Psychosocial interventions for the prevention of relapse in bipolar disorder: Systematic review of controlled trials

Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK.
The British Journal of Psychiatry (Impact Factor: 7.34). 02/2008; 192(1):5-11. DOI: 10.1192/bjp.bp.107.037887
Source: PubMed

ABSTRACT Pharmacological interventions alone do not provide sufficient benefit for some individuals with bipolar disorder.
To determine the effectiveness of psychosocial interventions for the prevention of relapse in bipolar disorder.
A systematic review and meta-analysis of randomised or quasi-randomised controlled trials were conducted.
Cognitive-behavioural therapy or group psychoeducation may be effective for relapse prevention in stable individuals. Family therapy was no more or less effective than individual psychosocial therapy or crisis management. There is no evidence that care management or integrated group therapy is effective in the prevention of relapse.
Cognitive-behavioural therapy, group psychoeducation and possibly family therapy may be beneficial as adjuncts to pharmacological maintenance treatments.

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Available from: Karla Soares Weiser, Jul 29, 2015
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    • "Previous research examining the effectiveness of psychological treatments, such as CBT, in treating bipolar disorder has also demonstrated mixed results. For instance, while some researchers have shown benefits using a range of adjunctive psychological treatments in the management of bipolar disorder (Beynon et al. 2008; Miklowitz 2008; Sachs 2008; Tomba and Fava 2009), others have noted no or minimal improvements (Miklowitz et al. 2007; Scott et al. 2006). Thus, it is important to place results of MBCT in this context. "
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    ABSTRACT: Mindfulness-based approaches are popular in the treatment of a variety of psychiatric disorders. This article examines how mindfulness-based inventions may assist in the management of bipolar disorder and in addressing common comorbidities, such as anxiety disorders. We also examine how mindfulness mediation may ameliorate cognitive deficits associated with bipolar disorder and reduce the impact of stress in managing day-to-day life events. Initial results of mindfulness-based cognitive therapy studies for those with bipolar disorder are promising; however, further research is needed to examine the efficacy of these approaches in the long term management of this disorder.
    Mindfulness 04/2014; 5:186-191. DOI:10.1007/s12671-012-0166-6
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    • "Bipolar disorder is characterized by emotional dysregulation and patients therefore demonstrate impairments in emotional control and executive functioning, even during euthymic states (Green et al., 2007; Phillips et al., 2008). Pharmacological management is considered the treatment of choice for bipolar disorder and there is some evidence that cognitive-behavioural therapy (CBT), group psycho-education and possibly family therapy may be beneficial as adjuncts to pharmacological maintenance treatments for the prevention of relapse in stable patients (Beyon et al., 2008;. Scott et al., 2007; Vieta and Colom, 2004). "
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    ABSTRACT: Preliminary research findings have shown that mindfulness-based cognitive therapy improves anxiety and depressive symptoms in bipolar disorder. In this study, we further investigated the effects of MBCT in bipolar disorder, in a controlled fMRI study. Twenty three patients with bipolar disorder underwent neuropsychological testing and functional MRI. Sixteen of these patients were tested before and after an eight-week MBCT intervention, and seven were wait listed for training and tested at the same intervals. The results were compared with 10 healthy controls. Prior to MBCT, bipolar patients reported significantly higher levels of anxiety and symptoms of stress, scored significantly lower on a test of working memory, and showed significant BOLD signal decrease in the medial PFC during a mindfulness task, compared to healthy controls. Following MBCT, there were significant improvements in the bipolar treatment group, in measures of mindfulness, anxiety and emotion regulation, and in tests of working memory, spatial memory and verbal fluency compared to the bipolar wait list group. BOLD signal increases were noted in the medial PFC and posterior parietal lobe, in a repeat mindfulness task. A region of interest analysis revealed strong correlation between signal changes in medial PFC and increases in mindfulness. The small control group is a limitation in the study. These data suggest that MBCT improves mindfulness and emotion regulation and reduces anxiety in bipolar disorder, corresponding to increased activations in the medial PFC, a region associated with cognitive flexibility and previously proposed as a key area of pathophysiology in the disorder.
    Journal of Affective Disorders 06/2013; DOI:10.1016/j.jad.2013.05.074 · 3.71 Impact Factor
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    • "In addition to examining CBT for attenuating symptoms of bipolar disorder, some meta-analyses focused on the efficacy of CBT for preventing relapse in bipolar patients. One study (Beynon et al. 2008) examined the efficacy of CBT for preventing relapse and found it to be somewhat effective when comparing CBT versus treatment as usual. Overall, CBT for bipolar disorder was an effective method of preventing or delaying relapses (e.g., Lam et al. 2009; Cakir and Ozerdem 2010). "
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    ABSTRACT: Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.
    Cognitive Therapy and Research 10/2012; 36(5):427-440. DOI:10.1007/s10608-012-9476-1 · 1.70 Impact Factor
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