A Randomised Controlled Feasibility Trial of Culturally Adapted Psychoeducation (CaPE) for Bipolar Disorders in Nigeria

Bipolar Disorders (BDs) are chronic mental health disorders that often result in functional impairment which constitutes a significant disease burden (Husain et al. 2017). It also accounts for 7% of the disability-adjusted life years (DALY) caused by mental disorders (Whiteford et al. 2013). Four out of 10 persons with a probable diagnosis of BDs received no mental health care within the preceding 12 months (Humpston et al. 2021). Compared to the general population, individuals with BDs tend to have a significantly higher rate of associated suicide mortality (Crump et al., 2013). Within the last decade, these mortality rates have substantially increased (Lomholt et al. 2019), suggesting the need for targeted research to address the unresolved needs of individuals suffering from BDs. A recent meta-analysis found that compared to the general population, bipolar patients had reduced life expectancy with about 13 years of potential life loss (Chan et al. 2022).BDs are historically under-researched compared to other mental health disorders, especially in Sub-Saharan Africa and Nigeria (Jidong et al., 2023). Our recent study on "Bipolar disorders in Nigeria" (Jidong et al., 2023) provided insight into contextual knowledge and beliefs about BDs, including the lived experiences of patients with BDs, their caregivers, and clinicians in Nigeria. The study recommended culturally adapted psychosocial intervention for bipolar patients, and hence the proposed study titled "A randomised controlled feasibility trial of Culturally adapted Psychoeducation (CaPE) for bipolar disorders in Nigeria".

Inclusion Criteria:diagnosis of DSM IV bipolar affective disordercurrently euthymic (BDI < 12 and YMRS < 8)age 18-65 years, participants engaged with the mental health services for the preceding 6 monthsable to give written informed consentresident of the trial catchment area andthe ability to speak English.Exclusion Criteria:severe cognitive impairmentcurrently experiencing relapse (mania, hypomania, mixed or depressive)being actively suicidalthe presence of any comorbid psychiatric illness such as substance misuse or alcohol dependence according to DSM IV criteria.