Otago researcher investigates novel new therapies for bipolar disorder

Professor Richard Porter

Finding a way to help people with treatment-resistant bipolar disorder has earned University of Otago researcher Professor Richard Porter a Health Research Council grant to undertake a feasibility study into the use of novel treatments.

Professor Porter will receive $241,384 over two years to investigate the effectiveness of Social Rhythm and Bright Light Therapies in treating patients with bipolar disorder who are not responding to medications.

He is one of three University of Otago researchers who have together been awarded $737,796 by the HRC to undertake feasibility studies. Professor Porter’s colleague, Associate Professor Caroline Bell from the Department of Psychological Medicine at the University of Otago, Christchurch, receives $247,231 to investigate a new psychological group treatment for anxiety and depression in primary care.

Associate Professor Caroline Bell

While Dr Ben Darlow from Primary Healthcare and General Practice at the University of Otago, Wellington, receives $249,181 to investigate reducing the burden of knee osteoarthritis through community pharmacy.

Bipolar disorder is a common disease with a high burden related to frequent relapse and cognitive impairment.  A significant factor in maintaining dysfunction and risk of relapse is circadian rhythm disturbance.

Professor Porter, a consultant psychiatrist and Professor in the Department of Psychological Medicine, Christchurch, explains that psychotherapies have been developed which have shown to impact upon this disturbance, and to reduce relapse – like Interpersonal and Social Rhythm Therapy.  Recent evidence also suggests that Bright Light Therapy may also be helpful.

Dr Ben Darlow

“However, patients rarely receive these therapies in clinical practice.  Medications are usually the only treatment option available in mental health services, yet many patients have an inadequate response to these, with results in ongoing symptoms and relapse,” Professor Porter says.

“We aim to evaluate, in a full study, the effectiveness of combined Social Rhythm Therapy – a modified form of Interpersonal and Social Rhythm Therapy – together with Bright Light Therapy in treating patients with ‘treatment resistant’ bipolar disorder.  Prior to embarking upon this, feasibility issues need to be clarified.”

Bright Light Therapy has been used for many years, primarily for seasonal affective disorder. While this disorder is relatively rare at the latitude of New Zealand, light boxes have been available for use for some time, though Professor Porter says clinicians have generally not been recommending them.

The light boxes are usually propped on a table and have a screen that emits light. Patients sit near the box and can do other things while doing this, but must have their eyes open while not looking directly at the box.  This is done daily, at around noon for 30-60 minutes.

Social Rhythm Therapy has been developed by the researchers in the Department of Psychological Medicine, Christchurch, in collaboration with researchers in Pittsburgh, US. It focuses on stabilising daily social rhythms, such as when a person wakes, eats, sleeps and has social interactions, with the aim of synchronising circadian rhythms.

“The hope is that in patients with particularly severe bipolar disorder the combination of intensive therapy to stabilise social rhythms and light therapy will improve outcomes,” Professor Porter says.

The HRC awarded just over $1.9 million nationally for eight feasibility studies.  These grants go towards testing the critical, practical issues affecting a planned larger study.

For further information, contact:

Professor Richard Porter
Department of Psychological Medicine
University of Otago, Christchurch
Email richard.porter@otago.ac.nz

Liane Topham-Kindley
Senior Communications Adviser
Tel +64 3 479 9065
Mob +64 27 467 9523
Email liane.topham-kindley@otago.ac.nz