Clin Psychopharmacol Neurosci.
2023 Aug;21(3):457-465. 10.9758/cpn.22.981.
Does Post-traumatic Stress Disorder Impact Treatment Outcomes within a Randomised Controlled Trial of Mitochondrial Agents for Bipolar Depression?
- Russell SE
1 - Wrobel AL1,2
- Ashton MM1
- Turner A1,3
- Mohebbi M1,4
- Berk M1,2,5,6
- Cotton S2,7
- Dodd S1,7,8
- Ng CH6
- Malhi GS9,10,11
- Dean OM1,5
- Affiliations
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- 1Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, VIC, Australia
- 2Orygen, Parkville, VIC, Australia
- 3School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, NSW, Australia
- 4Deakin University, Faculty of Health, Biostatistics Unit, Geelong, VIC, Australia
- 5Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- 6Department of Psychiatry, University of Melbourne, The Melbourne Clinic, Richmond, VIC, Australia
- 7Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- 8Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- 9CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
- 10Department of Psychiatry, The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Sydney, NSW, Australia
- 11Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
- KMID: 2545806
- DOI: http://doi.org/10.9758/cpn.22.981
Abstract
Objective
Bipolar disorder often co-occurs with post-traumatic stress disorder, yet few studies have investigated the impact of post-traumatic stress disorder in bipolar disorder on treatment outcomes. The aim of this sub-analysis was to explore symptoms and functioning outcomes between those with bipolar disorder alone and those with comorbid bipolar disorder and post-traumatic stress disorder.
Methods
Participants (n = 148) with bipolar depression were randomised to: (i) N-acetylcysteine alone; (ii) a combination of nutraceuticals; (iii) or placebo (in addition to treatment as usual) for 16 weeks (＋4 weeks discontinuation). Differences between bipolar disorder and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning at five timepoints, as well as on the rate of change from baseline to week 16 and baseline to week 20, were examined.
Results
There were no baseline differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder apart from the bipolar disorder alone group being significantly more likely to be married (p = 0.01). There were also no significant differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning.
Conclusion
There were no differences in clinical outcomes over time within the context of an adjunctive randomised controlled trial between those with bipolar disorder alone compared to those with comorbid bipolar disorder and post-traumatic stress disorder. However, differences in psychosocial factors may provide targets for areas of specific support for people with comorbid bipolar disorder and post-traumatic stress disorder.
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