Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T10:51:07.707Z Has data issue: false hasContentIssue false

Chapter 28 - Evidence-Based Psychological Interventions for Bipolar Disorders

Published online by Cambridge University Press:  16 May 2024

By
Thomas D. Meyer  and
Jan Scott
Edited by
Allan Young ,
Marsal Sanches ,
Jair C. Soares  and
Mario Juruena
Allan Young
Affiliation:
Institute of Psychiatry, King's College London
Marsal Sanches
Affiliation:
Baylor College of Medicine, Texas
Jair C. Soares
Affiliation:
McGovern Medical School, The University of Texas
Mario Juruena
Affiliation:
King's College London
Get access

Summary

Bipolar disorders (BD) are recurrent conditions and many clinical and social impairments persist even with optimal pharmacotherapy. This chapter explores the development of psychological treatments, from initial uncertainties about offering therapies for BD, and then following the tentative steps to offer support to individuals with BD and to their families. Much of the focus is on the rationale, evolution and testing of specific psychological treatments. As well as examining any added value attained from providing psychological treatments alongside medications, we also consider how therapies might be further developed in the future. For example, we discuss how network meta-analysis might shed light on active ingredients that are common to all successful therapies and consider if these components might herald the introduction of multi-modal interventions. The chapter ends by noting the progress being made regarding the mediators and moderators of therapeutic effects and highlighting the importance of continuing to undertake efficacy trials but also comparative effectiveness trials that will enable researchers, clinicians and patients to determine how best to deploy psychological treatments in the real world.

Keywords

bipolar disorderspsychological treatmentsmulti-modalnetwork meta-analysistherapeutic techniquescommon strategiesmediatorsmoderators
Type
Chapter
Information
Clinical Textbook of Mood Disorders , pp. 294 - 303
Publisher: Cambridge University Press
Print publication year: 2024

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

Scott, J. Psychotherapy for bipolar disorder. Br J Psychiatry. 1995;167(5):581–8.CrossRefGoogle ScholarPubMed
Benson, R. The forgotten treatment modality in bipolar illness: psychotherapy. Dis Nerv Syst. 1975;36(11):634–9.Google ScholarPubMed
Davenport, YB, Ebert, MH, Adland, ML, Goodwin, FK. Couples group therapy as an adjunct to lithium maintenance of the manic patient. Am J Orthopsychiatry. 1977;47(3):495.CrossRefGoogle ScholarPubMed
Mayo, JA. Marital therapy with manic-depressive patients treated with lithium. Comp Psychiatry. 1979;20(5):419–26.CrossRefGoogle ScholarPubMed
Shakir, SA, Volkmar, FR, Bacon, S, Pfefferbaum, A. Group psychotherapy as an adjunct to lithium maintenance. Am J Psychiatry. 1979;136(4A):455–6.CrossRefGoogle ScholarPubMed
Cochran, SD. Preventing medical noncompliance in the outpatient treatment of bipolar affective disorders. J Consult Clin Psychol. 1984;52(5):873.CrossRefGoogle ScholarPubMed
Goldberg, JF, Harrow, M. A 15‐year prospective follow‐up of bipolar affective disorders: comparisons with unipolar nonpsychotic depression. Bipolar Disord. 2011;13(2):155–63.CrossRefGoogle ScholarPubMed
Treuer, T, Tohen, M. Predicting the course and outcome of bipolar disorder: a review. Eur Psychiatry. 2010;25(6):328–33.CrossRefGoogle ScholarPubMed
Paykel, ES, Scott, J, Teasdale, JD, et al. Prevention of relapse in residual depression by cognitive therapy: a controlled trial. Arch Gen Psychiatry. 1999;56(9):829–35.CrossRefGoogle ScholarPubMed
Sensky, T, Turkington, D, Kingdon, D, et al. A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Arch Gen Psychiatry. 2000;57(2):165–72.CrossRefGoogle ScholarPubMed
Scott, J, Colom, F. Gaps and limitations of psychological interventions for bipolar disorders. Psychother Psychosom. 2008;77(1):4–11.CrossRefGoogle ScholarPubMed
Fountoulakis, KN, Tohen, M. Interpreting the findings of a meta-analysis of psychosocial interventions in bipolar disorder. JAMA Psychiatry. 2021;78(4):447–8.CrossRefGoogle ScholarPubMed
Beck, A. Depression: Clinical, Experimental and Theoretical Aspects. New York: Harper and Row, 1967.Google Scholar
Beck, AT. Cognitive Therapy of Depression: New York: Guilford Press, 1979.Google Scholar
Meyer, T, Hautzinger, M. Psychotherapie bei bipolaren affektiven Störungen – Ein Überblick über den Stand der Forschung. Verhaltenstherapie. 2000;10(3):177–86.CrossRefGoogle Scholar
Meyer, TD. Hypomanie und Manie (chapter 18). In Röhrle, B, Caspar, F, Schlottke, PF, editors. Lehrbuch der klinisch-psychologischen Diagnostik. Stuttgart: Kohlhammer, 2008; 433–74.Google Scholar
Meyer, TD. Manie (chapter 6). In Rief, W, Schramm, E, Strauss, B, editors. Psychologische Psychotherapie: Ein Kompetenzorientiertes Lehrbuch München. Elsevier Urban & Fischer, 2021; 99–108.CrossRefGoogle Scholar
Newman, CF, Leahy, RL, Beck, AT, Reilly-Harrington, NA, Gyulai, L. Bipolar Disorder: A Cognitive Therapy Approach. Washington, DC: American Psychological Association, 2002.CrossRefGoogle Scholar
Lyon, HM, Startup, M, Bentall, RP. Social cognition and the manic defense: attributions, selective attention, and self-schema in bipolar affective disorder. J Abnorm Psychol. 1999;108(2):273.CrossRefGoogle ScholarPubMed
Pavlickova, H, Varese, F, Turnbull, O, et al. Symptom-specific self-referential cognitive processes in bipolar disorder: a longitudinal analysis. Psychol Med. 2013;43(9):1895–907.CrossRefGoogle ScholarPubMed
Reilly-Harrington, NA, Alloy, LB, Fresco, DM, Whitehouse, WG. Cognitive styles and life events interact to predict bipolar and unipolar symptomatology. J Abnorm Psychol. 1999;108(4):567.CrossRefGoogle ScholarPubMed
Scott, J, Pope, M. Cognitive styles in individuals with bipolar disorders. Psychol Med. 2003;33(6):1081.CrossRefGoogle ScholarPubMed
Lex, C, Hautzinger, M, Meyer, TD. Cognitive styles in hypomanic episodes of bipolar I disorder. Bipolar Disord. 2011;13(4):355–64.CrossRefGoogle ScholarPubMed
Meyer, TD, Hautzinger, M, Bauer, IE. A mania-related memory bias is associated with risk for relapse in bipolar disorder. J Affect Disord. 2018;235:557–64.CrossRefGoogle ScholarPubMed
Schönfelder, S, Langer, J, Schneider, EE, Wessa, M. Mania risk is characterized by an aberrant optimistic update bias for positive life events. J Affect Disord. 2017;218:313–21.CrossRefGoogle ScholarPubMed
Lam, D, Wright, K, Smith, N. Dysfunctional assumptions in bipolar disorder. J Affect Disord. 2004;79(1–3):193–9.CrossRefGoogle ScholarPubMed
Fletcher, K, Parker, G, Manicavasagar, V. Behavioral Activation System (BAS) differences in bipolar I and II disorder. J Affect Disord. 2013;151(1):121–128.CrossRefGoogle Scholar
Lex, C, Bazner, E, Meyer, TD. Does stress play a significant role in bipolar disorder? A meta-analysis. J Affect Disord. 2017;208:298–308.CrossRefGoogle ScholarPubMed
Aldinger, F, Schulze, TG. Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry Clin Neurosci. 2017;71(1):6–17.CrossRefGoogle ScholarPubMed
Inder, ML, Crowe, MT, Porter, R. Effect of transmeridian travel and jetlag on mood disorders: evidence and implications. Aus N Z J Psychiatry. 2016;50(3):220–7.CrossRefGoogle ScholarPubMed
Malkoff-Schwartz, S, Frank, E, Anderson, B, et al. Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes: a preliminary investigation. Arch Gen Psychiatry. 1998;55(8):702–7.CrossRefGoogle ScholarPubMed
Murray, G, Harvey, A. Circadian rhythms and sleep in bipolar disorder. Bipolar Disord. 2010;12(5):459–72.CrossRefGoogle ScholarPubMed
Shen, GH, Alloy, LB, Abramson, LY, Sylvia, LG. Social rhythm regularity and the onset of affective episodes in bipolar spectrum individuals. Bipolar Disord. 2008;10(4):520–9.CrossRefGoogle ScholarPubMed
Frank, E. Treating Biopolar Disorder: A Clinician’s Guide to Interpersonal and Social Rhythm Therapy. New York: Guilford Press, 2005.Google Scholar
Miklowitz, DJ. Bipolar Disorder: A Family-Focused Treatment Approach. 2nd ed. New York: Guilford Press; 2010.Google Scholar
Depue, RA, Iacono, WG. Neurobehavioral aspects of affective disorders. Annu Rev Psychol. 1989;40(1):457–92.CrossRefGoogle ScholarPubMed
Johnson, SL. Mania and dysregulation in goal pursuit: a review. Clin Psychol Rev. 2005;25(2):241–62.CrossRefGoogle ScholarPubMed
Alloy, LB, Abramson, LY. The role of the behavioral approach system (BAS) in bipolar spectrum disorders. Cur Dir Psychol Sci. 2010;19(3):189–94.CrossRefGoogle Scholar
Alloy, LB, Nusslock, R, Boland, EM. The development and course of bipolar spectrum disorders: an integrated reward and circadian rhythm dysregulation model. Annur Rev Clin Psychol. 2015;11:213–50.Google ScholarPubMed
Johnson, SL, Edge, MD, Holmes, MK, Carver, CS. The behavioral activation system and mania. Annu Rev Clin Psychol. 2012;8:243–67.CrossRefGoogle ScholarPubMed
Kwan, JW, Bauer, IE, Hautzinger, M, Meyer, TD. Reward sensitivity and the course of bipolar disorder: a survival analysis in a treatment seeking sample. J Affect Disord. 2020;261:126–30.CrossRefGoogle Scholar
Chatterton, ML, Stockings, E, Berk, M, Barendregt, JJ, Carter, R, Mihalopoulos, C. Psychosocial therapies for the adjunctive treatment of bipolar disorder in adults: network meta-analysis. Br J Psychiatry. 2017;210(5):333–41.CrossRefGoogle ScholarPubMed
Macheiner, T, Skavantzos, A, Pilz, R, Reininghaus, EZ. A meta-analysis of adjuvant group-interventions in psychiatric care for patients with bipolar disorders. J Affect Disord. 2017;222:28–31.CrossRefGoogle ScholarPubMed
Miklowitz, DJ, Scott, J. Psychosocial treatments for bipolar disorder: cost‐effectiveness, mediating mechanisms, and future directions. Bipolar Disord. 2009;11:110–22.CrossRefGoogle ScholarPubMed
Schöttle, D, Huber, CG, Bock, T, Meyer, TD. Psychotherapy for bipolar disorder: a review of the most recent studies. Curr Opin Psychiatry. 2011;24(6):549–55.CrossRefGoogle ScholarPubMed
Lynch, D, Laws, K, McKenna, P. Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials. Psychol Med. 2010;40(1):9–24.CrossRefGoogle Scholar
Oud, M, Mayo-Wilson, E, Braidwood, R, et al. Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis. Br J Psychiatry. 2016;208(3):213–22.CrossRefGoogle ScholarPubMed
Szentagotai-Tatar, A, David, D. Evidence-based psychological interventions for bipolar disorder. In David, D, Lynn, SJ, Montgomery, GH, editors. Evidence-Based Psychotherapy: The State of the Science and Practice. Wiley Blackwell, 2018; 37–61.CrossRefGoogle Scholar
Miklowitz, DJ, Efthimiou, O, Furukawa, TA, et al. Adjunctive psychotherapy for bipolar disorder: a systematic review and component network meta-analysis. JAMA Psychiatry. 2021;78(2):141–50.CrossRefGoogle ScholarPubMed
Cipriani, A, Higgins, JP, Geddes, JR, Salanti, G. Conceptual and technical challenges in network meta-analysis. Ann Inter Med. 2013;159(2):130–7.CrossRefGoogle ScholarPubMed
Etain, B, Scott, J, Cochet, B, et al. A study of the real-world effectiveness of group psychoeducation for bipolar disorders: is change in illness perception a key mediator of benefit? J Affect Disord. 2018;227:713–20.CrossRefGoogle ScholarPubMed
Jonas, DE, Mansfield, AJ, Curtis, P, et al. Identifying priorities for patient-centered outcomes research for serious mental illness. Psychiatr Serv. 2012;63(11):1125–30.CrossRefGoogle ScholarPubMed
Jones, SH, Smith, G, Mulligan, LD, et al. Recovery-focused cognitive–behavioural therapy for recent-onset bipolar disorder: randomised controlled pilot trial. Br J Psychiatry. 2015;206(1):58–66.CrossRefGoogle ScholarPubMed
Murray, G, Leitan, ND, Thomas, N, et al. Towards recovery-oriented psychosocial interventions for bipolar disorder: quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. Clin Psychol Rev. 2017;52:148–63.CrossRefGoogle ScholarPubMed
Tremain, H, Fletcher, K, Scott, J, et al. The influence of stage of illness on functional outcomes after psychological treatment in bipolar disorder: a systematic review. Bipolar Disord. 2020;22(7):666–92.CrossRefGoogle ScholarPubMed
Berk, M, Conus, P, Lucas, N, et al. Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disord. 2007;9(7):671–8.CrossRefGoogle ScholarPubMed
Vallarino, M, Henry, C, Etain, B, et al. An evidence map of psychosocial interventions for the earliest stages of bipolar disorder. Lancet Psychiatry. 2015;2(6):548–63.CrossRefGoogle ScholarPubMed
Leopold, K, Bauer, M, Bechdolf, A, et al. Efficacy of cognitive-behavioral group therapy in patients at risk for serious mental illness presenting with subthreshold bipolar symptoms: results from a prespecified interim analysis of a multicenter, randomized, controlled study. Bipolar Disord. 2020;22(5):517–29.CrossRefGoogle ScholarPubMed
Miklowitz, DJ, Schneck, CD, Singh, MK, et al. Early intervention for symptomatic youth at risk for bipolar disorder: a randomized trial of family-focused therapy. J Am Acad Child Adolesc Psychiatry. 2013;52(2):121–31.CrossRefGoogle ScholarPubMed
Scott, J, Meyer, TD. Brief research report: a pilot study of Cognitive Behavioral Regulation Therapy (CBT-REG) for young people at high risk of early transition to bipolar disorders. Front Psychiatry. 2020;11:616829.CrossRefGoogle ScholarPubMed
Davison, J, Scott, J. Should we intervene at stage 0? A qualitative study of attitudes of asymptomatic youth at increased risk of developing bipolar disorders and parents with established disease. Early Interv Psychiatry. 2018;12(6):1112–19.CrossRefGoogle Scholar
Lee, JY, Harvey, AG. Memory for therapy in bipolar disorder and comorbid insomnia. J Consult Clin Psychol. 2015;83(1):92.CrossRefGoogle ScholarPubMed
Bauer, IE, Hautzinger, M, Meyer, TD. Memory performance predicts recurrence of mania in bipolar disorder following psychotherapy: a preliminary study. J Psychiatr Res. 2017;84:207–13.CrossRefGoogle ScholarPubMed
Crowe, M, Eggleston, K, Douglas, K, Porter, RJ. Effects of psychotherapy on comorbid bipolar disorder and substance use disorder: a systematic review. Bipolar Disord. 2021;23(2):141–51.CrossRefGoogle ScholarPubMed
Biseul, I, Icick, R, Seguin, P, Bellivier, F, Scott, J. Feasibility and acceptability of the ‘HABIT’ group programme for comorbid bipolar and alcohol and substance use disorders. Clin Psychol Psychother. 2017;24(4):887–98.CrossRefGoogle ScholarPubMed
Barbato, A, Vallarino, M, Rapisarda, F, et al. Do people with bipolar disorders have access to psychosocial treatments? A survey in Italy. Int J Soc Psychiatry. 2016;62(4):334–44.CrossRefGoogle ScholarPubMed
Crusey, A, Schuller, K, Trace, J. Access to care barriers for patients with bipolar disorder in the United States. J Healthc Qual Res. 2020;35(3):167–72.CrossRefGoogle ScholarPubMed
Rummel-Kluge, C, Kluge, M, Kissling, W. Frequency and relevance of psychoeducation in psychiatric diagnoses: results of two surveys five years apart in German-speaking European countries. BMC Psychiatry. 2013;13(1):1–5.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×