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Psychosocial Strategies to Improve Concordance and Adherence in Bipolar Disorder

Noreen Reilly-Harrington, Ph.D., and Gary S. Sachs, M.D.


Half of patients with bipolar disorder may exhibit poor medication compliance, and relapse often occurs even when patients take their medication as prescribed. Psychosocial strategies can help patients to recognize the need for treatment and, therefore, improve medication adherence. Another benefit of psychosocial strategies is that they aid patients in controlling their moods. Cognitive-behavioral therapy teaches patients to modify dysfunctional thinking and behavior. Treatment contracting allows patients to develop a plan for identifying and coping with symptoms before they become severe. Daily mood charting assists patients in quickly identifying and intervening when changes occur. Creating and following a weekly activity schedule ensures that patients will participate in enough positive activities and avoid destructive activities. Using a variety of psychosocial strategies, patients can train themselves and a support team to effectively deal with bipolar disorder.

(J Clin Psychiatry 2006;67[7]:e04)


From the Bipolar Clinic and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston.