Internet-based psychological interventions for bipolar disorder: Review of the present and insights into the future

In the last decade, there has been an increasing advent of innovative concepts in psychological interventions aimed at empowering bipolar patients by means of technological advancements and taking advantage of the proliferation of the Internet. Since the adoption of these technologies for behavioral monitoring and intervention is not trivial in clinical practice, the main objective of this review is to provide an overview and to discuss the several initiatives published so far in the literature related to the Internet-based technologies aimed to deliver evidence-based psychological interventions for bipolar disorder patients.

We conducted a comprehensive systematic review of the literature from multiple technological, psychiatric and psychological domains. The search was conducted by applying the Boolean algorithm "BIPOLAR AND DISORDER AND (treatment OR intervention) AND (online OR Internet OR web-based OR smartphone OR mobile)" at MEDLINE, SCOPUS, EMBASE, ClinicalTrials, ISI Web of Science and Google Scholar.

We identified over 251 potential entries matching the search criteria and after a thorough manual review, 29 publications pertaining to 12 different projects, specifically focusing on psychological interventions for bipolar patients through diverse Internet-based methods, were selected.

Taking into consideration the diversity of the initiatives and the inconclusive main outcome results of the studies, there is still limited evidence available to draw firm conclusions about the efficacy of interventions using Internet-based technologies for bipolar disorder.

However, considering the high rates of retention and compliance reported, they represent a potential highly feasible and acceptable method of delivering this kind of interventions to bipolar patients.