Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T08:21:02.077Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial Treatment for Bipolar Disorder

Published online by Cambridge University Press:  07 November 2014

Noreen Reilly-Harrington
Get access Rights & Permissions [Opens in a new window]

Extract

Medication is the mainstay of treatment for bipolar disorder. However, no medication will be effective if patients do not take it, and the rates of medication compliance in bipolar disorder are very low. Johnson and McFarland found that the modal length of compliance with a mood stabilizer was only 2 months. Keck and colleagues found that 50% to 66% of patients with bipolar disorder exhibit poor compliance within the first 12 months of treatment. In addition, even with adequate medication compliance, high rates of relapse persist.

Adjunctive psychosocial treatments can help reduce relapse and provide patients as well as their families with tools to manage bipolar disorder more effectively. Several forms of intensive psychotherapy have shown promise for the treatment of bipolar disorder. In the Systematic Treatment Enhancement Program for Bipolar Disorder, Miklowitz and colleagues compared three forms of intensive interventions: cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy, and family-focused treatment. These were compared to a brief, 3-session psychoeducational intervention known as collaborative care. A total of 293 depressed patients with bipolar type I or type II disorder were treated with protocol pharmacotherapy and were randomly assigned to either one of the three intensive interventions or the brief psychoeducational intervention.

The three intensive interventions provided up to 30 sessions of treatment over a 9-month period. The collaborative care intervention consisted of three sessions administered over a 6-week period. The authors found that patients who received one of the intensive interventions had a median time to recovery 110 days earlier than patients who had received the collaborative care conditions. Patients who received one of the three intensive psychotherapies also had significantly higher year-end recovery rates, and are more than 1 to 1.5 times more likely to be clinically well during any study month. No statistically significant differences were found between the 3 intensive treatments.

Type
Research Article
Information
CNS Spectrums , Volume 15 , supplement S3: Recognition and Treatment Strategies for Bipolar Disorder Across the Life Cycle , February 2010 , pp. 14 - 16
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Johnson, RE, McFarland, BH. Lithium use and discontinuation in a health maintenance organization. Am J Psychiatry. 1996;153(8):993-1000.Google Scholar
2.Keck, PE Jr, McElroy, SL. Outcome in the pharmacologic treatment of bipolar disorder. J Clin Psychopharmacol. 1996;16(2 suppl 1):15S-23S.CrossRefGoogle ScholarPubMed
3.Keck, PE Jr, McElroy, SL, Strakowski, SM, et al. 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry. 1998;155(5):646-652.CrossRefGoogle ScholarPubMed
4.Miklowitz, DJ, Otto, MW, Frank, E, et al. Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program. Arch Gen Psychiatry. 2007;64(4):419-426.CrossRefGoogle ScholarPubMed
5.Ekers, D, Richards, D, Gilbody, S. A meta-analysis of randomized trials of behavioural treatment of depression. Psychol Med. 2008;38(5):611-623.CrossRefGoogle ScholarPubMed
6.McHugh, RK, Smits, JA, Otto, MW. Empirically supported treatments for panic disorder. Psychiatr Clin North Am. 2009;32(3):593-610.CrossRefGoogle ScholarPubMed
7.Storch, EA, Mariaskin, A, Murphy, TK. Psychotherapy for obsessive-compulsive disorder. Curr Psychiatry Rep. 2009:11(4):296-301.CrossRefGoogle ScholarPubMed
8.Singh, JS, Hope, DA. Cognitive-behavioral approaches to the treatment of social anxiety disorder. Isr J Psychiatry Relaat Sci. 2009:46(1):62-69.Google Scholar
9.Newman, CF, Leahy, RL, Beck, AT, Reilly-Harrington, N. Bipolar Disorder: A Cognitive Therapy Approach. Washington, DC: American Psychological Association; 2001.Google Scholar
10.Otto, MW, Reilly-Harrington, NA, Knauz, RO, Henin, A. Living With Bipolar Disorder: A Guide for Individuals and Families. New York, NY: Oxford University Press: 2008.Google Scholar
11. The Massachusetts General Hospital Bipolar Clinic and Research Program. Mood Chart. Available at: www.manicdepressive.org/moodchart.html. Accessed January 13, 2009.Google Scholar
12.Otto, MW, Reilly-Harrington, NA. Managing Bipolar Disorder: A Cognitive-Behavioral Approach: Therapist Guide & Workbook. New York, NY: Oxford University Press; 2009.Google Scholar