Cognitive behaviour therapy in the treatment of bipolar disorder

AbstractThis article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

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Efficacy of Internet Delivered Cognitive Behaviour Therapy for Anxiety and Depression in People with Bipolar Disorder

10.21203/rs.3.rs-80609/v1 ◽

2020 ◽

Author(s):

Olav Nielssen ◽

Lauren Staples ◽

Eyal Karin ◽

Rony Kayrouz ◽

Blake Dear ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Behaviour Therapy ◽

Routine Care ◽

Anxiety And Depression ◽

Behaviour Therapy ◽

Research Reporting ◽

Cognitive Behaviour ◽

Assessment And Treatment ◽

Patient Health ◽

Psychiatric Conditions

Abstract BackgroundMindSpot is a national digital mental health service providing free assessment and treatment for anxiety and depression. Mindspot services have been accessed by people with a broad range of psychiatric conditions, including people who report a diagnosis of bipolar disorder (BD). There is comparatively little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of BD (BDd), including as part of routine care. MethodDemographic characteristics, baseline scores and treatment outcomes were examined for patients who reported taking Lithium and had entries in their clinic records confirming the diagnosis of BD. Results were compared to the clinic benchmarks. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety as measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), respectively. ResultsA total of 21,745 people completed a MindSpot assessment between January 2013 and December 2019 and enrolled in a MindSpot treatment course. Of these, 124 reported that they were currently taking Lithium, of whom 83 had entries in their clinic records confirming a diagnosis of BD. Mean age of patients with confirmed BD was 43.8 years, compared to the clinic mean of 39.8 years. Their baseline symptom scores were higher than the benchmark. However, reductions in symptoms on the K-10, PHQ-9, and GAD-7 were large (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with BD, and the outcomes were comparable to clinic benchmarks. Results suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with BDd.

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Efficacy of Internet Delivered Cognitive Behaviour Therapy for People in the Depressed Phase of Bipolar Disorder

10.21203/rs.3.rs-497279/v1 ◽

2021 ◽

Author(s):

Olav Nielssen ◽

Lauren Staples ◽

Eyal Karin ◽

rony kayrouz ◽

Blake Dear ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Behaviour Therapy ◽

Bipolar Depression ◽

Routine Care ◽

Completion Rates ◽

Depression And Anxiety ◽

Behaviour Therapy ◽

Research Reporting ◽

Cognitive Behaviour ◽

Patient Health

Abstract BackgroundThere is little research reporting the outcome of internet delivered cognitive behaviour therapy (iCBT) for the depressed phase of bipolar disorder as part of routine care. MethodsDemographic information, baseline scores and treatment outcomes were examined for patients of MindSpot Clinic, a national iCBT service who reported taking Lithium and their clinic records confirming the diagnosis of bipolar disorder. Outcomes were completion rates, patient satisfaction and changes in measures of psychological distress, depression and anxiety measured by the Kessler-10 item (K-10), Patient Health Questionnaire 9 Item (PHQ-9), and Generalized Anxiety Disorder Scale 7 Item (GAD-7), compared to clinic benchmarks. ResultsOut of 21,745 people completed a MindSpot assessment and enrolled in a MindSpot treatment course in a 7 year period, 83 reported taking Lithium and had a confirmed a diagnosis of bipolar disorder. Reductions in symptoms were large on all measures (effect sizes > 1.0 on all measures, percentage change between 32.4% and 40%), and lesson completion and satisfaction with the course were also high. ConclusionsMindSpot treatments were effective in treating anxiety and depression in people diagnosed with bipolar, and suggest that the routine provision of iCBT can help overcome the under-use of evidence based psychological treatments of people with bipolar depression.

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Transdiagnostic group cognitive behaviour therapy for anxiety in bipolar disorder—a pilot feasibility and acceptability study

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00719-6 ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Tania Perich ◽

Philip B. Mitchell ◽

Tanya Meade

Keyword(s):

Bipolar Disorder ◽

Cognitive Behaviour Therapy ◽

Therapy Group ◽

Working Hours ◽

Structured Interview ◽

Self Report ◽

Behaviour Therapy ◽

Co Morbidity ◽

Cognitive Behaviour ◽

Homework Adherence

Abstract Objective Anxiety is prominent for many people living with bipolar disorder, yet the benefit of psychological interventions in treating this co-morbidity has been minimally explored and few studies have been conducted in a group format. This study aimed to assess the feasibility and acceptability of a transdiagnostic cognitive behaviour therapy group anxiety programme (CBTA-BD) for people living with bipolar disorder. Methods Participants were recruited to take part in a 9-week group therapy programme designed to treat anxiety in bipolar disorder using cognitive behaviour therapy. They were assessed by structured interview (SCID-5 RV) to confirm the diagnosis of bipolar disorder and assessed for anxiety disorders. Self-report questionnaires—DASS (depression, anxiety, stress), ASRM (mania), STAI (state and trait anxiety) and Brief QOL.BD (quality of life) pre- and post-treatment were administered. Results Fourteen participants enrolled in the programme, with 10 participants (5 male; 5 female) completing the follow-up assessments. Two groups (one during working hours, the other outside working hours) were conducted. The programme appeared acceptable and feasible with a mean of 6.9 (77%) sessions attended, though five (50%) participants completed less than 3 weeks homework. Conclusion The transdiagnostic cognitive behaviour therapy group anxiety programme (CBTA-BD) proved feasible and acceptable for participants; however, homework compliance was poor. A larger randomised pilot study is needed to assess the benefits of the intervention on symptom measures and address homework adherence, possibly through providing support between sessions or tailoring it more specifically to participant needs.

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The Role of Cognitive Behaviour Therapy in Bipolar Disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246580001506x ◽

1996 ◽

Vol 24 (3) ◽

pp. 195-208 ◽

Cited By ~ 10

Author(s):

Jan Scott

Keyword(s):

Bipolar Disorder ◽

Cognitive Behaviour Therapy ◽

Outcome Data ◽

Psychological Interventions ◽

Psychosocial Issues ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

And Control ◽

Risk Of Relapse

There is increasing support for the use of systematic psychological interventions in combination with pharmacotherapy in the treatment of bipolar disorder (BD). A “manualised” approach, such as cognitive behaviour therapy (CBT), can be used to facilitate adjustment to the disorder, increase the acceptability of prescribed medications and reduce morbidity. This paper outlines psychosocial issues of relevance to individuals with BD and a model to engage individuals in therapy is described. A brief overview is given of some of the interventions that may help sufferers identify and control the acute symptoms of BD, reduce the risk of relapse and improve how they cope with the disorder and its treatment. The available outcome data on the use of CBT and the need for research are also noted.

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