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Cognitive-behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial
Jan Scott1, Eugene Paykel, Richard Morriss
1Department of Psychological Medicine, PO Box 96, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. j.scott@iop.kcl.ac.uk
Summary
Cognitive-behavioural therapy (CBT) did not significantly reduce mood episode recurrence in bipolar disorder patients overall. However, CBT showed benefits for those with fewer than 12 prior episodes.
Area of Science:
- Psychiatry
- Clinical Psychology
- Mood Disorders Research
Background:
- Structured psychological therapies show promise in reducing mood episode recurrence in bipolar disorder.
- Bipolar disorder management often involves various treatment approaches.
Purpose of the Study:
- To compare the effectiveness of standard treatment versus standard treatment plus 22 sessions of cognitive-behavioural therapy (CBT).
Main Methods:
- A multicentre, pragmatic, randomised controlled trial involving 253 patients.
- Participants were monitored for 18 months with assessments every 8 weeks.
Main Results:
- Over half of all patients experienced recurrence within 18 months; no overall significant difference between groups.
- Post hoc analysis revealed CBT was more effective than treatment as usual for patients with fewer than 12 prior episodes.
- Conversely, CBT was less effective for patients with more than 12 prior episodes.
Conclusions:
- Cognitive-behavioural therapy (CBT) may benefit individuals with bipolar disorder who have experienced fewer mood episodes.
- This subgroup represents a minority of patients currently receiving mental healthcare.
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