title: A critical update on psychological interventions for bipolar disorders.
abstract: Although pharmacotherapy is the mainstay of treatment for bipolar disorder, the combination of evidence-based psychological interventions and drug treatment enhances overall effectiveness, mostly by further protecting patients from relapse/recurrence. In recent years, well-designed controlled studies have added weight to evidence favoring specific psychotherapy modalities for bipolar disorders. However, critical issues that may limit the benefits of psychotherapy in day-to-day clinical practice have emerged. In this article, we critically examine the effectiveness of psychosocial approaches to bipolar illness by reviewing the literature, which has been substantially enriched during the past 5 years. Recent studies further support the fact that psychoeducation and cognitive-behavioral therapy are effective in bipolar disorder, especially the early stages. Family interventions based on a psychoeducational model are also effective. Intensive psychotherapies may be more effective than short, managed care-based ones. Group psychoeducation seems to have long-lasting effects and to be cost-effective. Future studies should focus on neurobiological markers of response to psychotherapy and tailor interventions to specific subtypes.
authors.affiliation: Bipolar Disorders Program, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, 08036 Barcelona, Spain. evieta@clinic.ub.es
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Isabella
authors.initials: I
authors.lastname: Pacchiarotti
authors.forename: Marc
authors.initials: M
authors.lastname: Valentí
authors.forename: Lesley
authors.initials: L
authors.lastname: Berk
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
authors.forename: Francesc
authors.initials: F
authors.lastname: Colom
mesh_terms: D001714:Bipolar Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005196:Family Therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence