Future research will evaluate the full intervention, incorporating group psychoeducation sessions, in a definitive RCT.