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Cognitive behaviour therapy and supportive therapy for bipolar disorders: relapse rates for treatment period and 2-year follow-up

Published online by Cambridge University Press:  21 November 2011

T. D. Meyer  and
M. Hautzinger
T. D. Meyer*
Affiliation:
Department of Clinical and Developmental Psychology, Institute of Psychology, Eberhard Karls Universität Tübingen, Germany Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
M. Hautzinger
Affiliation:
Department of Clinical and Developmental Psychology, Institute of Psychology, Eberhard Karls Universität Tübingen, Germany
*
*Address for correspondence: T. D. Meyer, Ph.D., Doctorate in Clinical Psychology, Institute of Neuroscience, Newcastle University, Ridley Building, Newcastle upon Tyne NE1 7RU, UK. (Email: thomas.meyer@newcastle.ac.uk)
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Abstract

Background

The efficacy of adjunctive psychosocial interventions such as cognitive behaviour therapy (CBT) for bipolar disorder (BD) has been demonstrated in several uncontrolled and controlled studies. However, these studies compared CBT to either a waiting list control group, brief psycho-education or treatment as usual (TAU). Our primary aim was to determine whether CBT is superior to supportive therapy (ST) of equal intensity and frequency in preventing relapse and improving outcome at post-treatment. A secondary aim was to look at predictors of survival time.

Method

We conducted a randomized controlled trial (RCT) at the Department of Psychology, University of Tübingen, Germany (n=76 patients with BD). Both CBT and ST consisted of 20 sessions over 9 months. Patients were followed up for a further 24 months.

Results

Although changes over time were observed in some variables, they were not differentially associated with CBT or ST. CBT showed a non-significant trend for preventing any affective, specifically depressive episode during the time of therapy. Kaplan–Meier survival analyses revealed that 64.5% of patients experienced a relapse during the 33 months. The number of prior episodes, the number of therapy sessions and the type of BD predicted survival time.

Conclusions

No differences in relapse rates between treatment conditions were observed, suggesting that certain shared characteristics (e.g. information, systematic mood monitoring) might explain the effects of psychosocial treatment for BD. Our results also suggest that a higher number of prior episodes, a lower number of therapy sessions and a diagnosis of bipolar II disorder are associated with a shorter time before relapse.

Keywords

Bipolar disordercognitive behaviour therapypredictorsrandomized controlled trialrelapse prevention
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 7 , July 2012 , pp. 1429 - 1439
Copyright
Copyright © Cambridge University Press 2011

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