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 Research & Giving News Article  Treating Bipolar Depression Adding specific, targeted psychotherapy to medication may help give patients a better shot at lasting recovery Bipolar disorder is a debilitating illness marked by severe mood swings between depression and mania that affects an estimated 8 million Americans (about 2.6 percent of the population). “We know that medication is an important component in the treatment of bipolar illness,” said NIH Director Dr. Elias A. Zerhouni, who added that Dr. Miklowitz’s paper “suggests that adding specific, targeted psychotherapy to medication may help give patients a better shot at lasting recovery.” Thomas R. Insel, M.D., the Director of the National Institute of Mental Health and a former member of NARSAD’s Scientific Council, said Dr. Miklowitz’s study “is helping us identify the best tools—both medications and psychosocial treatments—that patients and their clinicians can use to battle the symptoms of bipolar illness." Psychotherapy is routinely employed as a means to treat bipolar illness in conjunction with medication, but the extent to which psychotherapy is effective has been unclear. Most psychotherapeutic studies to date have been limited to a single site and have compared only one type of treatment to routine care. In view of this, in addition to examining the role of medication, Dr. Miklowitz’s study set out to compare several types of psychotherapy to pinpoint the most effective treatment combinations. Dr. Miklowitz, a Professor in the Department of Psychology at the University of Colorado and a 2001 NARSAD Distinguished Investigator, provided three types of standardized, intensive psychotherapy to one group of patients over a nine-month period and compared the results with those for subjects in a control group given a three-session psychoeducational program called collaborative care. The three intensive therapies employed in the study included:
The researchers compared patients' time to recovery and their stability over one year. Over the course of the year, 64 percent of those in the intensive psychotherapy groups had become well, compared with 52 percent of those in collaborative care therapy. Importantly, patients in intensive psychotherapy became well an average of 110 days faster than those in collaborative care. In addition, patients who received intensive psychotherapy were one and a half times more likely to be clinically well during any month out of the study year than those who received collaborative care. Discontinuation rates among the groups were similar—36 percent of those in the intensive programs and 31 percent of those in collaborative care discontinued their care. None of the three intensive psychotherapies appeared to be significantly more effective than the others, although rates of recovery were higher among those in family-focused therapy compared to the other groups. "Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person's chances for recovering from depression and staying healthy over the long term,” said Dr. Miklowitz. “It should be considered a vital part of the effort to treat bipolar illness.” This article has been adapted by NARSAD with permission from the National Institute of Mental Health. For more information about bipolar disorder, visit www.narsad.org and the website of the NIMH, www.nimh.nih.gov. |
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