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Affective disorders are associated with impaired functioning and quality of life, as well as comorbid somatic disorders and increased mortality. Despite different medical and psychological treatment options, the prognosis for affective disorder remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting the patient groups having impaired functioning. The core idea of the AWARE project is to focus on improving functioning and quality of life in patients with affective disorders every-day life using a comprehensive 360 degrees intervention.
The trial has a randomized, controlled, parallel-group design. Study participants will be 140 outpatients, male or female age 18-65 with a diagnosis of bipolar disorder or unipolar disorder, in a current state of remission, with an objectively rated impaired functioning. Participant will be randomized to six month AWARE intervention or treatment as usual (TAU).
Assessments encompassing Activities of Daily Living (ADL), neuropsychological testing, mood ratings, physical health and questionnaires on subjective cognitive complaints, psychosocial functioning, quality of life are, sleep quality and satisfaction with psychiatric treatment are carried out at baseline and after the end of treatment.
Discussion: It is hypothesised that the AWARE arm in comparison with standard care will improve observed ability to perform Activities of Daily Living (ADL) and improve Quality of Life.
Despite different medical and psychological treatment options, the prognosis for affective disorder remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting the patient groups having impaired functioning.
The core idea in the AWARE project is to focus on improving functioning and quality of life in patients with affective disorders every-day life using a comprehensive 360 degrees intervention. The present AWARE intervention represent an integrated treatment avenue to improve functioning in patients with affective disorders.
The aim of the study is, in a pragmatically Randomised Controlled Trial (RCT), to investigate the effect of a 360 degrees intervention based on the ICF Brief Core Set for BD and unipolar disorder targeting functioning.
The participants will upon inclusion, be randomised to participate in either 6 months AWARE treatment or standard care. The control group will receive standard care consisting of the standard out-patient mental health service routines in The Capital Region of Denmark.
The AWARE intervention targets multiple aspects of the described enhancers of functioning based on on the ICF Brief Core Set, including ADL ability as a part of carrying out daily routines.
The study carried out in a randomized design. The investigators who assess the patients are blinded to whether the patient has participated in the active or passive treatment arm, so the results will be valid. In addition, validated standardized survey methods according to all the outcomes is applied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental | AWARE intervention |
|
| Control group | No Intervention | Treatment as usual (consisting of the standard out-patient mental health service routines in The Capital Region of Denmark) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AWARE intervention | Combination Product | Comprehensive 360 degrees intervention. The intervention targets multiple aspects of the described enhancers of functioning based on on the ICF Brief Core Set. 1) ADL ability as a part of carrying out daily routines 2) Mood symptoms, medication and side effects 3) Social, relatives and network 4) Physical health, including BMI, biomarkers and exercise5) Cognition, circadian rhythm measured as sleep quality, and coping (stress reduction). |
| Measure | Description | Time Frame |
|---|---|---|
| ADL ability | Assessment of Motor and Process Skills (AMPS) is a standardized observation-based assessment providing measures of the quality of ADL task performance. | 6 month |
| Measure | Description | Time Frame |
|---|---|---|
| Patient quality of Life | PSS (Cohen's Perceived Stress Scale) and WHOQoL (World Health Organization, Quality of life) | 6 month |
| Daily functioning | FAST (Functioning Assessment Short Test) and WHODAS (WHO Disability Assessment Schedule 2.0) |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive scores using a composite score from baseline to endpoint and physical health | SCIP, DART and Trailmaiking | 6 month |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maj Vinberg, Prof, MD, DMSc | Psychiatric Centre North Zealand, Copenhagen University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Psychiatric Centre North Zealand, Copenhagen University Hospital | Hillerød | 3400 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39479758 | Derived | Schwarz R, Miskowiak KW, Christensen MS, Kessing LV, Vinberg M. Affective disorders: eliminate WArning signs And REstore functioning: AWARE. Results from a randomized controlled multimodular intervention study targeting functioning in patients with affective disorders. Psychol Med. 2024 Oct;54(14):3985-3994. doi: 10.1017/S0033291724002526. Epub 2024 Oct 31. | |
| 35618335 |
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The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
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No current time frame
Reasonable request
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| ID | Term |
|---|---|
| D019964 | Mood Disorders |
| D001714 | Bipolar Disorder |
| D001523 | Mental Disorders |
| ID | Term |
|---|---|
| D000068105 | Bipolar and Related Disorders |
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| 6 month |
| Schwarz R, Decker L, Seeberg I, Miskowiak KW, Kessing LV, Vinberg M. Affective disorders: eliminate WArning signs and REstore functioning-AWARE-a randomised controlled multimodule intervention study, presentation of design and intervention. BMJ Open. 2022 May 26;12(5):e058839. doi: 10.1136/bmjopen-2021-058839. |