The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Effectiveness of cognitive behavioral therapy in treating bipolar disorder: An updated meta‐analysis with randomized controlled trials
Open accessAbstract
Aim: The aim of this updated meta‐analysis was to further assess the effectiveness of cognitive behavioral therapy ( CBT ) in treating bipolar disorder ( BD ). Methods: We carried out a literature search on P ubMed, E mbase, and the C ochrane L ibrary up to O ctober 2015. We calculated the pooled relative risk of relapse rate and standard mean difference ( SMD ) of mean change (data at a follow‐up time‐point – baseline) of the Beck Depression Inventory, Beck Hopelessness Scale, Hamilton Rating Scale for Depression, Young Mania Rating Scale (YMRS) and Mania Rating Scale scores with their 95% confidence interval (95% CI ). Subgroup analyses based on follow‐up time were performed. Results: Nine randomized controlled trials with 520 bipolar I or II disorder patients were reanalyzed. Overall analysis showed that CBT did not significantly reduce the relapse rate of BD or improve the level of depression. However, significant efficacy of CBT in improving severity of mania was proved based on the YMRS ( SMD = −0.54, 95% CI , −1.03 to −0.06, P = 0.03) but not based on MRS . Subgroup analyses showed that CBT had short‐term efficacy in reducing relapse rate of BD (at 6 months’ follow‐up: relative risk = 0.49, 95% CI : 0.29–0.81, P = 0.006) and improving severity of mania based on YMRS score (post‐treatment: SMD = −0.30, 95% CI , −0.59 to −0.01, P = 0.04). Conclusion: Short‐term efficacy of CBT in reducing relapse rate of BD and improving the severity of mania was proved. But these effects could be weakened by time. In addition, there was no effect of CBT on level of depression in BD .
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
From meta-analyses, effects of CBT on either depressive symptoms or relapse remain uncertain due to important methodological problems and study selection factors.
“From meta‐analyses, effects on either depressive symptoms or on relapse remain uncertain due to important methodological problems and study selection factors.87, 88, 89”
From Canadian Network for Mood and Anxiety Treatments ( CANMAT ) and International Society for Bipolar Disorders ( ISBD ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [88]
The Discussion (page unavailable) reports conflicting findings on depressive symptoms across meta-analyses, differences in included studies and outcome calculations, and limitations including small samples and substantial heterogeneity. The relapse analysis found no significant overall effect, but the paper reports a significant reduction at six months; describing the relapse effect as simply uncertain omits that short-term finding. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
The Long-term Natural History of the Weekly Symptomatic Status of Bipolar I Disorder
Judd, L. L., Akiskal, H. S., Schettler, P. J., Endicott, J., Maser, J., Solomon, D. A., Leon, A. C., Rice, J. A., & Keller, M. B. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.6.530 · Cited by 2,106
Cognitive Impairment and Functional Outcome in Schizophrenia and Bipolar Disorder
Green, M. F. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.1006e12 · Cited by 794
Comorbidities and Mortality in Bipolar Disorder: A Swedish National Cohort Study
Crump, C., Sundquist, K., Winkleby, M. A., & Sundquist, J. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.1394 · Cited by 677
Functioning and Disability in Bipolar Disorder: An Extensive Review
Sánchez‐Moreno, J., Martínez‐Arán, A., Tabarés‐Seisdedos, R., Torrent, C., Vieta, E., & Ayuso‐Mateos, J. L. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000228249 · Cited by 467
Epidemiology of suicide in bipolar disorders: a systematic review of the literature
Pompili, M., Gonda, X., Serafini, G., Innamorati, M., Sher, L., Amore, M., Rihmer, Z., & Girardi, P. (2013) · Bipolar Disorders · doi:10.1111/bdi.12087 · Cited by 359
Adjunctive Psychotherapy for Bipolar Disorder: State of the Evidence
Miklowitz, D. J. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.08040488 · Cited by 311 · cited 1×
“Among these psychosocial interventions, it has been shown that CBT and group psychoeducation have better effectiveness when initiated during a period of recovery.(10) However, the positive influence of psychoeducation on virtually important cognitive variables may disappear with time.”
BackgroundHarvey, A. G., Soehner, A. M., Kaplan, K., Hein, K., Lee, J., Kanady, J. C., Li, D., Rabe‐Hesketh, S., Ketter, T. A., Neylan, T. C., et al. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0038655 · Cited by 271
Cognitive Therapy for Bipolar Illness—A Pilot Study of Relapse Prevention
Lam, D. H., Bright, J., Jones, S. H., Hayward, P., Schuck, N., Chisholm, D., & Sham, P. C. (2000) · Cognitive Therapy and Research · doi:10.1023/a:1005557911051 · Cited by 206
A Randomized Controlled Trial of Cognitive Therapy for Bipolar Disorder
Ball, J. R. B., Mitchell, P. B., Corry, J., Skillecorn, A., Smith, M., & Malhi, G. S. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0215 · Cited by 199
Treatment-resistant bipolar disorder
Gitlin, M. J. (2006) · Molecular Psychiatry · doi:10.1038/sj.mp.4001793 · Cited by 184
Family‐focused treatment for caregivers of patients with bipolar disorder
PERLICK, D. A., Miklowitz, D. J., López, N., Chou, J., Kalvin, C. B., Adzhiashvili, V., & Aronson, A. C. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00852.x · Cited by 154
Is Cognitive-Behavioural Therapy More Effective Than Psychoeducation in Bipolar Disorder?
Zaretsky, A. E., Lancee, W. J., Miller, C., Harris, A. L., & Parikh, S. V. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300709 · Cited by 153
Beynon, S., Soares‐Weiser, K., Woolacott, N. F., Duffy, S., & Geddes, J. R. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.037887 · Cited by 146
Predictors of Relapse in Bipolar Disorder: A Review
ALTMAN, S., Haeri, S., Cohen, L. J., Ten, A., BARRON, E., GALYNKER, I. I., & DuHamel, K. N. (2006) · Journal of Psychiatric Practice · doi:10.1097/00131746-200609000-00002 · Cited by 123
Meyer, T. D., & Hautzinger, M. (2011) · Psychological Medicine · doi:10.1017/s0033291711002522 · Cited by 105
Hamilton, N. A., Kitzman, H. E., & Guyotte, S. (2006) · Journal of Cognitive Psychotherapy · doi:10.1891/088983906780639754 · Cited by 103
Aaronson, C. J., Shear, M. K., Goetz, R. R., Allen, L. B., Barlow, D. H., White, K. S., Ray, S., Money, R. W., Saksa, J. R., Woods, S. W., et al. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0312 · Cited by 95
Kertz, S. J., Koran, J., Stevens, K. T., & Björgvinsson, Þ. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.03.006 · Cited by 91
Therapist emotional reactions and client resistance in cognitive behavioral therapy.
Westra, H. A., Aviram, A., Connors, L., Kertes, A., & Ahmed, M. S. (2011) · Psychotherapy · doi:10.1037/a0023200 · Cited by 83
The Efficacy of Cognitive-Behavioral Therapy in Bipolar Disorder: A Quantitative Meta-Analysis
Szentagotai, A., & David, D. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08r04559yel · Cited by 70
Johnson, S. L., & Jones, S. H. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20585 · Cited by 69
Hamilton, N. A., Kitzman, H. E., & Guyotte, S. (2006) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.20.2.123 · Cited by 66
Ball, J. R. B., Mitchell, P. B., Malhi, G. S., Skillecorn, A., & Smith, M. (2003) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2003.01098.x · Cited by 60
A Randomized Controlled Trial of Cognitive Behavioral Group Therapy for Bipolar Disorder
Gomes, B. C., Abreu, L. N., Brietzke, E., Caetano, S. C., Kleinman, A., Nery, F. G., & Lafer, B. (2011) · Psychotherapy and Psychosomatics · doi:10.1159/000320738 · Cited by 52
Costa, R. T. D., Cheniaux, E., Rosaes, P. A. L., Carvalho, M. R. D., Freire, R. C. D. R., Versiani, M., Rangé, B. P., & Nardi, A. E. (2011) · Revista Brasileira de Psiquiatria · doi:10.1590/s1516-44462011000200009 · Cited by 52
Koukopoulos, A., Reginaldi, D., Serra, G., KOUKOPOULOS, A., Sani, G., & Serra, G. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00803.x · Cited by 39
Cognitive-Behavioral Therapy for Depression in Bipolar Disorder: A Meta-Analysis
Gregory, V. L. (2010) · Journal of Evidence-Based Social Work · doi:10.1080/15433710903176088 · Cited by 36
Dickens, C., Coventry, P., Khara, A., Bower, P., Mansell, W., & Bakerly, N. D. (2012) · Chronic Illness · doi:10.1177/1742395311433058 · Cited by 9 · cited 1×
“Previous studies have shown that long-term depression is associated with perseverative negative cognitive processes.(26) Meanwhile, repetitive negative thinking can affect the efficacy of brief CBT for depression.”
BackgroundLam, D. H., Watkins, E. R., Hayward, P., Bright, J., Wright, K., Kerr, N., Parr-Davis, G., & Sham, P. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.2.145 · Cited by 4
Mączka, G., Grabski, B., Dudek, D., & Gierowski, J. K. (2014) · Psychiatria Polska · doi:10.12740/pp/24992 · Cited by 3
Flagged first, then by citations
Cited by
Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852
“From meta-analyses, effects on either depressive symptoms or on relapse remain uncertain due to important methodological problems and study selection factors (87-89).”
BackgroundVieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., Gao, K., Miskowiak, K. W., & Grande, I. (2018) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2018.8 · Cited by 891
Chiang, K., Tsai, J.-C., Liu, D., Lin, C., Chiu, H., & Chou, K. (2017) · PLoS ONE · doi:10.1371/journal.pone.0176849 · Cited by 238
Madireddy, S., & Madireddy, S. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23031844 · Cited by 76
Fordham, B., Sugavanam, T., Edwards, K., Hemming, K., Howick, J., Copsey, B. J., Lee, H., Kaidesoja, M., Kirtley, S., Hopewell, S., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25090 · Cited by 61
Yilmaz, S., Huguet, A., Kisely, S. R., Rao, S., Wang, J., Baur, K., Price, M., O’Mahen, H., & Wright, K. A. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.112 · Cited by 21
Chattopadhyay, S., Ball, S., Kargupta, A., Talukdar, P. S., Roy, K., Talukdar, A., & Guha, P. (2017) · HIV & AIDS Review · doi:10.5114/hivar.2017.67303 · Cited by 13
Hautzinger, M. (2022) · Springer eBooks · doi:10.1007/978-3-662-65734-8_21 · Cited by 12
Adjuvant Psychotherapies to Prevent Relapse in Bipolar Disorder: A Randomized Clinical Trial
Hautzinger, M., & A2 BipoLife Consortium (2024) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2024.1310 · Cited by 10
The Management of Prodromal Symptoms of Bipolar Disorder: Available Options and Future Perspectives
Favero, E. D., Montemagni, C., Bozzatello, P., Brasso, C., Riccardi, C., & Rocca, P. (2021) · Medicina · doi:10.3390/medicina57060545 · Cited by 11
Girelli, F., Rossetti, M. G., Perlini, C., & Bellani, M. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.02.054 · Cited by 9
Hassas, O., Mashhadi, A., Shamloo, Z. S., & Bordbar, M. R. F. (2023) · International Journal of Cognitive Therapy · doi:10.1007/s41811-023-00196-8 · Cited by 7
Probing the impact of psychoanalytic therapy for bipolar disorders: A scoping review
Stefana, A., D’Imperio, D., Dakanalis, A., Vieta, E., Fusar‐Poli, P., & Youngstrom, E. A. (2022) · International Forum of Psychoanalysis · doi:10.1080/0803706x.2022.2097307 · Cited by 7
Positive irrational beliefs are associated with hypomanic personality
Tiba, A., Trip, S., Bora, C. H., Drugas, M. I., Borz, F., Miclăuș, D., Manea, L., Iova, C. S., & Pop, S. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1053486 · Cited by 7
Exploring aspects of self-reported emotional mental imagery in patients with bipolar disorder
van den Berg, K. C., Voncken, M. J., Hendrickson, A. T., Simplicio, M. C. D., Regeer, E. J., Rops, L., & Keijsers, G. P. J. (2023) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2023.101861 · Cited by 7
Kognitive Verhaltenstherapie bei affektiven Störungen
Zwick, J. C., & Hautzinger, M. (2020) · PSYCH up2date · doi:10.1055/a-0973-2550 · Cited by 6
Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review
Valdivieso-Jiménez, G. (2023) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2021.05.009 · Cited by 5
Stamm, T. J., Fiebig, J., Malley, G. O., Sondergeld, L. M., Treu, P., Bermpohl, F., Friedel, E., Hindi-Attar, G., Quinlivian, E., Schreiter, S., et al. (2024) · Der Nervenarzt · doi:10.1007/s00115-024-01720-7 · Cited by 3
Kazempour, V., Ebrahimi, H., Jafarabadi, M. A., Nourazar, S. G., & Zamani, H. (2018) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.61555 · Cited by 3
Eficacia de la Terapia Cognitiva Conductual Para el Trastorno Bipolar: una Revisión Sistemática
Valdivieso-Jiménez, G. (2021) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2021.05.006 · Cited by 3
Tercer Consenso Argentino sobre el manejo de los Trastornos Bipolares. Segunda Parte B
Cetkovich, M., Abadi, A. F., Camino, S., Bonetto, G. G., Herbst, L., Marengo, E., Torrente, F. M., Maresca, T., Bustin, J., Morra, C. A., et al. (2023) · Vertex Revista Argentina de Psiquiatría · doi:10.53680/vertex.v34i160.459 · Cited by 4
Erfurth, A., & Sachs, G. (2018) · psychopraxis neuropraxis · doi:10.1007/s00739-018-0470-6 · Cited by 2
Yilmaz, S., Huguet, A., Kisely, S. R., Rao, S., Wang, J., Price, M., Morriss, R. K., Inder, M., Perich, T., & Wright, K. A. (2025) · Psychological Medicine · doi:10.1017/s0033291725001023 · Cited by 1
Parker, S., Pearson, L., Carney, R., Bentall, R. P., Broome, M. R., Černis, E., Clarke, T., Jones, S. H., Moran, K. A., Wilson, J., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06973-3 · Cited by 1
Pharmacotherapy and psychotherapy for bipolar disorder in the context of early childhood trauma
Jaworska-Andryszewska, P., & RYBAKOWSKI, J. K. (2019) · Pharmacotherapy in Psychiatry and Neurology · doi:10.33450/fpn.2019.04.001 · Cited by 2
Vaghee, S., Eshaghzadeh, M., Vashani, H. B., Asgharipour, N., & Namaghi, S. M. E. (2021) · Polish Annals of Medicine · doi:10.29089/2020.20.00164
Alloy, L. B., Chat, I. K.-Y., Grehl, M. M., Kautz, M. M., Dunning, E. E., Adogli, Z. V., Smith, L. T., Walsh, R. F. L., & Stephenson, A. R. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00225-9
Härtling, S., & Hoyer, J. (2020) · Springer eBooks · doi:10.1007/978-3-662-61814-1_36
A journey to compassion:A service user perspective
Mohammed, K., Jessica, T., & Rachel, C. (2021) · Clinical Psychology Forum · doi:10.53841/bpscpf.2021.1.337.63
Cetkovich, M., Abadi, A. F., Camino, S., Bonetto, G. G., Herbst, L., Marengo, E., Torrente, F. M., Maresca, T., Bustin, J., Morra, C. A., et al. (2023) · Vertex Revista Argentina de Psiquiatría · doi:10.53680/vertex.v34i159.363
Stangier, U., & Arens, E. A. (2015) · Wiley eBooks · doi:10.1002/9781394259229.ch10
Psychological Therapies and Bipolar Disorder: A Review of the Evidence
Arnold, R. A., & Burlingame, G. M. (2024) · Springer eBooks · doi:10.1007/978-3-031-63349-2_4
AI-Driven Cognitive Behavioural Therapy (CBT) Using Wearables
Jain, N., & Chatterjee, E. (2025) · Advances in computational intelligence and robotics book series · doi:10.4018/979-8-3373-0467-0.ch002
Akhoondi, M., Maddineshat, M., Ayubi, E., & Sadeghian, E. (2026) · Addiction and Health · doi:10.34172/ahj.1646
The role of intolerance of uncertainty in bipolar disorder
Maratchi, L., Richardson, T. H., & Morriss, J. (2026) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.70115
Metadata
- Authors
- Ye, B., Jiang, Z., Li, X., Cao, B., Cao, L., Lin, Y., Xu, G., & Miao, G.
- Affiliations
- Department of Affective Disorders, Guangzhou Huiai Hospital (Guangzhou Psychiatric Hospital) The Affiliated Brain Hospital of Guangzhou Medical University Guangzhou China
- Guangzhou Psychiatric Hospital (CN)
- The University of Texas Health Science Center at Houston (US)
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2016-06-26
- Volume
- 70
- Issue
- 8
- Pages
- 351-361
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- OpenAlex
- W2404426701
- Cited by
- 35
- References
- 30
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 2
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medicine & Health Science and Technology Projects of Guangzhou (20121A011091)
- Guangzhou Huiai Hospital (2015-2016)
- 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
- cognitive behavioral therapy, bipolar disorder, relapse prevention, mania severity, depression, treatment efficacy, bipolar I disorder, bipolar II disorder, follow-up duration
- MeSH terms
- Bipolar Disorder, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
