https://doi.org/10.1371/journal.pone.0176849.g002. During the maintenance phase, booster sessions might be necessary, but the data are generally overall negative. The results revealed no significant difference between therapies [63]. The comparison of 12 sessions of psychoeducation vs. TAU in 71 BD patients reported that at 6 weeks, the intervention improved treatment adherence [52], while another on 61 BD-II patients reported no significant effect on the regulation of biological rhythms when compared to standard pharmacological treatment [53]. Tables 3 and 4 present all the subgroup analyses for efficacy outcomes, according to the characteristics of the patients, therapists, and therapies. In a meta-analysis, Ye et al described the short-term efficacy of CBT in lowering the relapse rate of BD [19]. Automated mobile-phone intervention is another option and it has been reported to be feasible, acceptable and might enhance the impact of brief psychoeducation on depressive symptoms in BD. References 1. However, the first study on the wide teaching of patients to recognize and identify the components of their disease with emphasis on early symptoms of relapse and recurrence and to seek professional help as early as possible had not been conducted until 1999. Clin Pract Epidemiol Ment Health 7:112–116, Torrent C, Bonnin CM, Martinez-Aran A, Valle J, Amann BL, Gonzalez-Pinto A et al (2013) Efficacy of functional remediation in bipolar disorder: a multicenter randomized controlled study. The book concludes with extensive reference materials that will be valuable both to general readers and medical practitioners. Found insideThis edited volume bridges the gap between basic and applied science in understanding the nature and treatment of psychiatric disorders and mental health problems. It has been found superior to TAU in 58 BD patients concerning the prevention of relapses, the decrease of manic symptoms and the improvement of medication adherence [76]. 1. However it is interesting that after the 5-year follow-up, 88.9% of patients in the control group and 20% of patients in the combination group showed persistent affective symptoms and difficulties in social–occupational functioning [27]. In the current study, we systematically reviewed the results of 19 RCTs and compared the treatment outcomes obtained by using CBT as an adjuvant therapy to pharmacotherapy and those obtained by using standard care for treating patients with BD. Susan . But what does it do to patients with depression or bipolar disorder? Yes Adult Bipolar Disorder Clinical Psychopharmacology. J Affect Disord 172C:291–299, Bauer MS, McBride L, Williford WO, Glick H, Kinosian B, Altshuler L et al (2006) Collaborative care for bipolar disorder: part II. Br J Psychiatry 158:200–204, Dogan S, Sabanciogullari S (2003) The effects of patient education in lithium therapy on quality of life and compliance. Bipolar disorder (BPD) is a devastating illness that is characterized by recurrent episodes of mania and depression. There are five papers on the efficacy of CR and FR. Millions of patients worldwide are affected by this severe mood illness, incurring costs of billions of USD for the years lived with disability [8]. Prophylactic treatment could also delay or prevent mixed episodes, at least as effectively as manic or depressive episodes in bipolar disorder. 2018;20:397–8. Psychoeducation concerned eight, 50-min sessions of psychological education, followed by monthly telephone follow-up care and psychological support. August 04, 2021. Randomized controlled trials (RCTs) published within the past 10 years have disclosed the potential benefits of CBT as an adjunct to mood stabilizers for preventing relapse, relieving symptoms, and enhancing drug adherence [9]. It reported a significant prolongation of the time to first manic relapse (P = 0.008) and significant reductions in the number of manic relapses over 18 months (30 vs. 52%; P = 0.013) as well as improved overall social functioning. Science News About Bipolar Disorder. Annals of General Psychiatry Found insideProviding a concise view of the current definitions, assessment and evidence-based management of such disorders, this work reviews novel therapeutic targets, which may enhance the future therapeutic armamentarium of clinicians. Acta Neuropsychiatrica 22:50–53, Javadpour A, Hedayati A, Dehbozorgi GR, Azizi A (2013) The impact of a simple individual psycho-education program on quality of life, rate of relapse and medication adherence in bipolar disorder patients. Miziou, S., Tsitsipa, E., Moysidou, S. et al. An 18-month study compared CBT vs. TAU in 253 BD patients and reported that at end point, there were no differences between groups with more than half of the patients having a recurrence. The safety of pharmacotherapy for bipolar disorder during pregnancy and lactation remains a subject of debate and uncertainty. Population Pharmacokinetics of Lithium in Young Pediatric Patients With Intellectual Disability. Bipolar Disord 10(7):798–805, Reinares M, Colom F, Sanchez-Moreno J, Torrent C, Martinez-Aran A, Comes M et al (2008) Impact of caregiver group psychoeducation on the course and outcome of bipolar patients in remission: a randomized controlled trial. Found insideThe Desk Reference to the Diagnostic Criteria From DSM-5® distills the most crucial, updated diagnostic information from this volume to provide clinicians with an invaluable resource for effectively diagnosing mental disorders, ranging ... Br J Psychiatry 196(5):383–388, van der Voort TY, van Meijel B, Goossens PJ, Hoogendoorn AW, Draisma S, Beekman A et al (2015) Collaborative care for patients with bipolar disorder: randomised controlled trial. Br J Psychiatry 206(5):393–400, Fiorillo A, Del Vecchio V, Luciano M, Sampogna G, De Rosa C, Malangone C et al (2014) Efficacy of psychoeducational family intervention for bipolar I disorder: a controlled, multicentric, real-world study. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and … School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, Large heterogeneity was observed in this analysis (Q = 116.179; P < 0.001; I2 = 89.671%). Transl Psychiatry. One suggestion concerns the enhancement of treatment adherence [93], while another proposes that improving lifestyle and especially biological rhythms, food intake and social zeitgebers could be the key factors [60]. Epidemiology. Bipolar disorder is a relatively common affliction that affects as many as 2.6 percent of the U.S. population, if not more. Again, negative findings concerning the relapse rate were reported by a 2-year study on 76 BD patients randomized to receive 20 sessions of CBT vs. support therapy [15]. Int J Surg 8(5):336–341, Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N et al (2003) A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. Bipolar I disorder starts on average at 18 years and bipolar II disorder at 22 years. Reference Simon and Unutzer 1 Despite the fact that the occurrence of manic episodes are the defining feature of bipolar I disorder, individuals spend a larger proportion of their lives in a depressed state. CBT is effective in decreasing the relapse rate and improving depressive symptoms, mania severity, and psychosocial functioning, with a mild-to-moderate effect size. There are different designs and approaches which were tested in essentially open trials. Poor outcomes include a high frequency of criminal acts, imprisonments, and repeat offenses. There are three papers investigating various methods of intensive psychosocial intervention. In this review, we outline the current state of evidence for lithium in the treatment of BD over the lifespan. This indispensable guide describes how to implement FFT with adult and adolescent patients and their family members. Copyright: © 2017 Chiang et al. 2021. The results suggested that there was an improvement of residual depressive symptoms, executive functions and general functioning. Medication isn’t the only effective treatment for bipolar disorder.Individuals with this disease may also benefit from psychosocial treatment, experts say. The lifetime prevalence of anxiety disorders is 45% when BD is present; patients with BD are 3 to 7 times more likely to meet criteria for diagnosis of an anxiety disorder than the general population. The results suggested that psychoeducation improved medication compliance (P = 0.008) and quality of life (P < 0.001) and had fewer hospitalizations (P < 0.001) [41]. Bipolar Disord 13(7–8):679–686, Reinares M, Papachristou E, Harvey P, Mar BC, Sanchez-Moreno J, Torrent C et al (2013) Towards a clinical staging for bipolar disorder: defining patient subtypes based on functional outcome. This was the conclusion from another study with a different design. Recently, the focus has expanded to analyze the impact of MBCT on brain activity and cognitive functioning in BD, but the findings are difficult to interpret [86, 89, 90]. Eur Psychiatry 27(4):281–284, Perlick DA, Miklowitz DJ, Lopez N, Chou J, Kalvin C, Adzhiashvili V et al (2010) Family-focused treatment for caregivers of patients with bipolar disorder. SAD appears to have high heritability. Because CBT is a form of psychotherapy, it relies on a strong collaborative relationship between therapists and patients; this connection is strengthened by a more thorough process and longer treatment duration. Based on exhaustive research culled from old patient medical records, historical accounts, and government documents, this haunting book raises important questions about our obligations to the mad, what it means to be "insane," and what we ... Yes Second, moderate-to-high heterogeneity was observed in the overall and subgroup analyses, indicating that a certain set of confounders (or possible personal and psychosocial factors), such as age, gender, and CBT style/approach, might be one of the heterogeneity sources affecting the results. Rev Bras Psiquiatr 33(2):144–149, Gonzalez Isasi A, Echeburua E, Liminana JM, Gonzalez-Pinto A (2014) Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: a 5-year controlled clinical trial. All data analyses were performed using Comprehensive Meta-Analysis, Version 3.3 (Biostat Inc., Englewood, NJ, USA). Google Scholar, Colom F, Vieta E, Sanchez-Moreno J, Palomino-Otiniano R, Reinares M, Goikolea JM et al (2009) Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement for the meta-analyses of RCTs. https://doi.org/10.1371/journal.pone.0176849.g004. J Affect Disord 123(1–3):81–86, Lam DH, Burbeck R, Wright K, Pilling S (2009) Psychological therapies in bipolar disorder: the effect of illness history on relapse prevention—a systematic review. eCollection 2021. Sensitivity analyses were performed using the leave-one-out approach to elevate the robustness of the pooled estimates. West J Nurs Res 36(3):312–328, Scott J, Colom F, Popova E, Benabarre A, Cruz N, Valenti M et al (2009) Long-term mental health resource utilization and cost of care following group psychoeducation or unstructured group support for bipolar disorders: a cost–benefit analysis. Patient nonadherence is an … Given the biological and hereditary underpinning of BD, pharmacotherapy is the first-line treatment. This readable guide to the assessment and management of patients with bipolar disorder can help physicians keep abreast of dramatic and rapid advances of recent years and integrate them into their practice. Quality assessment of the selected RCTs was conducted according to Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials [24]. No, Is the Subject Area "Metaanalysis" applicable to this article? A quality-control process for the data extraction was undertaken by another researcher to verify all the extracted data against the original sources. The findings and conclusions in this document are those of the authors, who are responsible for its contents. The depression is the most prevalent state throughout the life of the bipolar patient. In the extensive electronic literature search, keywords such as “bipolar disorder,” “manic-depressive psychosis,” “bipolar affective disorder,” “bipolar depression,” “cognitive therapy,” “cognitive-behavioral therapy,” and “psychotherapy” were transformed into MeSH terms, and only randomized controlled trials (RCTs) were included. Google Scholar, Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ et al (2013) The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Relevant … Since bipolar disorder is a highly comorbid disorder and childbirth can trigger or exacerbate bipolar disorder as well as its comorbidities, it is important to assess postpartum women with bipolar disorder for disorders that commonly accompany bipolar illness. There was some beneficial effect of MBCT on anxiety symptoms [87, 88]. After starting your medications, it may take two to six weeks before you begin to … This book has been considered by academicians and scholars of great significance and value to literature. Bipolar Disord 7(5):431–440. It is well known that this kind of studies suffers from problems pertaining to blindness and the nature of the control intervention. J Clin Psychiatry 64(9):1101–1105, Lobban F, Taylor L, Chandler C, Tyler E, Kinderman P, Kolamunnage-Dona R et al (2010) Enhanced relapse prevention for bipolar disorder by community mental health teams: cluster feasibility randomised trial. Some evidence suggests a genetic link. Daily routine can also be an excellent way to treat bipolar without medication (or alongside existing medication). It has been shown that a strict bipolar routine involving good sleep hygiene, eating, sleeping and socializing times can be a natural mood stabilizer. Behav Res Ther 51(7):338–343, Howells FM, Ives-Deliperi VL, Horn NR, Stein DJ (2012) Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study. At the end of the 2-year follow-up, 23 subjects (92%) in the control group fulfilled the criteria for recurrence versus 15 patients (60%) in the psychoeducation group (P < 0.01). Psychother Psychosom 81(6):389–390, Fountoulakis KN, Gonda X, Siamouli M, Rihmer Z (2009) Psychotherapeutic intervention and suicide risk reduction in bipolar disorder: a review of the evidence. Although we conceive that this is not the case here (for example, the largest published RCTs of CBT in BD [29] had null findings), we calculated the number of studies with an effect size of zero that would be needed to reduce the present effect size to zero [46]. The inter-personal relationships of patients with BD are also highly affected by the dramatic alternation of manic/hypomanic and depressive mood cycles. Roubalová L, Vošahlíková M, Slaninová J, Kaufman J, Alda M, Svoboda P. Naunyn Schmiedebergs Arch Pharmacol. Use the GCU Library databases and include a minimum of two scholarly sources from the GCU Library to support your claims in addition to the article you are critiquing. more than 40 years previously [15, 16]. This is called a manic episode. The number of paper reported for each intervention includes RCTs, post hoc analyses and meta-analyses together. Arch Gen Psychiatry 64(4):419–426, Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Kogan JN, Sachs GS et al (2007) Intensive psychosocial intervention enhances functioning in patients with bipolar depression: results from a 9-month randomized controlled trial. Found insideWritten by world experts in the field of bipolar disorder, The Treatment of Bipolar Disorder: Integrative Clinical Strategies and Future Directions provides readers with a concise and comprehensive guide to the integrative management of ... All authors read and approved the final manuscript. J Consult Clin Psychol 71(3):482–492, Scott J, Colom F, Pope M, Reinares M, Vieta E (2012) The prognostic role of perceived criticism, medication adherence and family knowledge in bipolar disorders. MeSH A study covering the 20 years between 1997 and 2016 shows that substantial changes have occurred in the way doctors are treating outpatients diagnosed with bipolar disorder. Objective: The purpose of this study was to conduct a pilot randomized trial of dialectical behavior therapy (DBT) versus psychosocial treatment as usual (TAU) for … Bipolar Disord 7(Suppl 5):32–36, Simoneau B, Lavallee P, Anderson PC, Bailey M, Bantle G, Berthiaume S et al (1999) Discovery of non-peptidic P2-P3 butanediamide renin inhibitors with high oral efficacy. 2014;16(5):523–30. In this frame, IPSRT includes the management of affective symptoms through improvement of adherence to medication and stabilizing social rhythms and the resolution of interpersonal problems. Understand the basic diagnostic criteria for pediatric bipolar disorder and know what tools are used to assess it. However, that study did not report the rate of recurrences and the time to recurrence [24]. Affiliations Effects of personality and attitude on health information acquisition and compliance. Among a number of important changes, one in particular stands out: a much smaller fraction of outpatients today are being treated with a mood stabilizer and a greater fraction are being treated with a second … Acta Psychiatr Scand 127(5):333–343, Perich T, Manicavasagar V, Mitchell PB, Ball JR (2013) The association between meditation practice and treatment outcome in mindfulness-based cognitive therapy for bipolar disorder. CNS Spectr. Further subgroup analyses were conducted according to the characteristics of the CBT approaches, patients, and therapists, if the data were available. PubMed Central  Placebo-controlled or active comparator … In particular, determining the efficacy (or effectiveness) of CBT in real-world practice—both alone and as an adjuvant to monotherapy—for patients with BD II, in whom pharmaceutical therapy with mood stabilizers have unclear benefits, moreover, only one second-generation antipsychotic drug, quetiapine, has received Food and Drug Administration approval [14]. The development of targeted treatments for depression in bipolar disorder (BD-D) has lagged behind recognition of the prevalence and severity of this condition. However this is rather restricted to manic episodes and to patients at the earlier stages of the disease who have achieved remission before the intervention has started. Yes Yes J Affect Disord 21(1):15–18, Miklowitz DJ, Simoneau TL, George EL, Richards JA, Kalbag A, Sachs-Ericsson N et al (2000) Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy. Hum Psychopharmacol 25(1):1–16, Fountoulakis K (2015) Bipolar disorder: an evidence-based guide to manic depression. These authors reported that at end point fewer patients in the CBT group relapsed in comparison to controls (44 vs. 75%; HR = 0.40, P = 0.004), had shorter episode duration, less admissions and mood symptoms, and higher social functioning [21]. PubMed  Funding: This study was supported by Ministry of Science and Technology (project no. Bookshelf Initially, 973 research reports were identified. Medication isn’t the only effective treatment for bipolar disorder.Individuals with this disease may also benefit from psychosocial treatment, experts say. Large heterogeneity was observed in this analysis (Q = 29.676; P < 0.001; I2 = 69.672%). The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2012 on the long-term … CNS Neurosci Ther 16(5):298–307, Martinez-Aran A, Torrent C, Sole B, Bonnin CM, Rosa AR, Sanchez-Moreno J et al (2011) Functional remediation for bipolar disorder. Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan, Seventy percent of people with bipolar disorder who take lithium experience fewer and less-intense manic episodes. All the included RCTs were published between 2000 and 2015. Another format of intervention included 12 sessions of group psychoeducation for the patients and their families. Br J Psychiatry 206(1):58–66, Steinan MK, Krane-Gartiser K, Langsrud K, Sand T, Kallestad H, Morken G (2014) Cognitive behavioral therapy for insomnia in euthymic bipolar disorder: study protocol for a randomized controlled trial. A new study conducted by researchers at NIMH suggests that differences in the expression of gene transcripts – readouts copied from DNA that help maintain and build our cells – may hold the key to understanding how mental disorders with shared genetic risk factors result in different patterns of onset, symptoms, course of illness, and treatment … Lamotrigine compared to placebo and other agents with antidepressant activity in patients with unipolar and bipolar depression: a comprehensive meta-analysis of efficacy and safety outcomes in short-term trials. In the random-effects model, the pooled ORs for the relapse rate did not exhibit marked dispersion, and similar findings for Hedges’s g were observed with regard to the level of depression, severity of mania, and level of psychosocial functioning. Ann Gen Psychiatry 14, 19 (2015). A prospective 5-year follow-up of 120 BD patients suggested that group psychoeducation might be more cost-effective [43]. Eur Neuropsychopharmacol 25(2):257–264, Williams JM, Alatiq Y, Crane C, Barnhofer T, Fennell MJ, Duggan DS et al (2008) Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning. Management of bipolar disorder in adults (2010) – “Archived” but still available through email ; World Federation of Societies of Biological Psychiatry (WFSBP) Acute and long-term treatment of mixed status in bipolar disorder (2017) Maintenance treatment of bipolar disorders (2013) Acute bipolar … There was not any placebo condition. KNF SM, SM and ET carried out the literature search and the interpretation of the results. Competing interests: The authors have declared that no competing interests exist. Please enable it to take advantage of the complete set of features! National Science Council (NSC)-NSC99-2627-B-038-001), Taiwan. here. https://doi.org/10.1186/s12991-015-0057-z, DOI: https://doi.org/10.1186/s12991-015-0057-z. Is the Subject Area "Bipolar disorder" applicable to this article? Background Although mood stabilizers such as lithium (LIT), valproate (VAL), and lamotrigine (LMT) appear to be efficacious treatments for bipolar disorder (BD) in … J Clin Psychiatry 71(10):e26, Murru A, Pacchiarotti I, Nivoli AM, Colom F, Vieta E (2012) Is schizoaffective disorder still a neglected condition in the scientific literature? If the study populations were duplicated, the most updated findings or most comprehensive outcome measures were chosen. Psychiatr Serv 57(7):937–945, Simon GE, Ludman EJ, Bauer MS, Unutzer J, Operskalski B (2006) Long-term effectiveness and cost of a systematic care program for bipolar disorder. Careers. The strength of CBT is in altering the course of bipolar disorder over time. By Lydia Chang April 30, 2020 Large heterogeneity was noted in this analysis (Q = 18.769; P < 0.001; I2 = 68.032%). The authors suggested that characteristics of the sample could explain this discrepancy, as patients with a more advanced stage of disease might have a worse response to psychoeducation [16]. Family intervention seems to have benefits mainly for caregivers, but it is uncertain whether they have an effect on patient outcomes. It is important to take your medications as prescribed. List and describe the top-line pharmacological and … In the meta-analysis for determining the effect of CBT treatment on reducing depression and mania levels, the findings suggested that CBT had an impressive effect in patients with refractory BD [39].
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