Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: preliminary evaluation of in‐person and telephone‐delivered treatment. (25th April 2015)

• Record Type: Journal Article
• Authors: Heffner, Jaimee L; McClure, Jennifer B; Mull, Kristin E; Anthenelli, Robert M; Bricker, Jonathan B
• Is Part Of: Bipolar disorders. Volume 17:Number 5(2015)
• Page Start: 560
• Page End: 566
• Publication Date: 2015-04-25
• Subjects: Manic-depressive illness -- Periodicals; Depression, Mental -- Periodicals; 616.895
• DOI: 10.1111/bdi.12300
• Languages: English
• ISSNs: 1398-5647

Abstract

<abstract abstract-type="main" id="bdi12300-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bdi12300-sec-0001" sec-type="section"> <title>Objectives</title> <p>People with bipolar disorder are two to three times more likely to smoke and 50% less likely to quit than the general population. New treatments are needed to improve smoking cessation outcomes in this group. The study aim was to develop and pilot test a novel cessation intervention for smokers with bipolar disorder using Acceptance and Commitment Therapy (ACT) combined with nicotine patches.</p> </sec> <sec id="bdi12300-sec-0002" sec-type="section"> <title>Methods</title> <p>The ten‐session ACT intervention was initially evaluated as in‐person, individual counseling (n = 10), then as telephone‐delivered counseling (n = 6). Participants were adult smokers with no more than mild current symptoms of bipolar disorder.</p> </sec> <sec id="bdi12300-sec-0003" sec-type="section"> <title>Results</title> <p>For the in‐person protocol, end‐of‐treatment outcomes were: 80% retention, 40% of participants with carbon monoxide (CO)‐verified seven‐day point prevalence abstinence (PPA), 90% satisfied with treatment, 8.3 of ten sessions attended, and 54% increase in acceptance of cravings to smoke (i.e., ACT's theory‐based change process) from baseline. The seven‐day PPA at one‐month follow‐up was 30%. For the telephone protocol, end‐of‐treatment outcomes were: 67% retention, 33% reporting seven‐day PPA, 100% satisfied with treatment, 6.7 of ten treatment calls completed, and 55% increase in acceptance from baseline. At one‐month follow‐up, seven‐day PPA was 17%. The proportion of treatment completers who used at least 80% of the nicotine patches was 62.5% for the in‐person protocol and 0% for the telephone protocol.</p> </sec> <sec id="bdi12300-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Both in‐person and telephone‐delivered ACT were feasible. Despite low adherence to nicotine patches, the intervention showed preliminary evidence of facilitating quitting and impacting ACT's change mechanism. A randomized, controlled trial of this targeted ACT intervention is now needed.</p> </sec> </abstract>