Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-25T11:02:35.038Z Has data issue: false hasContentIssue false

Psychotherapy for Bipolar Disorder

Published online by Cambridge University Press:  02 January 2018

Jan Scott*
Affiliation:
University Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP

Abstract

Background

Psychosocial factors may contribute 25–30% to the outcome variance in bipolar disorders. Sufferers have identified benefits from psychotherapy, but biological models and treatments dominate the research agenda. The author reviews research on psychosocial issues and interventions in this disorder.

Method

Research on adjustment to the disorder, interpersonal stressors and obstacles to treatment compliance were located by computerised searches and the author's knowledge of the literature. All published outcome studies of psychosocial interventions in bipolar disorder are reviewed.

Results

There is an inadequate database on psychosocial factors associated with onset and maintenance of bipolar disorder. While the outcome studies available are methodologically inadequate, the accumulated evidence suggests that psychosocial interventions may have significant benefits for bipolar sufferers and their families.

Conclusions

Given the significant associated morbidity and mortality, there is a clear need for more systematic clinical management that addresses psychosocial as well as biological aspects of bipolar disorder. The author identifies appropriate research strategies to improve knowledge of effective psychosocial interventions.

Type
Review Articles
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benson, R. (1975) The forgotten treatment modality in bipolar illness: psychotherapy. Diseases of the Nervous System, 36, 634638.Google ScholarPubMed
Bloch, S., Hafner, J., Harari, E., et al (1994) The Family in Clinical Psychiatry, pp. 92108. Oxford: Oxford Medical.Google Scholar
Brodie, H. & Leff, M. (1971) Bipolar depression – a comparative study of patient characteristics. American Journal of Psychiatry, 127, 10861090.Google Scholar
Clarkin, J., Glick, G., Haas, G., et al (1990) A randomized clinical trial of in-patient family intervention. V: results for affective disorder. Journal of Affective Disorders, 18, 1728.Google Scholar
Cochran, S. (1984) Preventing medical non-compliance in the out-patient treatment of bipolar affective disorder. Journal of Consulting and Clinical Psychology, 52, 873878.Google Scholar
Cochran, S. & Gitlin, M. (1988) Attitudinal correlates of lithium compliance in bipolar affective disorders. Journal of Nervous and Mental Diseases, 176, 457464.Google Scholar
Davenport, Y., Ebert, M., Adland, M., et al (1977) Couples therapy as an adjunct to lithium maintenance of the manic patient. Journal of Orthopsychiatry, 47, 495502.Google Scholar
Fitzgerald, R. (1972) Mania as the message: treatment with family therapy and lithium carbonate. American Journal of Psychotherapy, 26, 547–535.Google Scholar
Frank, E., Prien, R., Kupfer, D., et al (1985) Implications of non-compliance on research in affective disorders. Psychopharmacology Bulletin, 21, 3742.Google Scholar
Frank, E., Targum, S., Gershon, E., et al (1981) A comparison of non-patient with bipolar-well spouse couples. American Journal of Psychiatry, 138, 764768.Google Scholar
Glick, I., Burti, L., Okonogi, K., et al (1994) Effectiveness in psychiatric care. III: psychoeducation and outcome for patients with major affective disorder and their families. British Journal of Psychiatry, 164, 104106.Google Scholar
Goodwin, F. & Jamison, K. (1990) Psychotherapy. In Manic–Depressive Illness (eds Goodwin, F. & Jamison, K.), pp. 725745. Oxford: Oxford University Press.Google Scholar
Harrow, M., Goldberg, J., Grossman, L., et al (1990) Outcome in manic disorders. Archives of General Psychiatry, 47, 665671.Google Scholar
Hooley, J., Richters, J., Weintraub, S., et al (1987) Psychopathology and marital distress: the positive side of positive symptoms. Journal of Abnormal Psychology, 96, 2733.Google Scholar
Jamison, K. & Akiskal, H. (1983) Medication compliance in patients with bipolar disorders. Psychiatric Clinics of North America, 6, 175192.Google Scholar
Jamison, K., Gerner, R. & Goodwin, F. (1979) Patient and physician attitudes towards lithium: relationship to compliance. Archives of General Psychiatry, 36, 866869.Google Scholar
Joyce, P. (1992) Prediction of treatment response. In Handbook of Affective Disorders (ed. Paykel, E. S.), pp 453464. London: Churchill Livingstone.Google Scholar
Kahn, D. (1990) The psychotherapy of mania. Psychiatric Clinics of North America, 13, 229240.Google Scholar
Kripke, D. & Robinson, D. (1985) Ten years with a lithium group. McLean Hospital Journal, 10, 111.Google Scholar
Lam, D. (1991) Psychosocial family interventions in schizophrenia: a review of empirical studies. Psychological Medicine, 21, 423441.Google Scholar
Miklowitz, D., Goldstein, M., Nuechterlein, K., et al (1988) Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225231.CrossRefGoogle ScholarPubMed
Peet, M. & Harvey, N. (1991) Lithium maintenance: 1. A standard education programme for patients. British Journal of Psychiatry, 158, 197200.Google Scholar
Prien, R. & Potter, W. (1990) NIMH workshop report on treatment of bipolar disorder. Psychopharmacology Bulletin, 26, 409427.Google Scholar
Rush, A. (1988) Cognitive approaches to adherence. In Review of Psychiatry (vol. 8) (eds Frances, A. & Hales, R.), pp. 627642. Washington: American Psychiatric Association.Google Scholar
Shakir, S. Volkman, F., Bacon, S., et al (1979) Group psychotherapy as an adjunct to lithium maintenance. American Journal of Psychiatry, 136, 455456.Google Scholar
Spencer, J., Glick, I., Haas, G., et al (1988) A randomized control trial of in-patient family intervention. III: effects at 6-month and 18-month follow-ups. American Journal of Psychiatry, 145, 11151121.Google Scholar
Targum, S., Dibble, E., Davenport, Y., et al (1981) The family attitude questionnaire. Patients' and spouses' views of bipolar illness. Archives of General Psychiatry, 38, 562568.Google Scholar
Volkmar, F., Shakir, S., Bacon, S., et al (1981) Group therapy in the management of manic-depressive illness. American Journal of Psychotherapy, 42, 2632671.Google Scholar
Wulsin, L., Bachop, M. & Hoffman, D. (1988) Group therapy in manic-depressive illness. American Journal of Psychotherapy, 42, 263271.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.