Relapse Prevention in Patients With Bipolar Disorder: Cognitive Therapy Outcome After 2 Years
Abstract
Objective In a previous randomized controlled study, the authors reported significant beneficial effects of cognitive therapy for relapse prevention in bipolar disorder patients up to 1 year. This study reports additional 18-month follow-up data and presents an overview of the effect of therapy over 30 months. Method Patients with DSM-IV bipolar I disorder (N=103) suffering from frequent relapses were randomly assigned into a cognitive therapy plus medication group or a control condition of medication only. Independent raters, who were blind to patient group status, assessed patients at 6-month intervals. Results Over 30 months, the cognitive therapy group had significantly better outcome in terms of time to relapse. However, the effect of relapse prevention was mainly in the first year. The cognitive therapy group also spent 110 fewer days (95% CI=32 to 189) in bipolar episodes out of a total of 900 for the whole 30 months and 54 fewer days (95% CI=3 to 105) in bipolar episodes out of a total of 450 for the last 18 months. Multivariate analyses of variance showed that over the last 18 months, the cognitive therapy group exhibited significantly better mood ratings, social functioning, coping with bipolar prodromes, and dysfunctional goal attainment cognition. Conclusions Patients in the cognitive therapy group had significantly fewer days in bipolar episodes after the effect of medication compliance was controlled. However, the results showed that cognitive therapy had no sig…
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CBT limitations have been identified, particularly high dropout rates, relapse prevention, and difficulties in maintaining the focus of treatment on positive symptoms after remission.
“Nevertheless, despite the considerable body of evidence concerning CBT efficacy for the psychosis continuum (e.g., Wykes et al., 2008;Thase, Kingdon, & Turnington, 2014), CBT limitations have been identified, particularly regarding high dropout rates (Startup, Jackson, Evans, & Bendix, 2005), relapse prevention (Garety et al., 2008;Lam, Hayward, Watkins, Wright, & Sham, 2005), and difficulties in”
From Contextual Cognitive-Behavioral Therapies Across the Psychosis Continuum: A Review of Evidence for Schizophrenia, Schizoaffective and Bipolar Disorders (2017) · cites this paper as Lam, Hayward, Watkins, Wright, & Sham, 2005
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- Authors
- Lam, D. H., Hayward, P., Watkins, E. R., Wright, K., & Sham, P.
- Venue
- American Journal of Psychiatry
- Published
- 2005-02-01
- Volume
- 162
- Issue
- 2
- Pages
- 324-329
- ISSN
- 0002-953X
- 1535-7228
- Cited by
- 265
- References
- 1
- Language
- en
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