title: Psychotherapeutic interventions in individuals at risk of developing bipolar disorder: a systematic review.
abstract: OBJECTIVE
  Accumulating data show that patients with bipolar disorder (BD) experience substantial symptomatology months or years before full manifestation. Based on the need for early preventive interventions in BD as well as data suggesting effectiveness of psychotherapeutic interventions for BD, we aimed to review the evidence for psychotherapeutic treatments in help-seeking individuals considered at risk for BD (At-Risk-BD).
  
  
  METHODS
  Searching PubMed and PsycINFO, clinical trial registries and recently published systematic reviews, a systematic review was performed of psychoeducational and psychotherapeutic intervention studies in At-Risk-BD individuals.
  
  
  RESULTS
  Only three completed studies were identified, two of which were randomized trials (n = 77) and one was an open pilot study (n = 13). Two ongoing studies (projected n = 150 and n = 100, respectively) were found in trial registries. The available evidence suggests potential effectiveness of multi-family psychoeducational psychotherapy and family-focussed therapy for symptom reduction and prevention of BD conversion.
  
  
  CONCLUSIONS
  Psychotherapeutic treatments are a reasonable starting point for At-Risk-BD subjects when symptom severity, distress and impairment are sufficiently significant to initiate treatment. Ongoing studies will further clarify the effectiveness and timing of psychotherapeutic interventions for At-Risk-BD individuals and whether or not they should be given alone or in conjunction with other treatments. Large multi-site studies with standardized procedures/manuals are needed to advance the field.
authors: Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische University Dresden, Dresden, Germany.
authors: Andrea
authors: A
authors: Pfennig
authors: Christoph U
authors: CU
authors: Correll
authors: Carolin
authors: C
authors: Marx
authors: Maren
authors: M
authors: Rottmann-Wolf
authors: Thomas D
authors: TD
authors: Meyer
authors: Michael
authors: M
authors: Bauer
authors: Karolina
authors: K
authors: Leopold
mesh_terms: D001714:Bipolar Disorder / Q000517:prevention & control* / Q000628:therapy*; D061345:Early Medical Intervention; D006801:Humans; D010353:Patient Education as Topic; D062706:Prodromal Symptoms; D011613:Psychotherapy
keywords: bipolar disorder; early intervention; early recognition; prevention; psychotherapy