Cognitive-Behavioral Management of Patients With Bipolar Disorder Who Relapsed While on Lithium Prophylaxis
J Clin Psychiatry 2001;62(7):556-559
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The application of
cognitive-behavioral treatment (CBT) to patients with bipolar
disorder who had an affective episode while on lithium
prophylaxis has received little research attention. The aim of
this preliminary study was to test whether reduction of residual
symptomatology by cognitive-behavioral methods could yield
long-term beneficial effects in patients with bipolar disorder,
as was found to be the case in recurrent unipolar depression.
Method: Fifteen patients with RDC bipolar
disorder, type I, who relapsed while on lithium prophylaxis
despite initial response and adequate compliance were treated by
cognitive-behavioral methods in an open trial. A 2- to 9-year
follow-up was performed.
Results: Five of the 15 patients had a new
affective episode during follow-up. CBT was associated with a
significant reduction of residual symptomatology.
Conclusion: These preliminary results suggest
that a trial of CBT may enhance lithium prophylaxis and improve
long-term outcome of bipolar disorder.