This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .
Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder.
CONTEXT Numerous studies have pointed to the failure of prophylaxis with pharmacotherapy alone in the treatment of bipolar I disorder . Recent investigations have demonstrated benefits from the addition of psychoeducation or psychotherapy to pharmacotherapy in this population . OBJECTIVE To compare 2 psychosocial interventions : interpersonal and social rhythm therapy ( IPSRT ) and an intensive clinical management ( ICM ) approach in the treatment of bipolar I disorder . DESIGN R and omized controlled trial involving 4 treatment strategies : acute and maintenance IPSRT ( IPSRT/IPSRT ) , acute and maintenance ICM ( ICM/ICM ) , acute IPSRT followed by maintenance ICM ( IPSRT/ICM ) , or acute ICM followed by maintenance IPSRT ( ICM/IPSRT ) . The preventive maintenance phase lasted 2 years . SETTING Research clinic in a university medical center . PARTICIPANTS One hundred seventy-five acutely ill individuals with bipolar I disorder recruited from inpatient and outpatient setting s , clinical referral , public presentations about bipolar disorder , and other public information activities . INTERVENTIONS Interpersonal and social rhythm therapy , an adaptation of Klerman and Weissman 's interpersonal psychotherapy to which a social rhythm regulation component has been added , and ICM . MAIN OUTCOME MEASURES Time to stabilization in the acute phase and time to recurrence in the maintenance phase . RESULTS We observed no difference between the treatment strategies in time to stabilization . After controlling for covariates of survival time , we found that participants assigned to IPSRT in the acute treatment phase survived longer without a new affective episode ( P = .01 ) , irrespective of maintenance treatment assignment . Participants in the IPSRT group had higher regularity of social rhythms at the end of acute treatment ( P<.001 ) . Ability to increase regularity of social rhythms during acute treatment was associated with reduced likelihood of recurrence during the maintenance phase ( P = .05 ) . CONCLUSION Interpersonal and social rhythm therapy appears to add to the clinical armamentarium for the management of bipolar I disorder , particularly with respect to prophylaxis of new episodes
This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .