Research code: 1208761
Ethics code: 1208761
Clinical trials code: 1208761
tarbiat modares , zeinabrostami@modares.ac.ir
Abstract: (139 Views)
Introduction: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) [1] broadly categorize bipolar disorder and related disorders into seven subtypes, each characterized by periods of elevated and depressed mood, fluctuating between extremes of happiness and sadness, depending on the severity and type of the disorder [2, 3]. Therefore, the symptoms of bipolar disorder, which appear to stem from a dysfunction in brain mood regulation [6], extend to other areas of functioning [4, 7, 8]. In addition to the functional decline observed in individuals with bipolar disorder who experience life events, their reactive responses to various situations differ from those of others. These differing behavioral responses are, in fact, the symptoms of bipolar disorder [9]. However, others, and sometimes even professionals, may not recognize these specific symptoms as stemming from bipolar disorder, instead perceiving them as behavioral problems [10]. Individuals with bipolar disorder often experience significant occupational difficulties and substantial declines in work performance due to their symptoms [11, 12, 13, 14, 15]. This decline in work performance and its consequences can lead to a relapse of depression and an exacerbation of bipolar disorder symptoms [16, 17, 18]. This study compared the effectiveness of a vocational rehabilitation program with a cognitive behavioral therapy-based career counseling program on the symptoms of bipolar disorder.
Methods: This study employed a quasi-experimental, pre-test/post-test design with a control group. A psychiatrist diagnosed twenty-four participants, selected using available sampling, and randomly assigned them to three groups: an experimental group receiving a vocational rehabilitation program (n=8), an experimental group receiving a cognitive behavioral therapy-based career counseling program (n=8), and a control group (n=8). The Bipolar Disorder Symptoms Checklist was used to quantify the symptoms of the disorder. Descriptive statistics and inferential statistical methods, including multivariate analysis of variance with repeated measures, were used to analyze the data. The vocational rehabilitation and cognitive behavioral therapy-based career counseling programs each consisted of 10 sessions, with an average duration of 100 minutes per session. The vocational rehabilitation program also included two sessions for family members and two sessions for employers or colleagues, provided the individual participant desired and consented to these sessions. The cognitive behavioral therapy-based career counseling model was based on the guidelines of Beck et al. [30]. The validity and reliability of both the developed career counseling program and the vocational rehabilitation program were assessed and validated based on the occupational difficulties experienced by individuals with bipolar disorder [7]. Multivariate analysis of variance with repeated measures was used to analyze the findings. Age and gender were controlled based on prior research and pre-test blinding. Participant bipolar disorder diagnoses were also blinded, demonstrating that the type of disorder had no impact on the results. The Kolmogorov-Smirnov test was used to test the normality assumption of the distribution of scores, and the normality of the symptom scores was confirmed for all three groups at all three stages of the study. The Box-and-Levine's test was used to verify the homogeneity of variances. The results indicated that the homogeneity of the variance-covariance matrix was well maintained, and the error variance of the dependent variables was equal across all interventions. Therefore, the use of analysis of variance was appropriate for analyzing the study findings.
Results: The findings indicated that the vocational rehabilitation program had a significant effect on the symptoms of bipolar disorder (p<0.0001), and this effect persisted after one month of follow-up (p>0.0001). The cognitive behavioral therapy-based career counseling program had no significant effect on bipolar disorder symptoms at the post-test (p<0.01) and follow-up stages (p<0.22). The control group showed no change in symptom scores.
Conclusion: Based on the study results, in response to the research question of whether the effects of the vocational rehabilitation program and the cognitive behavioral therapy-based career counseling program on bipolar disorder symptoms differ, the results suggest that symptoms significantly decreased in the vocational rehabilitation group at both post-test and follow-up stages, while the cognitive behavioral therapy-based career counseling group showed minimal, non-significant symptom reduction at post-test and a subsequent increase in symptoms at follow-up. The control group showed no change in symptoms. Overall, while cognitive behavioral therapy appears to be a successful treatment approach, it seems that a more future-oriented approach, incorporating techniques for preventing relapse, such as a vocational rehabilitation program, is preferable for long-term prevention of bipolar disorder relapse. This study provides evidence of the effectiveness of a vocational rehabilitation program in reducing symptoms in individuals with bipolar disorder. Given the results, the vocational rehabilitation program can be used as an early intervention rehabilitation approach to improve the mental health and career paths of individuals with bipolar disorder. The vocational rehabilitation program appears to be effective in reducing bipolar disorder symptoms, and this effect is sustained over time. Based on the study results, the vocational rehabilitation program is an effective and sustainable approach to improving the well-being and career paths of individuals with bipolar disorder.
Methods: This study employed a quasi-experimental, pre-test/post-test design with a control group. A psychiatrist diagnosed twenty-four participants, selected using available sampling, and randomly assigned them to three groups: an experimental group receiving a vocational rehabilitation program (n=8), an experimental group receiving a cognitive behavioral therapy-based career counseling program (n=8), and a control group (n=8). The Bipolar Disorder Symptoms Checklist was used to quantify the symptoms of the disorder. Descriptive statistics and inferential statistical methods, including multivariate analysis of variance with repeated measures, were used to analyze the data. The vocational rehabilitation and cognitive behavioral therapy-based career counseling programs each consisted of 10 sessions, with an average duration of 100 minutes per session. The vocational rehabilitation program also included two sessions for family members and two sessions for employers or colleagues, provided the individual participant desired and consented to these sessions. The cognitive behavioral therapy-based career counseling model was based on the guidelines of Beck et al. [30]. The validity and reliability of both the developed career counseling program and the vocational rehabilitation program were assessed and validated based on the occupational difficulties experienced by individuals with bipolar disorder [7]. Multivariate analysis of variance with repeated measures was used to analyze the findings. Age and gender were controlled based on prior research and pre-test blinding. Participant bipolar disorder diagnoses were also blinded, demonstrating that the type of disorder had no impact on the results. The Kolmogorov-Smirnov test was used to test the normality assumption of the distribution of scores, and the normality of the symptom scores was confirmed for all three groups at all three stages of the study. The Box-and-Levine's test was used to verify the homogeneity of variances. The results indicated that the homogeneity of the variance-covariance matrix was well maintained, and the error variance of the dependent variables was equal across all interventions. Therefore, the use of analysis of variance was appropriate for analyzing the study findings.
Results: The findings indicated that the vocational rehabilitation program had a significant effect on the symptoms of bipolar disorder (p<0.0001), and this effect persisted after one month of follow-up (p>0.0001). The cognitive behavioral therapy-based career counseling program had no significant effect on bipolar disorder symptoms at the post-test (p<0.01) and follow-up stages (p<0.22). The control group showed no change in symptom scores.
Conclusion: Based on the study results, in response to the research question of whether the effects of the vocational rehabilitation program and the cognitive behavioral therapy-based career counseling program on bipolar disorder symptoms differ, the results suggest that symptoms significantly decreased in the vocational rehabilitation group at both post-test and follow-up stages, while the cognitive behavioral therapy-based career counseling group showed minimal, non-significant symptom reduction at post-test and a subsequent increase in symptoms at follow-up. The control group showed no change in symptoms. Overall, while cognitive behavioral therapy appears to be a successful treatment approach, it seems that a more future-oriented approach, incorporating techniques for preventing relapse, such as a vocational rehabilitation program, is preferable for long-term prevention of bipolar disorder relapse. This study provides evidence of the effectiveness of a vocational rehabilitation program in reducing symptoms in individuals with bipolar disorder. Given the results, the vocational rehabilitation program can be used as an early intervention rehabilitation approach to improve the mental health and career paths of individuals with bipolar disorder. The vocational rehabilitation program appears to be effective in reducing bipolar disorder symptoms, and this effect is sustained over time. Based on the study results, the vocational rehabilitation program is an effective and sustainable approach to improving the well-being and career paths of individuals with bipolar disorder.
Type of Study: Research |
Subject:
Psychiatric Rehabilitation
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