Browsing by Author "Wright, Kim"

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Patient Experiences of Behavioural Therapy for Bipolar Depression: A33 Qualitative Study
(Wiley, 2025) Yilmaz, Sakir; Hancox, Anna; Price, Molly; Regan, Jemma; Dunn, Barney; O'Mahen, Heather; Wright, Kim
BackgroundAlthough multiple qualitative studies have explored participants' experiences of behavioural activation (BA) for unipolar depression, none have investigated the experiences of BA in people with bipolar depression. This is of particular interest because qualitative studies concerning the experience of receiving therapy can help inform the theory of change underpinning the intervention.AimThe purpose of this study was to explore the experiences and perspectives of individuals with bipolar disorder who received a course of one-to-one BA for bipolar depression. We sought to explore participants' experience of the effects of BA therapy, both proximally and distally.MethodSemi-structured interviews were conducted with nine individuals meeting research diagnostic criteria for bipolar I or II disorder who had received up to 20 sessions of BA adapted for bipolar depression. Thematic analysis using a framework approach was used to explore and describe the experiences of participants.ResultsParticipants' perspectives on the impact of therapy were categorized under four subthemes: client behaviour inside and outside sessions, changes in clients' perspectives, the impact on symptoms and impact on life and functioning.ConclusionsParticipants' accounts of the impact of therapy were broadly consistent with the theory underpinning a behavioural approach. Participants described a central role for perspective change, and particularly increased acceptance of the self and mood states, as facilitating behavioural changes and more distal benefits. Process evaluations embedded in future trials may include quantitative measures of key processes described by our participants, as well as those clearly implied by the behavioural theory of depression.
The Clinical Efficacy of Psychological Interventions for Bipolar Depression: A Systematic Review and Individual Patient Data (IPD) Meta-Analysis
(Cambridge University Press, 2025) Yilmaz, Sakir; Huguet, Anna; Kisely, Steve; Rao, Sanjay; Wang, Jianli; Price, Molly; Wright, Kim
Unlike conventional meta-analyses, individual patient data (IPD) meta-analysis assesses moderator variables at the level of each participant, which generates more precise and biased estimates. The objective of this study was to investigate whether psychological therapy reduces depression symptoms in people with Bipolar I and II disorders and examine whether baseline depression has a moderating effect on treatment outcomes. Through the use of several electronic databases, a systematic search was conducted. Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. Titles and abstracts were screened, followed by full texts. The authors of the included studies were asked to provide IPD from their trials. A multilevel model approach was used to analyze the data. From the 7552 studies found by our searches, six studies with 668 study participants were eligible. Intervention significantly reduced depression scores. There was a significant association between baseline depression and post treatment depression scores. There was no statistically significant interaction between condition allocation and baseline depression score. When IPD from the two most comparable studies were analyzed, CBT had reduced depression scores relative to the comparator condition. The study included patient data from only six studies which were heterogeneous in terms of intervention type, outcome measure, and comparators. Overall, the psychological interventions tested significantly reduced bipolar depression scores. There was no evidence of moderation by baseline depression scores.