Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial

Abstract

Background: Bipolar disorder (BD) is one of the most burdensome mental disorder, with a lifetime prevalence of 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II. Several interventions have been developed to implement the treatment strategy of bipolar disorder, including the Interpersonal and Social Rhythm Therapy (IPSRT). This intervention has been specifically developed to manage patients' stressful life events, improve the disruptions of social and circadian rhythms and increase adherence to medications. The aim of the present study is to assess the efficacy of IPSRT on affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI) in BD patients.Methods: BD patients were consecutively recruited at the Mood Disorder Unit of the University of Campania "Luigi Vanvitelli" and randomly assigned to the experimental group receiving the IPSRT or to the Treatment as Usual (TAU) group. Patients were assessed at baseline, after 3 and 6 months with several validated assessment tools and with the affective morbidity index. Results:At the end of the intervention, compared to controls, patients from the experimental group reported a significant improvement in anxious depressive and manic symptomatology, global functioning; and response to mood stabilizers. Patients in the IPSRT group reported a reduction at the AMI score.Conclusions: IPSRT has been confirmed to be effective in improving the clinical symptomology of BD patients and in improving the affective morbidity index. Further studies with longer follow-up are needed in order to assess the stability of the results.Trial registration The study was approved by the local ethical review board (N001567/28.01.2018)

DAILY—A Personalized Circadian Zeitgeber Therapy as an Adjunctive Treatment for Alcohol Use Disorder Patients: Study Protocol for a Randomized Controlled Trial

“…IPSRT focuses primarily on stabilizing social rhythms such as eating regularly with other people and thus improving social interactions and relationships ( 75 ). Its efficacy has been proven multiple times ( 61 , 76 ). Interestingly, there is a renewing increase in awareness and clinical interest for therapy approaches taking the effects of regular daily structures and sleep hygiene into account ( 19 , 63 , 77 ).…”

Schema Therapy for Patients with Bipolar Disorder: Theoretical Framework and Application

“…One of the most common psychosocial stressors that precede bipolar episodes are interpersonal conflicts. 27 Role-playing situations focusing on coping with criticism, underestimation, rejection, and acquiring assertive skills can help the patients increase their resilience to the psychosocial struggles and reduce the stress load that may trigger a future episode. 28 It is necessary to describe the challenging communication situations in detail, write down the communication sequences, and gradually practice alternative interactions.…”

Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials

“…Six studies reported on the administration of BLT as a treatment (47)(48)(49)(50)(51)(52), four on IPSRT (7,(53)(54)(55), two on blue-light blocking glasses (56)(57)(58), one on CBT-I (5), one on TSD (59), and four on combination treatments (60)(61)(62)(63). Most studies included both BD-I and II (n=9; 47%), followed by BD-I alone (n=6; 32%), and one study looked specifically at BD-II (5%).…”

“…Current treatment guidelines recommend pharmacological approaches as the first-line treatment (2,3). However, these approaches are only partially effective (4)(5)(6) and have varied acceptability rates (7,8).…”