Cognitive-Behavioral Therapy for Mania: A Meta-Analysis of Randomized Controlled Trials
CBT helps patients recognize and address mood symptoms early on, before they become severe. This can reduce the likelihood of future relapses. Furthermore, CBT teaches individuals their triggers for mania so that they can prevent an episode in the future.
Mood Tracking: Some people utilize a mood tracker to record their symptoms from 0 (depressed) to 10 (manic). This helps them recognize when they are having a relapse and take action before it gets worse.
Social Rhythm Therapy: This behavioral and cognitive therapy aims to maintain regular sleep patterns and activity schedules. It is based on the notion that sleep deprivation or disruptions to circadian rhythms may contribute to symptoms of bipolar disorder. Typically, this type of therapy is employed with younger adults.
Family Therapy: This type of treatment aims to assist patients manage their bipolar disorder in conjunction with family members. The aim is to reduce family stress and tension while improving family functioning.
According to the National Institute of Mental Health, this type of treatment can be highly effective when utilized as part of an overall treatment plan. A recent meta-analysis found that it reduced relapses, improved mood stability and helped people stay on their medication schedules.
After six months, the relapse rate for major depressive disorder was significantly lower in the CBT group than in the control group; however, this effect had faded by 12 months. Furthermore, mania severity increased following intervention but did not return to normal after 12 months.
Clinical practice guidelines advocate for a multifaceted approach that incorporates medication and behavioral therapy in treating bipolar disorder. This strategy helps people adhere to their medications, reduces their risk of relapse, and keeps manic episodes under control.
Medications for Mania: In addition to mood stabilizers, antidepressants may also be prescribed. While these drugs can be helpful temporarily, they may increase the likelihood of mania in the long run due to their interference with serotonin production which leads to an increase in symptoms associated with mania.
In the past, research into the effectiveness of adjunctive therapies like psychotherapy or behavioral therapy relied on trials that recruited homogenous samples of people without depression who adhered to their prescribed mood stabilizers. These randomized controlled trials, commonly referred to as pragmatic effectiveness trials, are generally quite reliable in their findings.
These trials are usually conducted in a university hospital setting and involve patients recently diagnosed with BD. The research is typically funded by the government and usually follows a randomised controlled trial format.
A meta-analysis of this literature identified 3255 abstracts and 39 randomized controlled trials that compared pharmacotherapy with manualized psychotherapy (cognitive behavioral therapy, family or conjoint therapy, interpersonal therapy or psychoeducational therapy) against a control intervention. Most of the studies were published in English and included participants aged 18-65 years with most reporting sex.
