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Cognitive behaviour therapy and supportive therapy for bipolar disorders: relapse rates for treatment period and 2-year follow-up
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Dr Thomas Meyer
Meyer TD, Hautzinger M
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The efficacy of adjunctive psychosocial interventions such as Cognitive Behaviour Therapy (CBT) has been shown in several uncontrolled and controlled studies. However all of these studies compared CBT to either a waiting list control group or treatment-as-usual, so we do not know, if the effects of CBT go beyond the effects of supportive therapy (ST) of equal intensity and frequency.
We conducted a randomized controlled trial in Germany at the outpatient clinic of a Psychological Institute (n = 76 patients with bipolar disorder). CBT and ST consisted of 20 sessions within 9 months both including psychoeducation and monitoring of symptoms. Patients were followed up for a further 24 months.
Although changes over time were observed in some variables, they were not differentially associated with CBT or ST. CBT showed a non-significant trend for preventing any affective, specifically depressive episode during the time of therapy. Kaplan Meier survival analyses revealed that 64.5 % of patients experienced a relapse during the 33 months, with CBT and ST being equally effective. Number of prior episodes, number of therapy sessions and type of bipolar disorder emerged as significant predictors of survival time.
: Certain shared characteristics (e.g. psychoeducation, systematic mood monitoring) might explain much of the variance in the effects of psychosocial treatment for bipolar disorder. Our results additionally suggest that a higher number of prior episodes, a lower number of therapy sessions and a diagnosis of bipolar II disorder are associated with shorter time before relapse despite therapy.
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