Efficacy of brief cognitive behavior therapy in improving symptoms, functioning, and adherence to treatment in patients with bipolar disorder in remission: A randomized control study

Abstract

Background: Residual symptoms in individuals with bipolar disorder (BD) in remission are common, and they contribute to significant functional impairment and distress. The incomplete efficacy of pharmacological treatments and improvements in psychotherapeutic approaches has led to renewed interest in psychotherapy for this disorder. However, there are fewer studies addressing the same. Aim: The study aims to examine brief CBT (cognitive behavior therapy) in addressing the residual symptoms in BD. Method: A two-group randomized control design with multiple assessments (pre, post, and 3-month follow-up) was adopted. The sample consisted of 30 patients each in the intervention and Treatment As Usual (TAU) groups selected from the outpatient services of a tertiary mental health hospital. The variables studied were interepisodic symtpoms, functioning, and adherence to treatment using the tools of Beck Depression Inventory-II, Young Mania Rating Scale, and Beck Anxiety Inventory. The intervention group received a brief integrated CBT of 8–10 sessions conducted weekly over 2–3 months. The TAU group received treatment as usual and brief weekly telephonic contact. Results: A significant difference was seen across the time points between the groups on all the variables. Significant changes in within group scores was noted in the intervention group on depressive and anxiety symptoms, medication adherence, and dysfunctional attitudes compared to the TAU group. However, there was no significant change in the functioning in both the groups. Larger within group effect sizes for anxiety, dysfunctional attitudes and emotion regulation, medium effect sizes for depression, and quality of life and small effect sizes for manic symptoms and medication adherence were found in the intervention group. Depression severity had a significant moderating effect on therapy outcomes. Conclusion: The study shows effectiveness of brief CBT in reducing residual symptoms in the patients with BD. A longer-term follow-up would validate the findings.

Keywords

• bipolar disorder
• brief cognitive behavior therapy
• dysfunctional cognitions
• emotion regulation remission
• mindfulness
• residual symptoms