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Cognitive–behavioural therapy for severe and recurrent bipolar disorders: Randomised controlled trial
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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,85 but not in another larger RCT, at least in patients who had multiple mood episodes.86”
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Metadata
- 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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