The Nature and Treatment of Bipolar Disorder and the Bipolar Spectrum

2014 ◽  
pp. 295-312
Author(s):  
Michael W. Otto ◽  
Allison J. Applebaum
Keyword(s):  
Bipolar Disorder ◽  
Group Treatment ◽  
Behavioral Therapy ◽  
Psychosocial Interventions ◽  
Bipolar Spectrum ◽  
Empirically Supported ◽  
Current State ◽  
Poor Treatment ◽  
Social Rhythm ◽  
Poor Treatment Response

In this chapter, we review the nature and treatment of bipolar disorder. We first present a perspective on the disorder, based on the dominant bipolar I and II classifications, and review the current state of medication and empirically supported psychosocial interventions (e.g., cognitive-behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy, and group treatment), including factors that lead to poor treatment response. Given the increased attention to how bipolar I and II may lie at one end of a continuum of patterns of mood instability, we subsequently address spectrum conceptualizations of bipolar disorder. The proposed spectrum models are presented and then considered in relation to revised prevalence rates and treatment implications.

The Nature and Treatment of Bipolar Disorder and the Bipolar Spectrum

2010 ◽  
pp. 294-311
Author(s):  
Michael W. Otto ◽  
Allison J. Applebaum
Keyword(s):  
Bipolar Disorder ◽  
Group Treatment ◽  
Behavioral Therapy ◽  
Psychosocial Interventions ◽  
Bipolar Spectrum ◽  
Empirically Supported ◽  
Current State ◽  
Poor Treatment ◽  
Social Rhythm ◽  
Poor Treatment Response

In this chapter, we review the nature and treatment of bipolar disorder. We first present a perspective on the disorder, based on the dominant bipolar I and II classifications, and review the current state of medication and empirically supported psychosocial interventions (e.g., cognitive-behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy, and group treatment), including factors that lead to poor treatment response. Given the increased attention to how bipolar I and II may lie at one end of a continuum of patterns of mood instability, we subsequently address spectrum conceptualizations of bipolar disorder. The proposed spectrum models are presented and then considered in relation to revised prevalence rates and treatment implications.

Empirically supported psychosocial interventions for bipolar disorder: Current state of the research

2016 ◽  
Vol 201 ◽  
pp. 203-214 ◽  
Author(s):  
Stephanie Salcedo ◽  
Alexandra K. Gold ◽  
Sana Sheikh ◽  
Peter H. Marcus ◽  
Andrew A. Nierenberg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychosocial Interventions ◽  
Empirically Supported ◽  
Current State

New Psychosocial Interventions for Bipolar Disorder: A Review of Literature and Introduction of the Systematic Treatment Enhancement Program

2006 ◽  
Vol 20 (2) ◽  
pp. 215-230 ◽  
Author(s):  
David J. Miklowitz ◽  
Michael W. Otto
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Empirical Support ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Systematic Treatment ◽  
Future Directions ◽  
Group Psychoeducation ◽  
Psychoeducational Treatment ◽  
Social Rhythm

What is the evidence that psychosocial treatment adds to the efficacy of pharmacotherapy in forestalling episodes of bipolar disorder (BPD)? This article gives the rationale for including psychosocial intervention in the outpatient maintenance of BPD. Attention is placed on 4 psychosocial modalities that have achieved empirical support in randomized trials: family-focused psychoeducational treatment (FFT), cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), and group psychoeducation. FFT, CBT, and IPSRT are being contrasted with a psychosocial control condition in the context of the ongoing, multicenter Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). The objectives, design, and potential contributions of the STEP-BD study are explained. Future directions for the evaluation and dissemination of manual-based psychosocial interventions are discussed.

Psychosocial Treatments for Bipolar Disorder

2015 ◽  
Author(s):  
Anjana Muralidharan ◽  
David J. Miklowitz ◽  
W. Edward Craighead
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Psychosocial Interventions ◽  
Primary Treatment ◽  
Coping With Stress ◽  
Adherence To Medication ◽  
Hospitalization Rates ◽  
Long Term Follow Up ◽  
Family Based ◽  
Bipolar Patients

Pharmacological interventions remain the primary treatment for bipolar disorder. However, adjunctive psychosocial interventions have the potential to increase adherence to medication regimens, decrease hospitalizations and relapses, decrease severity of symptoms, improve quality of life, and enhance mechanisms for coping with stress. Group psychoeducation, designed to provide information to bipolar patients about the disorder and its treatment, leads to lower rates of recurrence and greater adherence to medication among remitted bipolar patients at both short- and long-term follow-up. Cognitive-behavioral therapy as an ancillary treatment has found mixed results but generally supportive evidence indicating that it is useful in preventing relapse to depression in remitted patients. Family-based intervention, such as Family-Focused Therapy (FFT), may be combined with pharmacotherapy to reduce recurrences and hospitalization rates in adult patients.

Psychosocial Treatment for Bipolar Disorder

CNS Spectrums ◽  
2010 ◽  
Vol 15 (S3) ◽  
pp. 14-16
Author(s):  
Noreen Reilly-Harrington
Keyword(s):  
Bipolar Disorder ◽  
Collaborative Care ◽  
Medication Compliance ◽  
Behavioral Therapy ◽  
Mood Stabilizer ◽  
Psychosocial Treatment ◽  
Psychoeducational Intervention ◽  
Type I ◽  
Bipolar Type ◽  
Social Rhythm

Medication is the mainstay of treatment for bipolar disorder. However, no medication will be effective if patients do not take it, and the rates of medication compliance in bipolar disorder are very low. Johnson and McFarland found that the modal length of compliance with a mood stabilizer was only 2 months. Keck and colleagues found that 50% to 66% of patients with bipolar disorder exhibit poor compliance within the first 12 months of treatment. In addition, even with adequate medication compliance, high rates of relapse persist.Adjunctive psychosocial treatments can help reduce relapse and provide patients as well as their families with tools to manage bipolar disorder more effectively. Several forms of intensive psychotherapy have shown promise for the treatment of bipolar disorder. In the Systematic Treatment Enhancement Program for Bipolar Disorder, Miklowitz and colleagues compared three forms of intensive interventions: cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy, and family-focused treatment. These were compared to a brief, 3-session psychoeducational intervention known as collaborative care. A total of 293 depressed patients with bipolar type I or type II disorder were treated with protocol pharmacotherapy and were randomly assigned to either one of the three intensive interventions or the brief psychoeducational intervention.The three intensive interventions provided up to 30 sessions of treatment over a 9-month period. The collaborative care intervention consisted of three sessions administered over a 6-week period. The authors found that patients who received one of the intensive interventions had a median time to recovery 110 days earlier than patients who had received the collaborative care conditions. Patients who received one of the three intensive psychotherapies also had significantly higher year-end recovery rates, and are more than 1 to 1.5 times more likely to be clinically well during any study month. No statistically significant differences were found between the 3 intensive treatments.

Psychosocial interventions for bipolar disorder

2009 ◽  
Vol 21 (6) ◽  
pp. 275-284 ◽  
Author(s):  
David J. Castle ◽  
Lesley Berk ◽  
Sue Lauder ◽  
Michael Berk ◽  
Greg Murray
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
Psychosocial Treatments ◽  
Cognitive Behavioural ◽  
Bipolar Ii ◽  
Social Rhythm ◽  
Family Based ◽  
Randomised Controlled

Aim:To provide a selected overview of the literature on psychosocial treatments for bipolar disorderMethod:Selective literature reviewResults:Randomised controlled trials of psychosocial interventions in bipolar disorder fall largely into five categories, namely: psychoeducation, integrated treatments, family based therapy, cognitive behavioural therapy and interpersonal social rhythm therapy. Most studies have shown some benefit in terms of relapse prevention, but have tended to be effective for either the depressed or the manic pole, and not both. Broader outcome parameters such as quality of life have not been reported consistently. The mechanisms whereby treatments might exert their effects have not been clearly delineated. Many studies have excluded patients with bipolar II and other variants, and those with psychiatric and substance use comorbidities, reducing their generalisability.Discussion:Whilst psychosocial treatments show promise in the area of bipolar disorder, more work is required to delineate the effective elements of such interventions, and to ensure generalisability to individuals with bipolar II and other forms of bipolar disorder, as well as those with psychiatric and substance use comorbidities. Other forms of delivery, such as via the internet, deserve further exploration.

Psychosocial Approaches to the Treatment and Prevention of Bipolar Disorder

2016 ◽  
pp. 489-498
Author(s):  
Noreen A. Reilly-Harrington
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Psychosocial Treatment ◽  
Future Research ◽  
Pediatric Bipolar Disorder ◽  
Treatment And Prevention ◽  
Social Rhythm ◽  
Psychosocial Approaches

Over the past two decades, adjunctive psychosocial treatments for bipolar disorder have been shown to hasten recovery, reduce relapse, and improve patients’ medication adherence, functioning, and quality of life. This chapter reviews four of the most widely studied psychosocial approaches for bipolar disorder: psychoeducation, cognitive-behavioral therapy (CBT), family-focused treatment (FFT), and interpersonal and social rhythm therapy (IPSRT). Core treatment strategies for each modality are presented, and key outcome studies are reviewed. The role of psychosocial treatment in pediatric bipolar disorder and in the prevention of bipolar disorder in youth at high risk for bipolar disorder is also presented. Suggestions for future research and the critical need for dissemination are also briefly discussed.

Bipolar Disorder

2017 ◽  
pp. 167-172
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Critical Factor ◽  
Primary Treatment ◽  
Behavioral Approach ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii ◽  
Environmental Stimulation ◽  
Social Rhythm ◽  
Important Extension

This chapter covers the treatment of bipolar disorder using an adaptation of IPT called Interpersonal and Social Rhythm Therapy (IPSRT). An amalgam of IPT with behavioral therapy developed by Frank and colleagues, IPSRT is an efficacious adjunct to medication for patients with bipolar I disorder. The behavioral component addresses coordination and stabilization of daily behaviors, especially the preservation of sleep, which is a critical factor in avoiding manic episodes, and modulation of environmental stimulation, whereas IPT targets the depressive aspects of the disorder. This combination represents an important extension of IPT into novel treatment territory. IPSRT is the first IPT adaptation to be designed as an adjunct to medication, rather than as a standalone, primary treatment; it is also the first attempt to integrate IPT with a behavioral approach. A case example is provided of the use of IPSRT in a patient with bipolar II disorder.

Treatment of Bipolar Disorder

2021 ◽  
pp. 212-228
Author(s):  
Kirstin Painter ◽  
Maria Scannapieco
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Behavioral Therapy ◽  
Real Life ◽  
Mood Stabilizers ◽  
Class Discussion ◽  
Proper Treatment ◽  
Life Outcomes ◽  
Psychosocial Therapy ◽  
Social Rhythm

There is currently no cure for bipolar disorder (BD). However, people can recover with proper treatment and lead a satisfying, normal life. Treating BD focuses on controlling and preventing the manic and/or depressive symptoms. Mood stabilizers are the first line of treatment for BD, most often in conjunction with psychosocial therapy. This chapter presents the medications commonly prescribed for treating children and adolescents diagnosed with BD along with their possible side effects. Interpersonal and social rhythm therapy, family-focused therapy, and cognitive-behavioral therapy are also presented. Chapter 14 returns to the case studies presented in Chapter 13 and describes the real-life outcomes along with questions for class discussion.

Psychosocial Treatment for Psychotic Disorders: Systems of Care and Empirically Supported Psychosocial Interventions

2016 ◽  
Author(s):  
Jessica M. Gannon ◽  
Shaun M. Eack
Keyword(s):  
Psychotic Disorders ◽  
Systems Of Care ◽  
Behavioral Therapy ◽  
Psychosocial Care ◽  
Cognitive Remediation ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Community Treatment ◽  
Empirically Supported ◽  
Somatic Therapies

In this chapter, we discuss psychosocial interventions, including psychotherapies and other services useful for helping individuals with psychotic disorders. We explain the basics components of the systems of care through which these services are frequently offered, focusing on outpatient treatments. Psychosocial rehabilitation is highlighted, as it helps patients move towards recovery, which is an important model for psychosocial care. A number of evidence-based psychotherapies are explored, notably cognitive-behavioral therapy (CBT), family therapy, and cognitive remediation. Many of these treatments can be given individually or in groups, and although underutilized, can improve outcome when combined with somatic therapies. Other services have been shown to be useful in recovery, such as case management, assertive community treatment, and housing, and these are explored in this chapter as well. Finally, we review the role of hospitalization and involuntary treatment in the care of patients with psychotic disorders.

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