Acceptance and Commitment Therapy and nicotine patch for smokers with bipolar disorder: preliminary evaluation of in-person and telephone-delivered treatment

作者：Heffner Jaimee L^*; McClure Jennifer B; Mull Kristin E; Anthenelli Robert M; Bricker Jonathan B

来源：Bipolar Disorders, 2015, 17(5): 560-566.

DOI：10.1111/bdi.12300

• depression
• mania
• nicotine
• smoking cessation
• tobacco

ObjectivesPeople with bipolar disorder are two to three times more likely to smoke and 50% less likely to quit than the general population. New treatments are needed to improve smoking cessation outcomes in this group. The study aim was to develop and pilot test a novel cessation intervention for smokers with bipolar disorder using Acceptance and Commitment Therapy (ACT) combined with nicotine patches.
MethodsThe ten-session ACT intervention was initially evaluated as in-person, individual counseling (n=10), then as telephone-delivered counseling (n=6). Participants were adult smokers with no more than mild current symptoms of bipolar disorder.
ResultsFor the in-person protocol, end-of-treatment outcomes were: 80% retention, 40% of participants with carbon monoxide (CO)-verified seven-day point prevalence abstinence (PPA), 90% satisfied with treatment, 8.3 of ten sessions attended, and 54% increase in acceptance of cravings to smoke (i.e., ACT's theory-based change process) from baseline. The seven-day PPA at one-month follow-up was 30%. For the telephone protocol, end-of-treatment outcomes were: 67% retention, 33% reporting seven-day PPA, 100% satisfied with treatment, 6.7 of ten treatment calls completed, and 55% increase in acceptance from baseline. At one-month follow-up, seven-day PPA was 17%. The proportion of treatment completers who used at least 80% of the nicotine patches was 62.5% for the in-person protocol and 0% for the telephone protocol.
ConclusionsBoth in-person and telephone-delivered ACT were feasible. Despite low adherence to nicotine patches, the intervention showed preliminary evidence of facilitating quitting and impacting ACT's change mechanism. A randomized, controlled trial of this targeted ACT intervention is now needed.

• 出版日期2015-8