Psychiatric Annals

CME Article 

What We have Learned from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Study

Jan Fawcett, MD

Abstract

The first publications from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) began to appear in 2003. STEP-BD was conceived in response to an initiative by the National Institutes for Mental Health (NIMB) seeking a public health intervention model that could generate externally valid answers to questions related to bipolar disorder. The study uses a hybrid design to collect longitudinal data for a patient’s transition between naturalistic studies and randomized clinical trials. About 4,360 patients were admitted to the STEP-BD program, receiving a systematic assessment battery at entry and treated by a range of psychiatrists trained to deliver care and measure outcomes in bipolar patients. A registry of all bipolar patients of every subtype = / > 15 was maintained. A report of the first 1,000 patients enrolled in this study found that the sample was 92.6% white and 58.6% female, less racially diverse than the national population, with higher than average education but also higher than average unemployment and lower than average income.

ABOUT THE AUTHOR

Jan Fawcett, MD, is Editor of Psychiatric Annals, and is Professor, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque.

Address correspondence to: Jan Fawcett, MD, jan.fawcett@comcast.net.

Dr. Fawcett has disclosed the following relevant financial relationships: Eli Lilly & Co.: Member of Speakers’ Bureau; and Abbott Laboratories: Member of Medical Advisory Board.

EDUCATIONAL OBJECTIVES

  1. Describe the findings of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.
  2. Discuss how the course and treatment of bipolar disorder and the difficulties in treating and preventing recurrences of bipolar depression.
  3. Demonstrate the difficulties of successfully treating bipolar disorder and its comorbidities.

Abstract

The first publications from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) began to appear in 2003. STEP-BD was conceived in response to an initiative by the National Institutes for Mental Health (NIMB) seeking a public health intervention model that could generate externally valid answers to questions related to bipolar disorder. The study uses a hybrid design to collect longitudinal data for a patient’s transition between naturalistic studies and randomized clinical trials. About 4,360 patients were admitted to the STEP-BD program, receiving a systematic assessment battery at entry and treated by a range of psychiatrists trained to deliver care and measure outcomes in bipolar patients. A registry of all bipolar patients of every subtype = / > 15 was maintained. A report of the first 1,000 patients enrolled in this study found that the sample was 92.6% white and 58.6% female, less racially diverse than the national population, with higher than average education but also higher than average unemployment and lower than average income.

ABOUT THE AUTHOR

Jan Fawcett, MD, is Editor of Psychiatric Annals, and is Professor, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque.

Address correspondence to: Jan Fawcett, MD, jan.fawcett@comcast.net.

Dr. Fawcett has disclosed the following relevant financial relationships: Eli Lilly & Co.: Member of Speakers’ Bureau; and Abbott Laboratories: Member of Medical Advisory Board.

EDUCATIONAL OBJECTIVES

  1. Describe the findings of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.
  2. Discuss how the course and treatment of bipolar disorder and the difficulties in treating and preventing recurrences of bipolar depression.
  3. Demonstrate the difficulties of successfully treating bipolar disorder and its comorbidities.

The first publications from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) began to appear in 2003. STEP-BD was conceived in response to an initiative by the National Institutes for Mental Health (NIMB) seeking a public health intervention model that could generate externally valid answers to questions related to bipolar disorder. The study uses a hybrid design to collect longitudinal data for a patient’s transition between naturalistic studies and randomized clinical trials. About 4,360 patients were admitted to the STEP-BD program, receiving a systematic assessment battery at entry and treated by a range of psychiatrists trained to deliver care and measure outcomes in bipolar patients. A registry of all bipolar patients of every subtype = / > 15 was maintained. A report of the first 1,000 patients enrolled in this study found that the sample was 92.6% white and 58.6% female, less racially diverse than the national population, with higher than average education but also higher than average unemployment and lower than average income.

ABOUT THE AUTHOR

Jan Fawcett, MD, is Editor of Psychiatric Annals, and is Professor, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque.

Address correspondence to: Jan Fawcett, MD, jan.fawcett@comcast.net.

Dr. Fawcett has disclosed the following relevant financial relationships: Eli Lilly & Co.: Member of Speakers’ Bureau; and Abbott Laboratories: Member of Medical Advisory Board.

EDUCATIONAL OBJECTIVES

  1. Describe the findings of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.
  2. Discuss how the course and treatment of bipolar disorder and the difficulties in treating and preventing recurrences of bipolar depression.
  3. Demonstrate the difficulties of successfully treating bipolar disorder and its comorbidities.

10.3928/00485713-20080701-02

Sign up to receive

Journal E-contents