Bipolar disorder (BD) is a serious, highly heritable mental health condition that often begins in adolescence and early adulthood. Despite the availability of effective treatments, many individuals go undiagnosed for years. This delay can lead to repeated mood episodes, hospitalizations, substance use and a higher risk of suicide.
“Early identification and intervention can be life-changing,” says Dr. Kamyar Keramatian, a psychiatrist and researcher in the mood disorders clinic at the Djavad Mowafaghian Centre for Brain Health and an Assistant Professor in UBC’s Department of Psychiatry. “If we can reach young people before their first major manic or depressive episode, we have the potential to reduce long-term complications and improve quality of life.”
To address this need, Dr. Keramatian and his team developed a manualized telehealth-based psychoeducational and resilience enhancement program for individuals at high risk for bipolar disorder (PREP-BD). Delivered in small groups over Zoom, the program provides practical education on early warning signs, self-management strategies, resilience building and help-seeking. Family members are also invited to selected sessions to strengthen understanding and support at home.
In a recent feasibility study published in the Canadian Journal of Psychiatry, 21 participants aged 17 to 24 who met criteria for being at risk of BD joined PREP-BD in four separate cohorts. Each cohort attended eight weekly, 60-minute sessions. The results were highly encouraging, with 100 per cent of invited participants signing up, and over 76 per cent completing at least 75 per cent of the program—completion rates higher than typically seen in similar group interventions.
Participants reported greater willingness to seek professional help, particularly if they noticed early symptoms of hypomania, which can be harder to recognize than depression. They also experienced significant improvements in quality of life. While measures of resilience and self-stigma showed positive trends that did not reach statistical significance, the findings point to meaningful changes in attitudes and readiness for early care.
Dr. Keramatian notes that accessibility was a key factor in the program’s success.
“By offering PREP-BD online, we reduced barriers like transportation and time constraints, which can be major obstacles for young people,” he explains. “The virtual format will also allow us to reach participants across a wider geographic area in the future.”
The program’s focus on both education and empowerment is intentional. By demystifying BD and providing clear, actionable strategies, PREP-BD aims to equip at-risk youth with the knowledge and confidence to recognize when they need help. Involving families further reinforces these messages and helps create a supportive environment for ongoing mental health care. While the initial study was small, its strong engagement and positive early outcomes suggest PREP-BD could be a valuable early intervention tool.
“Our goal is to make early support for bipolar disorder as routine as early screening for other health conditions,” says Dr. Keramatian. “The sooner we act, the better the outcomes and the more we can help young people live full, healthy lives.”
Following the feasibility study, the program has now been adapted into self-paced e-modules to increase scalability and accessibility. Next, the research team is planning a randomized controlled trial to assess the effectiveness of the online version.
