title: Memory for therapy in bipolar disorder and comorbid insomnia.
abstract: OBJECTIVE
  To examine the extent to which patients recall the contents of therapy from 1 session to the next and to determine whether recall is associated with treatment outcome.
  
  
  METHODS
  Thirty interepisode individuals with bipolar disorder and comorbid insomnia (ages 21-62 years, 56.7% women, 56.7% Caucasian) participated in a randomized controlled trial of psychotherapies. Patients received either cognitive behavior therapy for insomnia (CBTI-BP; n = 17) or psychoeducation (PE; n = 13). At the beginning of each weekly session, patients freely recalled as many therapy points (i.e., distinct ideas, principles, and experiences) as they could from their previous session. After each session, therapists recorded a list of all therapy points delivered. Treatment outcome was measured via the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Patient-Reported Outcome Measurement Info System-Sleep, and Quality of Life-Sleep (QOL-Sleep), administered pre- and posttreatment, and treatment evaluation questions administered posttreatment.
  
  
  RESULTS
  Patients recalled 19.6% to 36.9% of therapy points listed by therapists. Raw numbers of therapy points recalled were positively correlated with reductions in ISI scores and gains in QOL-Sleep and with most treatment evaluation questions. Percentages of therapy points recalled were positively correlated with gains in QOL-Sleep but with no other sleep outcome measures or any of the treatment evaluation questions. Patients in CBTI-BP recalled more therapy points than did those in PE but did not differ in the percentages of points recalled.
  
  
  CONCLUSIONS
  Memory for therapy is poor. The amount of content recalled is positively associated with treatment outcome. Enhancing memory for therapy might play a key role in improving treatment outcome.
authors.affiliation: Department of Psychology, University of California.
authors.forename: Jason Y
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Psychology, University of California.
authors.forename: Allison G
authors.initials: AG
authors.lastname: Harvey
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult