Bipolar Disorder benefits from Cognitive Behavioral Therapy as part of treatment protocol

A recent review in Annals of General Psychiatry focuses on the current status of treatment protocols for Bipolar Disorder, which the authors describe as “a multi-faceted illness with an inevitably complex treatment.” Psychoactive drugs are, and have been for many years, primary to treatment protocols. After a review of the current data, the authors conclude that in addition to drug therapies, the best approaches to treatment and relapse prevention include psychoeduation, family-focused psychoeducation, and cognitive-behavioral therapy. This multi-level approach also extends to patients’ family members; patients and their families learn to identify possible triggering factors, recognize the early signs of episodes, and initiate early interventions.

Study authors: K. N. Fountoulakis, E. Vieta, M. Siamouli, M. Valenti, S. Magiria, T. Oral, D. Fresno, P. Giannakopoulos, G. S. Kaprinis

Late-life anxiety: CBT beneficial for Generalized Anxiety Disorder in geriatric patients

In a recent Psychology and Aging review of treatments for geriatric anxiety disorders, CBT for late-life generalized anxiety disorder (GAD) showed the most consistent positive results. Particularly strong support was found for an enhanced CBT protocol that included memory aids and between-session phone-calls to increase homework completion.

The authors emphasize the prevalence and consequences of GAD in older populations. Anxiety in geriatric patients often coexists with increased physical disability and impairment, overuse of medical services, decreased life satisfaction, and other negative effects. Although anxiolytic medications appear to be effective for geriatric anxiety, many older adults avoid them because of side effects and because of concerns about adding to their existing medications. The authors suggested that “effective psychosocial treatments as an alternative to or in combination with pharmacotherapy for late-life anxiety remains an important priority.”

Study authors: C. R. Ayers, J. T. Sorrell, S. R. Thorp, J. L. Wetherell

CBT and rapid-cycling Bipolar Disorder

People diagnosed with rapid-cycling bipolar disorder experience four or more separate episodes of depression and hypomania within the span of one year. Therapists have recently implemented cognitive behavioral therapy (CBT) to focus on treating depressive symptoms and reducing suicidal risk when caring for patients diagnosed with rapid-cycling bipolar disorder.

In a study reported in the Journal of Psychiatric Practice, researchers trained rapid-cycling bipolar disorder patients to utilize CBT skills to identify and respond to negative core beliefs, such as “Nobody cares about me” or “I am incompetent.” Addressing these beliefs is essential when administering CBT because they are likely to intensify the depressive episodes. Through implementing CBT, patients were also able to develop anxiety-management strategies and reduce symptoms of depression.

Study authors: N. A. Reilly-Harrington, T. Deckersbach, R. Knauz, Y. Wu, T. Tran, P. Eidelman, H. G. Lund, G. Sachs, A. A. Nierenberg

Short-term CBT in a partial-hospital setting

 

Patients in partial-hospital settings live at home but come to the hospital three to five days a week to receive structured treatment. A two-week pilot study reported in the Journal of Psychiatric Practice investigated subjects who attended a mood and anxiety program in a partial-hospital setting. Researchers administered cognitive behavioral therapy (CBT) and found a significant decrease in symptoms and negative thought patterns.

Treatment interventions were based on psychoeducation and skills training, and specifically targeted self-assessment and behavioral coping. Acquiring CBT skills prompted patients to develop a structured self awareness, which led to “reduced negative thought patterns and improved satisfaction with life.” The study authors indicated that future studies were planned to evaluate the effectiveness of the treatment during a follow-up period.

Study authors: E. C. Neuhaus, M. Christopher, K. Jacob, J. Guillaumot, J. P. Burns