Key Findings of the STEP-BD Study for Bipolar Disorder

Closer Look at the STEP-BD Study and What it Means for Your Care

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Bipolar disorder is a challenging illness to treat because of its variable symptoms and high risk of suicide. The good news is that there are a number of studies on bipolar disorder to help doctors provide excellent therapy regimens for their patients.

One research study in the United States that has brought insight into the treatment and course of bipolar disorder is the STEP-BD study — a very large seven-year study in the United States.

Let's learn a few significant results of this study.

What is STEP-BD?

STEP-BD — which stands for Systematic Treatment Enhancement Program for Bipolar Disorder — is a large study that followed over 4000 people with bipolar disorder in the United States. The aim of this long-term study was to find out which treatments or combinations of treatments were most effective for treating bipolar episodes and preventing new episodes. Participants could choose to continue their current treatment, change treatment, or enroll in randomized studies. No one was given placebo-only treatment ("sugar" pills).

In addition to bipolar disorder therapies, the study provided information on the typical course of bipolar disorder and other psychiatric illnesses that are common in people with bipolar disorder, like anxiety disorders and ADD. Suicide in people with bipolar disorder was also examined.

Who Funded the Step-BD Study?

The study was funded by the National Institute of Mental Health, the U.S. government agency responsible for research on mental disorders and their treatment.

What are Some Key Findings in the Step-BD Study?

A 2010 study in the Canadian Journal of Psychiatry nicely summarized key findings of the Step-BD study. These included:

  • Bipolar depression is particularly disabling and often is not treated effectively with various medications, especially antidepressants.
  • Many people with bipolar disorder have other psychiatric illness that affect the stability of their bipolar. Of these psychiatric illnesses, anxiety disorders and smoking — known as tobacco abuse — can usually be treated most easily.
  • The earlier the age at which a person develops bipolar disorder, the more likely they are to have a severe disease course.
  • Even with good treatment, suicide  is still a problem in bipolar disorder. The most significant factor in determining whether a person is at an increased risk of suicide is prior attempts. Finally, improving hopelessness — a symptom of depression — may reduce a person's risk of suicide.
  • Subsyndromal symptoms — meaning symptoms do not meet the criteria for a true bipolar episode, but are close — are common in people who are bipolar.

What Does This Mean for Me?

If you suffer from bipolar disorder, remain hopeful that there are excellent therapies and resources out there for you — and this is a disorder that is continually being studied. Continue your medications and seeing your psychiatrist regularly so you can optimize your bipolar and overall health.

Sources:

Kogan, J.N., et al. Demographic and diagnostic characteristics of the first 1000 patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Bipolar Disorders 6(2004): 460-9.

Parikh SV, LeBlanc SR & Ovanessian MM. Advancing bipolar disorder: key lessons from the Systematic Treatment Enhancement Program for Bipoalr Disorder (STEP-BD). Can J Psychiatry. 2010 Mar;55(3):136-43.

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