Evidence-based research on the efficacy of psychologic interventions in bipolar disorders: a critical review

Abstract

Although pharmacotherapy is the mainstay of treatment strategies for bipolar disorder, research over the last 5 years suggests that combining psychologic interventions with drug treatment increases overall effectiveness, mostly by further protecting from relapse or recurrence. We aimed at critically examining the relevance and effectiveness of psychosocial approaches to bipolar illness by doing a systematic review of the current literature. Currently, most studies show that patients receiving psychologic treatments have significantly fewer relapses, reduced hospitalization rates, and increased treatment adherence. Psychoeducation, family-focused psychoeducation, and cognitive-behavioral therapy seem to be the most efficacious interventions in the prophylaxis from recurrences in medicated bipolar patients. Recent studies have shown that psychologic approaches do not have the same "weight" in all bipolar patients. Pharmacologic treatment and psychologic interventions are complementary and share many goals, such as avoiding recurrences and improving clinical outcome. A wise combination of these two approaches may help bipolar patients to achieve a better symptomatic and functional recovery. Further research should focus on determining the therapeutic value of each ingredient of the tested psychologic interventions.