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October 14, 2020

Beyond Efficacy and Toward Dissemination and Personalization of Psychotherapy for Bipolar Disorder

Author Affiliations
  • 1Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
JAMA Psychiatry. Published online October 14, 2020. doi:10.1001/jamapsychiatry.2020.2980

In a well-executed network meta-analysis (NMA) in this issue of JAMA Psychiatry, Miklowitz and colleagues1 offer further evidence that adjunctive, manualized psychotherapy is effective for individuals with bipolar disorder (BD). The authors identified 39 randomized clinical trials among individuals with BD (36 of adults and 3 of adolescents) in which a manualized psychosocial intervention plus pharmacotherapy was compared with a control intervention plus pharmacotherapy. Using NMA, the authors examined illness recurrence as the primary long-term outcome. They conclude that manualized treatments were associated with reduced episode recurrence vs treatment as usual and family or group delivery of psychoeducation and skills appeared superior to individual delivery of these interventions. With regard to secondary outcomes (affective symptoms over 1 year), data supported cognitive behavioral therapy (CBT), family therapies, and interpersonal therapies over treatment as usual for stabilizing depressive symptoms.

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