BACKGROUND: Efficacy trials suggest that structured psychological therapies may significantly reduce recurrence rates of major mood episodes in individuals with bipolar disorders. AIMS: To compare the effectiveness of treatment as usual with an additional 22 sessions of cognitive-behavioural therapy (CBT). METHOD: We undertook a multicentre, pragmatic, randomised controlled treatment trial (n=253). Patients were assessed every 8 weeks for 18 months. RESULTS: More than half of the patients had a recurrence by 18 months, with no significant differences between groups (hazard ratio=1.05; 95% CI 0.74-1.50). Post hoc analysis demonstrated a significant interaction (P=0.04) such that adjunctive CBT was significantly more effective than treatment as usual in those with fewer than 12 previous episodes, but less effective in those with more episodes. CONCLUSIONS:People with bipolar disorder and comparatively fewer previous mood episodes may benefit from CBT. However, such cases form the minority of those receiving mental healthcare.
RCT Entities:
BACKGROUND: Efficacy trials suggest that structured psychological therapies may significantly reduce recurrence rates of major mood episodes in individuals with bipolar disorders. AIMS: To compare the effectiveness of treatment as usual with an additional 22 sessions of cognitive-behavioural therapy (CBT). METHOD: We undertook a multicentre, pragmatic, randomised controlled treatment trial (n=253). Patients were assessed every 8 weeks for 18 months. RESULTS: More than half of the patients had a recurrence by 18 months, with no significant differences between groups (hazard ratio=1.05; 95% CI 0.74-1.50). Post hoc analysis demonstrated a significant interaction (P=0.04) such that adjunctive CBT was significantly more effective than treatment as usual in those with fewer than 12 previous episodes, but less effective in those with more episodes. CONCLUSIONS:People with bipolar disorder and comparatively fewer previous mood episodes may benefit from CBT. However, such cases form the minority of those receiving mental healthcare.
Authors: Thilo Deckersbach; Britta K Hölzel; Lori R Eisner; Jonathan P Stange; Andrew D Peckham; Darin D Dougherty; Scott L Rauch; Sara Lazar; Andrew A Nierenberg Journal: CNS Neurosci Ther Date: 2011-04-02 Impact factor: 5.243
Authors: Michael Berk; Lesley Berk; Seetal Dodd; Sue Cotton; Craig Macneil; Rothanthi Daglas; Philippe Conus; Andreas Bechdolf; Steven Moylan; Gin S Malhi Journal: Bipolar Disord Date: 2013-06-20 Impact factor: 6.744
Authors: L Lavagnino; B Cao; B Mwangi; M-J Wu; M Sanches; G B Zunta-Soares; F Kapczinski; J Soares Journal: Acta Psychiatr Scand Date: 2015-01-31 Impact factor: 6.392
Authors: David J Miklowitz; Elizabeth L George; David A Axelson; Eunice Y Kim; Boris Birmaher; Christopher Schneck; Carol Beresford; W Edward Craighead; David A Brent Journal: J Affect Disord Date: 2004-10 Impact factor: 4.839