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Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder
Abstract
Interpersonal and social rhythm therapy is an individual psychotherapy designed specifically for the treatment for bipolar disorder. Interpersonal and social rhythm therapy grew from a chronobiological model of bipolar disorder postulating that individuals with bipolar disorder have a genetic predisposition to circadian rhythm and sleep-wake cycle abnormalities that may be responsible, in part, for the symptomatic manifestations of the illness. In our model, life events (both negative and positive) may cause disruptions in patients' social rhythms that, in turn, perturb circadian rhythms and sleep-wake cycles and lead to the development of bipolar symptoms. Administered in concert with medications, interpersonal and social rhythm therapy combines the basic principles of interpersonal psychotherapy with behavioral techniques to help patients regularize their daily routines, diminish interpersonal problems, and adhere to medication regimens. It modulates both biological and psychosocial factors to mitigate patients' circadian and sleep-wake cycle vulnerabilities, improve overall functioning, and better manage the potential chaos of bipolar disorder symptomatology.
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“Treatments to amplify, phase advance or delay circadian rhythms have been developed for potential use in psychiatric disorders in adults.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [189]
In the citing paper
“circadian disruptions can precipitate mood and psychotic episodes in individuals who already have psychiatric disorders189–191”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [189]
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“The role of early morning BLT in winter depression may be actually an intervention based on ‘Social Rhythm Therapy’ which has been proven as effective strategy to deal with bipolar disorder patients because early morning BLT in winter depression invariably promotes concept of chronotherapeutics in management of SAD.[2…”
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“This treatment option was developed from a chronobiological model of bipolar disorder, which proposes that the symptoms associated with bipolar disorder arise, to some extent, from the patient’s genetic predisposition to disruptions in the sleepwake cycle and circadian rhythm.(30) These sleep disruptions are related t…”
BackgroundLe traitement des troubles bipolaires
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“Les synchroniseurs externes tels que lumière, repères sociaux modifient la phase des rythmes circadiens : l’arrêt brutal des activités peut générer une récidive, la sévérité d’un épisode notamment dépressif pouvant être proportionnelle à la perte des activités sociales (11).”
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“A study by Frank, Swartz, and Kupfer (2000) of patients with bipolar disorders postulated that regulation of daily routines (such as enabling modulation of patients’ circadian and sleep/wake cycle) could lead to an improvement in overall functioning and help in reducing the risk of relapse.”
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“INTERPERSONAL PSYCHOTHERAPY The use of IPT in the treatment of depression has been reported in several clinical trials, with proven efficacy, especially when associated to pharmacotherapy.(12-21,36,37) It was developed by Klerman, Weissman and cols.”
MethodMolecular Architecture and Neurobiology of Bipolar Disorder
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Mathematical Models of Bipolar Disorder
Daugherty, D., Roque-Urrea, T., Urrea-Roque, J., Snyder, J., Wirkus, S. A., & Porter, M. A. (2003) · Oxford University Research Archive (ORA) (University of Oxford) · doi:10.48550/arxiv.nlin/0311032 · Cited by 3
“[11] and Gottschalk et al.”
CBT‐I Protocol for Insomnia Co‐morbid with Affective Disorders
Blom, K., & Jernelöv, S. (2022) · doi:10.1002/9781119891192.ch12 · Cited by 3
Are There Connections between the Neuroendocrine and Dopamine Systems in Bipolar Disorder?
Trouillas, J., Claustrat, B., Henry, E., Lemius, J., Alafuzoff, I. I., & Nataf, S. (2025) · Neuroendocrinology · doi:10.1159/000547042 · Cited by 2
“Along this line, disruptions in the sleep/wake cycle were suggested to trigger manic or depressive episodes in patients with BPD [127].”
Adapting a mood disorders group therapy programme for the screen in the time of COVID-19
Wong, C., Mok, Y. M., Wong, P. F., Thia, H. T., Chan, B. J., & Tang, W. L. J. (2021) · Singapore Medical Journal · doi:10.11622/smedj.2021012 · Cited by 3
“We are currently in the midst of transitioning the programme’s manualised psychotherapy groups (transdiagnostic Cognitive Behavioural Therapy[26] and Interpersonal and Social Rhythm Therapy[27]) to”
MethodAfshari, B. (2023) · Exploration of neuroscience · doi:10.37349/en.2023.00032 · Cited by 2
Suchterkrankungen und komorbide psychische Störungen
Moggi, F., & Preuss, U. W. (2018) · Elsevier eBooks · doi:10.1016/b978-3-437-23021-9.00019-9 · Cited by 2
Perlis, R. H., Ostacher, M. J., & Kapson, H. S. (2003) · Current Psychosis & Therapeutics Reports · doi:10.1007/bf02629387 · Cited by 2
Mesures psychoéducatives et troubles bipolaires. Données actuelles
Gay, C., Cuche, H., & Cléry-Melin, P. (2006) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2006.05.016 · Cited by 2
Devenir fonctionnel et thérapeutiques psycho-sociales dans le trouble bipolaire
Gut, A. (2008) · L Encéphale · doi:10.1016/s0013-7006(08)80628-8 · Cited by 2
Pearson, M., & Burlingame, G. M. (2013) · International Journal of Group Psychotherapy · doi:10.1521/ijgp.2013.63.2.303 · Cited by 2
Cognitive Behavioral Therapy for Older Adults with Bipolar Disorder
Reiser, R. P., Truong, D., Nguyen, T. T. T., Wachsmuth, W., Marquett, R. M., Feit, A., & Thompson, L. W. (2007) · Springer eBooks · doi:10.1007/978-0-387-72007-4_16 · Cited by 2
“Specifically, older adults experience higher levels of stress related to role transitions and interpersonal losses and this has been demonstrated to increase vulnerability to bipolar episodes in other populations; (b) The role of disruptions in social rhythms as posited by Frank et al. (2000) in inducing new episodes…”
BackgroundInfluentialBowden, C. L., Gitlin, M. J., Keck, P. E., Perlis, R. H., Thase, M. E., & Wagner, K. D. (2002) · Cited by 2
Otto, M. W., & Miklowitz, D. J. (2006) · Springer eBooks · doi:10.1007/978-0-387-28370-8_12 · Cited by 2
Kumar, M., Das, R., Mukherjee, A., Paul, A., & Chakraborty, B. (2023) · Indian Journal Of Applied Research · doi:10.36106/ijar/3816457 · Cited by 2
Yokotani, K., Takano, M., & Abe, N. (2023) · IEEE/ACM International Conference on Advances in Social Networks Analysis and Mining (ASONAM) · doi:10.1145/3625007.3627319 · Cited by 2
“Our rationale is the interpersonal and social rhythm therapy [15], which assumes that the interpersonal problems of people with BD exacerbate their symptoms, while solving these interpersonal problems improves these symptoms [16].”
BackgroundBackenstraß, M., & Mundt, C. (2008) · Elsevier eBooks · doi:10.1016/b978-343723730-0.50022-7 · Cited by 2
Relapse Prevention and Bipolar Disorder: A Focus on Bipolar Depression
Rapaport, M. H., & Hales, D. J. (2003) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.1.1.15 · Cited by 2
Biological Rhythm and Neuropsychiatric Disorders
Datta, K. (2022) · Springer eBooks · doi:10.1007/978-981-16-0123-1_3 · Cited by 2
Evidence‐Based Psychological Interventions for Bipolar Disorder
Szentágotai‐Tătar, A., & David, D. O. (2017) · Wiley eBooks · doi:10.1002/9781119462996.ch3 · Cited by 2
Bledsoe, S. E. (2011) · Oxford University Press eBooks · doi:10.1093/obo/9780195389678-0139 · Cited by 2
Psychotherapy for Psychiatric Disorders
McQuaid, J. R., & Campbell‐Sills, L. (2007) · Humana Press eBooks · doi:10.1007/978-1-59259-960-8_27 · Cited by 2
“There is some evidence for CBT as an intervention for bipolar disorder, as well as family therapy and a modified version of IPT ( 21 ,22).”
Background
Metadata
- Authors
- Frank, E., Swartz, H. A., & Kupfer, D. J.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Frank, Ellen
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2000-09
- Volume
- 48
- Issue
- 6
- Pages
- 593-604
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2163455012
- Cited by
- 521
- References
- 47
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 18 · 2023: 9 · 2022: 17 · 2021: 18 · 2020: 12 · 2019: 14 · 2018: 20 · 2017: 20 · 2016: 26 · 2015: 19 · 2014: 25 · 2013: 22 · 2012: 24
- FWCI
- 2.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH60473, MH 29618, R25MH060473, MH30915)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- interpersonal and social rhythm therapy, bipolar disorder, circadian rhythm, sleep-wake cycle, social rhythms, chronobiology, interpersonal psychotherapy, life events, medication adherence, psychosocial interventions
- MeSH terms
- Affect, Behavior Therapy, Bipolar Disorder, Combined Modality Therapy, Humans, Interpersonal Relations, Life Change Events, Models, Psychological, Psychotherapy, Tranquilizing Agents, Randomized Controlled Trials as Topic, Sleep Disorders, Circadian Rhythm
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