[Psychoeducational and cognitive behavioral treatments of bipolar disorder].
Bipolar disorder is a severe mood disorder characterized by recurrence of mania and depression. Despite the use of mood stabilizers, a significant proportion of bipolar patients experience relapse, psychosocial impairment and persistent symptoms. A significant part of patients show poor adhesion to the pharmacological treatment. This article aims to provide an overview of research focusing on psychoeducational and cognitive-behavioral treatment (CBT) of bipolar patients.


METHODS
Studies were identified through Medline searches between 1971 and 2005.


RESULTS
Studies on bipolar patients suggest that psychoeducational interventions may improve treatment adherence, illness knowledge, ability to cope with early manic symptoms and tend to reduce the risk of manic relapses. CBT tends to diminish depressive symptoms, improve treatment adherence and reduce the risk of depressive and manic relapses. Most psychoeducational and CBT studies share a common medical model of the illness, thereby making clear distinctions of impact of each intervention difficult. Few studies focused on patients with problems with mood stabilizers adherence. It is now important to develop specific interventions for those patients.


CONCLUSIONS
According to these studies, bipolar patients are likely to benefit from psychoeducational or CBT interventions added to usual pharmacotherapy. In order to overcome limitations of existing research, future studies should adjust for the effect of pharmacological treatment, the type and severity of psychopathology at baseline, the acceptance of and the adaptability to the illness and it's awareness.
Khazaal
Yasser
Y
Département universitaire de psychiatrie adulte, Lausanne, Suisse.
Preisig
Martin
M
Zullino
Daniele Fabio
DF
D000223:Adaptation, Psychological; D000927:Anticonvulsants / Q000008:administration & dosage; D018692:Antimanic Agents / Q000008:administration & dosage; D001364:Awareness; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D006801:Humans; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D055502:Secondary Prevention; D012803:Sick Role
D000927:Anticonvulsants; D018692:Antimanic Agents