{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:58:05Z","timestamp":1784714285295,"version":"3.55.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p>There is little research reporting the outcome of internet delivered cognitive behaviour therapy, (iCBT), which helps patients identify and modify unhelpful cognitions and behaviours, for the depressed phase of bipolar disorder as part of routine care. Demographic information, baseline scores and treatment outcomes were examined for patients of MindSpot Clinic, a national iCBT service who reported taking Lithium and their clinic records confirmed the diagnosis of bipolar disorder. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), compared to clinic benchmarks. Out of 21,745 people who completed a MindSpot assessment and enrolled in a MindSpot treatment course in a 7 year period, 83 reported taking Lithium and had a confirmed a diagnosis of bipolar disorder. Outcomes of reductions in symptoms were large on all measures (effect sizes &gt; 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. MindSpot treatments appear to be effective in treating anxiety and depression in people diagnosed with bipolar, and suggest that iCBT has the potential to overcome the under-use of evidence based psychological treatments of people with bipolar depression.<\/jats:p>","DOI":"10.1371\/journal.pdig.0000194","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T18:27:11Z","timestamp":1677090431000},"page":"e0000194","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of internet delivered cognitive behaviour therapy provided as routine care for people in the depressed phase of bipolar disorder treated with Lithium"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5172-2781","authenticated-orcid":true,"given":"Olav","family":"Nielssen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Staples","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Karin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rony","family":"Kayrouz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake","family":"Dear","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7268-729X","authenticated-orcid":true,"given":"Nickolai","family":"Titov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"pdig.0000194.ref001","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/0706743716656607","article-title":"Meta-Analysis of the Interval between the Onset and Management of Bipolar Disorder","volume":"62","author":"J Dagani","year":"2016","journal-title":"Can J Psychiatry"},{"key":"pdig.0000194.ref002","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5694\/mja12.11740","article-title":"Treatment of bipolar depression","volume":"198","author":"M Berk","year":"2013","journal-title":"The Medical journal of Australia"},{"key":"pdig.0000194.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40345-019-0160-1","article-title":"Bipolar depression: a major unsolved challenge","volume":"8","author":"RJ Baldessarini","year":"2020","journal-title":"Int J Bipolar Disord"},{"key":"pdig.0000194.ref004","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1001\/archpsyc.59.6.530","article-title":"The long-term natural history of the weekly symptomatic status of bipolar I disorder","volume":"59","author":"LL Judd","year":"2002","journal-title":"Arch Gen Psychiatry"},{"issue":"6","key":"pdig.0000194.ref005","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/bdi.12929","article-title":"Diagnostic conversion from unipolar depression to bipolar disorder, schizophrenia, or schizoaffective disorder: A nationwide prospective 15-year register study on 43 495 inpatients","volume":"22","author":"I Baryshnikov","year":"2020","journal-title":"Bipolar Disord"},{"key":"pdig.0000194.ref006","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4088\/JCP.v62n0314a","article-title":"The clinical features of bipolar depression: a comparison with matched major depressive disorder patients","volume":"6","author":"PB Mitchell","year":"2001","journal-title":"J Clin Psychiatry"},{"key":"pdig.0000194.ref007","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1192\/bjp.bp.107.045294","article-title":"Clinical differences between bipolar and unipolar depression","volume":"192","author":"L Forty","year":"2008","journal-title":"Brit J Psychiatry"},{"key":"pdig.0000194.ref008","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/bdi.12855","article-title":"Mood spectrum symptoms during a major depressive episode: Differences between 145 patients with bipolar disorder and 155 patients with major depressive disorder. 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