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The current status of psychological treatments in bipolar disorders: a systematic review of relapse prevention.

Scott J, Gutierrez MJ

Department of Psychological Medicine, Institute of Psychiatry, Denmark Hill, London, UK. j.scott@iop.kcl.ac.uk

OBJECTIVE: This paper reviews published randomized-controlled treatment trials of psychological therapies added to standard psychiatric treatment versus medication and standard psychiatric treatment alone to explore whether adjunctive psychotherapy reduces relapse rates in individuals with bipolar disorders (BDs). METHOD: Relapse rates were calculated for individual trials that met inclusion criteria and then pooled odds ratios were calculated using meta-analytic techniques. RESULTS: The majority of studies quoted demonstrate that individuals receiving psychological treatments had significantly fewer relapses. The length of therapy required was between 10 and 20 h over 6-9 months and the models of effective therapies had many shared characteristics in terms of style and content. CONCLUSIONS: Adjunctive psychological treatments for individuals with BDs are acceptable and feasible and reduce relapse risk. There are relatively few differences in the benefits that accrue from the different therapy models. It is now important to explore whether they have added value in terms of additional health gains and social functioning compared with standard treatment approaches.

Published 15 November 2004 in Bipolar Disord, 6(6): 498-503.
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