Whereas pharmacological interventions remain the primary treatment for bipolar disorder, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, improve quality of life, and enhance mechanisms for coping with stress. Controlled studies have established that individual, family, and group psychoeducation, designed to provide information to bipolar patients and their families about the disorder, its pharmacological treatment, and the treatments’ side effects, leads to lower rates of recurrence and greater adherence to pharmacological treatment among bipolar patients. Type 1 and 2 studies have evaluated cognitive behavioral therapy (CBT) as an ancillary treatment. These studies indicate that CBT is associated with better medication adherence and significantly fewer recurrences and/or rehospitalizations. One Type 1 study has evaluated the effectiveness of IPSRT (interpersonal and social rhythm therapy) for bipolar disorder. IPSRT demonstrated its greatest symptomatic effects during a maintenance treatment period, especially if bipolar patients had been successful in stabilizing their daily and nightly routines during an acute treatment period. Finally, four Type 1 studies in adult and pediatric patients have shown that marital/ family therapy may be effectively combined with pharmacotherapy to reduce recurrences and improve medication adherence and family functioning.
7.1 Development of the Customized Adherence Enhancement Intervention for Adolescents and Young Adults to Improve Medication Adherence in Bipolar Disorder
