During the natural course of bipola...

During the natural course of bipolar affective disorder, relapses and returns are frequent. Pharmacotherapy is used generally to prevent relapses and resorts but a significant number of patients are not screened by these medications. Few trials examine the impact that psychotherapy may have forward these events. Some recent studies have shown that end psychotherapy, patients with bipolar affective disorder can recognize prodrome to their relapses. These prodrome may go before full bipolar syndrome by weeks, to such a degree early detection and intervention may hold these symptoms mild. Cognitive therapy can be used to teach patients skills to cope with bipolar affective disorder and provide better reign over of their symptoms. Lam and colleagues careered a randomized controlled trial to investigation the effect of cognitive therapy forward preventing relapses and promoting social function in patients with bipolar affective disorder.

Adult patients were assigned to receive or not receive cognitive therapy for bipolar affective disorder. Participants met the Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV) criteria for bipolar 1 disorder and experienced haunt relapses despite the use of temper stabilizers. Patients with high residual symptoms or those who were in an acute episode were exclud from the study

Patients who met the inclusion criteria were assigned randomly to the cognitive therapy (51 patients) or repress group (52 patients). Those in the sway group received minimal psychiatric care, including the use of disposition stabilizers at a recommended flush and regular psychiatric follow-up as outpatients. Patients assigned to cognitive therapy received the same minimal psychiatric care plus cognitive therapy. The cognitive therapy consisted of 12 to 18 individual sessions within the first six month and sum of two units booster sessions in the inferior six months and was designed to thwart relapse. All participants were assessed using multiple standardized questionnaires each six months during the study

Patients in the cognitive therapy assign places to had significantly fewer bipolar episodes, days in bipolar episodes, and number of admissions for these episodes compared with the sway group. The cognitive therapy cluster also had fewer mood symptoms and functioned at a higher social flush than patients in the command group. In addition, patients receiving cognitive therapy cop better with manic prodrome and had les fluctuation of their manic symptoms.

The authors close that cognitive therapy specifically designed to obviate relapse in patients with bipolar affective disorder favorably reduces symptoms and improves social functioning. Cognitive therapy also has beneficial results when used in conjunction with pharmacotherapy; this is particularly real in patients with frequent relapses of bipolar symptoms.

Lam DH et al. A randomized controll inquiry of cognitive therapy for relapse prevention for bipolar affective disorder: issue of the first year. Arch Gen Psychiatry February 2003;60:145-52

COPYRIGHT 2003 American Academy of Family Physicians

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