Cognitive–behavioural therapy for severe and recurrent bipolar disorders: Randomised controlled trial
Open accessAbstract
Background: Efficacy trials suggest that structured psychological therapies may significantly reduce recurrence rates of major mood episodes in individuals with bipolar disorders. Aims: To compare the effectiveness of treatment as usual with an additional 22 sessions of cognitive–behavioural therapy (CBT). Method: We undertook a multicentre, pragmatic, randomised controlled treatment trial (n=253). Patients were assessed every 8 weeks for 18 months. Results: More than half of the patients had a recurrence by 18 months, with no significant differences between groups (hazard ratio=1.05; 95% CI 0.74–1.50). Post hoc analysis demonstrated a significant interaction (P=0.04) such that adjunctive CBT was significantly more effective than treatment as usual in those with fewer than 12 previous episodes, but less effective in those with more episodes. Conclusions: People with bipolar disorder and comparatively fewer previous mood episodes may benefit from CBT. However, such cases form the minority of those receiving mental healthcare.
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Efficacy of CBT in relapse prevention was observed in one RCT but not in another larger RCT, at least in patients who had multiple mood episodes.
“Efficacy of CBT in relapse prevention was observed in one RCT,85 but not in another larger RCT, at least in patients who had multiple mood episodes.86”
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- Authors
- Scott, J., Paykel, E., Morriss, R., Bentall, R., Kinderman, P., Johnson, T., Abbott, R., & Hayhurst, H.
- Affiliations
- King's College London (GB)
- University of Cambridge (GB)
- Royal Liverpool University Hospital (GB)
- University of Manchester (GB)
- University of Liverpool (GB)
- Corresponding author
- Scott, Jan
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2006-04
- Volume
- 188
- Issue
- 4
- Pages
- 313-320
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2269399764
- Cited by
- 566
- References
- 24
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 13 · 2023: 14 · 2022: 13 · 2021: 8 · 2020: 21 · 2019: 32 · 2018: 20 · 2017: 27 · 2016: 40 · 2015: 39 · 2014: 35 · 2013: 34 · 2012: 45
- FWCI
- 27.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- 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, mood episode recurrence, adjunctive psychotherapy, usual care, treatment effectiveness
- MeSH terms
- Adult, Bipolar Disorder, Female, Humans, Male, Recurrence, Cognitive Behavioral Therapy, Treatment Outcome
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