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.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Goldstein TR, Hafeman DM. Beyond Efficacy and Toward Dissemination and Personalization of Psychotherapy for Bipolar Disorder. JAMA Psychiatry. Published online October 14, 2020. doi:10.1001/jamapsychiatry.2020.2980
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: