Therapy plus medication better than medication alone in bipolar disorder


Date:
October 14, 2020
Source:
University of California - Los Angeles Health Sciences
Summary:
A review of 39 randomized clinical trials has found that combining
the use medication with psychoeducational therapy is more effective
at preventing a recurrence of illness in people with bipolar
disorder than medication alone.



FULL STORY ==========================================================================
A review of 39 randomized clinical trials by scientists from UCLA
and their colleagues from other institutions has found that combining
the use medication with psychoeducational therapy is more effective at preventing a recurrence of illness in people with bipolar disorder than medication alone.


==========================================================================
For the paper, published in JAMA Psychiatry researchers analyzed studies
that included adult and adolescent patients currently receiving medication
for bipolar disorder who were randomly assigned to either an active
family, individual or group therapy, or "usual care," meaning medication
with routine monitoring and support from a psychiatrist.

David Miklowitz, PhD, the study's lead author, and a distinguished
professor of psychiatry at the Jane and Terry Semel Institute for
Neuroscience and Human Behavior at UCLA, said the studies reviewed
followed patients for at least a year, measured rates of recurrence
of bipolar disorder, depression and mania symptoms, and included study attrition or dropout rates.

The findings were:
* Psychoeducation with guided practice of illness management skills
(for
example, how to keep regular sleep and wake cycles) in a family or
group format was more effective in reducing recurrences of mania
and depressive symptoms than the same strategies in an individual
therapy format.

* Cognitive behavioral therapy, family therapy and interpersonal
therapy
were better at stabilizing depressive symptoms than other forms
of treatment.

* Rates of dropout were lower in patients who received family-oriented
therapies.

* Of the findings, Miklowitz said they point to the importance of
having a
support system.

"Not everyone may agree with me, but I think the family environment is
very important in terms of whether somebody stays well," he said. "There's nothing like having a person who knows how to recognize when you're
getting ill and can say, 'you're starting to look depressed or you're
starting to get ramped up.' That person can remind their loved one to
take their medications or stay on a regular sleep-wake cycle or contact
the psychiatrist for a medication evaluation." Miklowitz said the same
is true for a patient who may not have close relatives but does have
support through group therapy.

"If you're in group therapy, other members of that group may be able to
help you recognize that you're experiencing symptoms," he said. "People
tend to pair off. It's a little bit like the AA model of having a
sponsor."

========================================================================== Story Source: Materials provided by University_of_California_-_Los_Angeles_Health_Sciences.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. David J. Miklowitz, Orestis Efthimiou, Toshi A. Furukawa, Jan
Scott, Ross
McLaren, John R. Geddes, Andrea Cipriani. Adjunctive Psychotherapy
for Bipolar Disorder. JAMA Psychiatry, 2020; DOI: 10.1001/
jamapsychiatry.2020.2993 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201014140938.htm

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