Integrated Family and Individual Therapy for Bipolar Disorder: Results of a Treatment Development Study
J Clin Psychiatry 2003;64(2):182-191
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Several studies have
established the efficacy of psychosocial interventions as
adjuncts to pharmacotherapy in the symptom maintenance of bipolar
disorder. This study concerned a new psychosocial
approach-integrated family and individual therapy (IFIT)-that
synthesizes family psychoeducational sessions with individual
sessions of interpersonal and social rhythm therapy.
Method: Shortly after an acute illness episode,
30 bipolar patients (DSM-IV criteria) were assigned to open
treatment with IFIT (up to 50 weekly sessions of family and
individual therapy) and mood-stabilizing medications in the
context of a treatment development study. Their outcomes over 1
year were compared with the outcomes of 70 patients from a
previous trial who received standard community care, consisting
of 2 family educational sessions, mood-stabilizing medications,
and crisis management (CM). Patients in both samples were
evaluated as to symptomatic functioning at entry into the project
and then every 3 months for 1 year.
Results: Patients in IFIT had longer
survival intervals (time without relapsing) than patients in CM.
They also showed greater reductions in depressive symptoms over 1
year of treatment relative to their baseline levels. The results
could not be explained by group differences in baseline symptoms
or pharmacologic treatment regimens.
Conclusion: Combining family and individual
therapy with medication may protect episodic bipolar patients
from early relapse and ongoing depressive symptoms. Further
examination of this integrative model within randomized
controlled trials is warranted.