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Research has highlighted the importance of recovery as defined by the
service user, and suggests a link to negative emotion, although little is
known about the role of negative emotion in predicting subjective
To investigate longitudinal predictors of variability in recovery scores
with a focus on the role of negative emotion.
Participants (n=110) with experience of psychosis
completed measures of psychiatric symptoms, social functioning,
subjective recovery, depression, hopelessness and self-esteem at baseline
and 6 months later. Path analysis was used to examine predictive factors
for recovery and negative emotion.
Subjective recovery scores were predicted by negative emotion, positive
self-esteem and hopelessness, and to a lesser extent by symptoms and
functioning. Current recovery score was not predicted by past recovery
score after accounting for past symptoms, current hopelessness and
current positive self-esteem.
Psychosocial factors and negative emotion appear to be the strongest
longitudinal predictors of variation in subjective recovery, rather than
Despite evidence for the effectiveness of structured psychological
therapies for bipolar disorder no psychological interventions have been
specifically designed to enhance personal recovery for individuals with
recent-onset bipolar disorder.
A pilot study to assess the feasibility and effectiveness of a new
intervention, recovery-focused cognitive–behavioural therapy (CBT),
designed in collaboration with individuals with recent-onset bipolar
disorder intended to improve clinical and personal recovery outcomes.
A single, blind randomised controlled trial compared treatment as usual
(TAU) with recovery-focused CBT plus TAU (n = 67).
Recruitment and follow-up rates within 10% of pre-planned targets to
12-month follow-up were achieved. An average of 14.15 h (s.d. = 4.21) of
recovery-focused CBT were attended out of a potential maximum of 18 h.
Compared with TAU, recovery-focused CBT significantly improved personal
recovery up to 12-month follow-up (Bipolar Recovery Questionnaire mean
score 310.87, 95% CI 75.00–546.74 (s.e. = 120.34), P =
0.010, d=0.62) and increased time to any mood relapse
during up to 15 months follow-up (χ2 = 7.64,
P<0.006, estimated hazard ratio (HR) = 0.38, 95%
CI 0.18–0.78). Groups did not differ with respect to medication
Recovery-focused CBT seems promising with respect to feasibility and
potential clinical effectiveness. Clinical- and cost-effectiveness now
need to be reliably estimated in a definitive trial.