Cognitive Behavioral Therapy for Rapid-Cycling Bipolar Disorder: A Pilot Study

Abstract

Bipolar disorder is characterized by depressive and/or manic episodes that interfere with daily functioning. Between 10%-24% of bipolar patients experience a rapid-cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood stabilizing medications, patients with rapid-cycling bipolar disorder are particularly in need of effective, adjunctive treatments. Adjunctive cognitive-behavioral therapy (CBT) has been shown to improve adherence to medication and reduce relapse rates in patients with bipolar disorder. However, no published trials to date have examined the application of CBT to the treatment of patients with a rapid-cycling course of illness, with only a single case study published in the literature. We recently developed a CBT protocol that addresses the specific needs of bipolar patients with rapid cycling. The present study was designed to investigate outcomes with this CBT protocol. Study participants were 10 patients with rapid-cycling bipolar disorder, 6 of whom completed the study. Completers showed significant decreases in depressive mood, and improvements remained stable during the 2-month follow-up. This suggests that CBT for rapid cycling may have beneficial effects.

The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study

“…CBGT sessions were essential for the improvement of depressive symptoms, which supports the findings of Scott et al, 27 Ball et al, 28 and Reilly-Harrington et al, 29 who investigated the efficacy of individual CBT.…”

Dysfunctional Attitudes, Attributional Styles, and Phase of Illness in Bipolar Disorder

“…Growing data supports the use of adjunctive CBT for bipolar disorder in improving medication compliance, symptoms, functioning, and relapse rates (Cochran 1984;Fava et al 2001;Lam et al 2000Lam et al , 2003Patelis-Siotis et al 2001;Reilly-Harrington et al 2007;Scott et al 2001;Palmer et al 1995;Zaretsky et al 1999), although there is also a multicenter nonreplication (Scott et al 2006). Data from STEP-BD has also supported the use of adjunctive, intensive psychosocial interventions for bipolar disorder.…”

“…Patients in a mixed state may shift from euphoric elation to irritable dysphoria over the course of a treatment session, requiring a great deal of flexibility on the part of the clinician. Such flexibility in addressing rapidly changing mood states is also an important component in the cognitive-behavioral treatment of rapid cycling bipolar disorder (ReillyHarrington and Knauz 2005;Reilly-Harrington et al 2007).…”

Cognitive–behavioral therapy for bipolar disorder

“…Reilly-Harrington et al investigated 20 CBT sessions as adjunctive treatment to standard mood-stabilizing medications to improve adherence to medication and reduce relapse rates in patients with rapid-cycling BD [33]. The authors tested a CBT protocol that addresses the specific needs of BD patients with rapid cycling.…”