Psychosocial interventions as adjunctive therapy for bipolar disorder.
Evidence suggests that adjunctive psychosocial interventions in bipolar disorder are clinically beneficial and cost effective when used in conjunction with pharmacotherapy. Appropriate adjunctive psychosocial interventions in bipolar disorder have been found to be associated with improved treatment adherence, greater stability, fewer hospitalizations, fewer days hospitalized, less need for crisis interventions, decreased relapse risk, and fewer acute episodes. Specific types of therapy that have shown efficacy include bipolar-specific cognitive-behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy, and systematic care management. A positive impact on medication adherence is a major goal of these adjunctive treatments. Studies show variable efficacy depending on patient characteristics, phase of illness, and presence of comorbid conditions so that therapies should be selected and administered on an individualized basis that takes into account each specific patient's current presentation and treatment history. For example, psychosocial interventions have been found to be more effective in patients with depressive than manic symptoms and during maintenance treatment. Given findings showing benefits of psychosocial interventions in the treatment of bipolar disorder, the STAndards for BipoLar Excellence (STABLE) project has developed and tested a performance measure to evaluate the use of this critical treatment component.
Sachs
Gary S
GS
Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. gsachs@partners.org
D001714:Bipolar Disorder / Q000628:therapy*; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D005196:Family Therapy; D006801:Humans; D012944:Social Support