title: Psychotherapy use in bipolar disorder: Association with functioning and illness severity.
abstract: OBJECTIVE
  This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not.
  
  
  METHODS
  Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups.
  
  
  RESULTS
  Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants.
  
  
  CONCLUSIONS
  These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden.
authors: Massachusetts General Hospital, Boston, USA Harvard Medical School, Boston, USA lsylvia2@mgh.harvard.edu.
authors: Louisa G
authors: LG
authors: Sylvia
authors: University of Pennsylvania, Philadelphia, USA.
authors: Michael E
authors: ME
authors: Thase
authors: Massachusetts General Hospital, Boston, USA Harvard Medical School, Boston, USA.
authors: Noreen A
authors: NA
authors: Reilly-Harrington
authors: Massachusetts General Hospital, Boston, USA.
authors: Stephanie
authors: S
authors: Salcedo
authors: Weill Cornell Medical College, New York, USA.
authors: Benjamin
authors: B
authors: Brody
authors: Massachusetts General Hospital, Boston, USA Harvard Medical School, Boston, USA.
authors: Gustavo
authors: G
authors: Kinrys
authors: Case Western Reserve University, Cleveland, USA.
authors: David
authors: D
authors: Kemp
authors: University of Alabama, Birmingham, USA.
authors: Richard C
authors: RC
authors: Shelton
authors: The Lindner Center of HOPE, Mason, Ohio and University of Cincinnati College of Medicine, Cincinnati, USA.
authors: Susan L
authors: SL
authors: McElroy
authors: Weill Cornell Medical College, New York, USA.
authors: James H
authors: JH
authors: Kocsis
authors: Mayo Clinic, Rochester, USA.
authors: William V
authors: WV
authors: Bobo
authors: University of Michigan, Ann Arbor, USA.
authors: Masoud
authors: M
authors: Kamali
authors: University of Michigan, Ann Arbor, USA.
authors: Melvin
authors: M
authors: McInnis
authors: University of Pittsburgh Medical Center, Pittsburgh, USA.
authors: Edward
authors: E
authors: Friedman
authors: University of New Mexico, Health Sciences Center, Albuquerque, USA.
authors: Mauricio
authors: M
authors: Tohen
authors: University of Texas Health Science, San Antonio, USA.
authors: Charles L
authors: CL
authors: Bowden
authors: Stanford University School of Medicine, Stanford, USA.
authors: Terence A
authors: TA
authors: Ketter
authors: University of Texas Health Science, San Antonio, USA.
authors: Vivek
authors: V
authors: Singh
authors: Case Western Reserve University, Cleveland, USA.
authors: Joseph
authors: J
authors: Calabrese
authors: Massachusetts General Hospital, Boston, USA Harvard Medical School, Boston, USA.
authors: Andrew A
authors: AA
authors: Nierenberg
authors: Biostatistics Center, Massachusetts General Hospital, Boston, USA.
authors: Dustin J
authors: DJ
authors: Rabideau
authors: Biostatistics Center, Massachusetts General Hospital, Boston, USA.
authors: Constance M
authors: CM
authors: Elson
authors: Massachusetts General Hospital, Boston, USA Harvard Medical School, Boston, USA.
authors: Thilo
authors: T
authors: Deckersbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008094:Lithium / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D000069348:Quetiapine Fumarate / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000069348:Quetiapine Fumarate; D008094:Lithium
keywords: Bipolar disorder; medication use; psychotherapy; service utilization