Psychosocial Treatments for Bipolar Depression

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Abstract
Bipolar disorder is an extremely debilitating illness, in large part because of the difficulty in treating bipolar depressive episodes. Patients experience significantly greater impairment and longer times to recovery from depressive than manic episodes and high levels of residual depressive symptoms between episodes.1-7 The limited efficacy of pharmacotherapy alone8-11 has motivated the study of adjunctive psychosocial interventions. Randomized controlled trials support the efficacy of adjunctive cognitive behavior therapy (CBT),12,13 family-focused treatment (FFT) or similar forms of family psychoeducation,14-18 interpersonal and social rhythm therapy (IPSRT),19 and group psychoeducation20,21 in preventing depressive and manic recurrences, stabilizing symptoms, or enhancing functioning in 1- to 2-year periods. One multicenter effectiveness trial22 found no main effect of CBT on time to recurrence, although post hoc analyses revealed benefits in patients with fewer than 12 episodes.