NZ trial involving patients from Canterbury offers new hope against severe mood disorders

Depression remains the leading cause of disability worldwide, while bipolar disorder presently ranked fourth on the World Health Organisation's global burden of disease index. Photo / File

Researchers are eyeing a fresh way to help Kiwis battling with severe mood disorders.

Depression remains the leading cause of disability worldwide, while bipolar disorder presently ranked fourth on the World Health Organisation's global burden of disease index.

Dr Katie Douglas, a clinical psychologist and Otago University researcher, said both of these disorders were linked with problems with memory, planning and attention, all of which made it harder for people to live and work.

Further, both depression and bipolar disorder are now recognised as ongoing, relapsing disorders, and not just episodic ones.

A four-year study being led by Douglas would bring together two therapies that are gaining rising attention around the world.

Interpersonal and Social Rhythm Therapy, or IPSRT, was designed to help people improve their moods by understanding their biological and social rhythms and making these more consistent.

The other, called Cognitive Remediation, was an intervention that drew on a range of different activities, such as playing computer games focused on improving memory strategies.

Douglas' study, supported with a $427,000 grant from the Health Research Council, would involve patients with mood disorders who had been recently discharged from mental health services in Canterbury.

One group would receive a combination of both therapies, while another would undergo IPSRT alone.

"The current study is very similar to a clinical trial currently under way at our Department of Psychological Medicine, so many of the processes for recruiting individuals with mood disorders are well-established," Douglas said.

"The main difference is that the Cognitive Remediation intervention in the current study will be provided in a group format, rather than individually."

The year-long programme first involved weekly sessions with a therapist, before these were spaced out fortnightly, and then monthly.

About half way through the year, participants receiving the combined treatment would be asked to start attending weekly group Cognitive Remediation sessions for three months.

At the end of the year, they'd be asked to complete the same assessments they did when starting the programme.

The research team would follow up with them another year later to check whether the intervention had had any effect on longer-term mood symptoms.

"In this field of research, one of the biggest challenges is getting enough people to participate in studies to answer our research questions comprehensively," Douglas said.

"But we do feel confident about the number of people we will be able to study in this project since we are getting good numbers of referrals into a current, similar study at the department."

Another obvious challenge was that the researchers were dealing with hugely complex conditions.

"For example, two people diagnosed with bipolar disorder might show vastly different symptoms to each other," she said.

"We want to get to the point where we can answer what type of treatment works best for which type of person, and this requires very large samples of patients.

"We have strong collaborations with many international research groups, which will be the way of the future in terms of being able to answer these very important clinical questions."

Her ultimate hope was that some of what was learned could be built into current clinical practice.

"Essentially, we want to be giving people the best chance possible to stay well once they have suffered a mood episode, by approaching their treatment from many different angles."