While bipolar disorder can be treated with medication, many people experience relapses into dangerous behavior. In a recent study, published in the Journal of Medical Internet Research, researchers tested the effectiveness of an online relapse prevention tool in offering an inexpensive, accessible treatment option.

Examining the Enhanced Relapse Prevention (ERPonline), an online platform developed by the Spectrum Centre for Mental Health Research in Lancaster, U.K., researchers measured how the tool prevented relapses in patients with bipolar disorder (BD). The platform teaches patients with BD to identify and respond to early symptoms of relapse and to seek treatment before dangerous circumstances, such as suicide, occur.

"The key elements are identifying your individual triggers and early warning signs for both mania and depression, and developing coping strategies to manage mood changes in everyday life,” said lead researcher Fiona Lobban, a professor at Lancaster University. "Online interventions may prove an important cheap, feasible and acceptable step forward in creating a choice of evidence-based interventions for people with BD at different stages of recovery."

The study included 96 bipolar participants, evaluated over 48 weeks by comparing 47 participants receiving ERPonline with usual treatment to 49 participants receiving “waitlist (WL) control” with usual treatment. Outcomes were measured for retention rates, levels of intervention use, adverse events and participant feedback.

Overall retention rates were high at 80 percent until week 48 when they dropped to 76 percent. Access to ERPonline correlated to increased levels of positivity, increased monitoring of depression and hypomania when compared to the WL group. Relapse rates in both groups were low at 15 percent.

“ERPonline offers a cheap accessible option for people seeking ongoing support following successful treatment,” concluded Lobban. “However, given high functioning and low relapse rates in this study, testing clinical effectiveness for this population would require very large sample sizes. Building in human support to use ERPonline should be considered.”