The Efficacy of Cognitive-Behavioral Therapy in Bipolar Disorder: A Quantitative Meta-Analysis
J Clin Psychiatry 2010;71(1):66-72
© Copyright 2015 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Objective: The goal of the current study was
to conduct a quantitative meta-analysis investigating the role of cognitive-behavioral therapy (CBT) as adjunctive treatment to medication for patients diagnosed with bipolar disorder.
Data Sources: Studies included in the sample were identified through a computer search of articles in English in the MEDLINE database from January 1980 to March 2008. Key terms entered were cognitive and bipolar disorder, cognitive therapy and bipolar disorder, cognitive behavioral therapy and bipolar disorder, psychotherapy and bipolar disorder, and psychosocial and bipolar disorder.
Study Selection: Inclusion criteria were (1)
randomized clinical trial investigating the role
of adjunctive CBT in patients diagnosed with bipolar disorder, (2) clearly defined CBT intervention, (3) the inclusion of a control group, and (4) sufficient data reported to allow calculation of effect sizes. Twelve randomized clinical trials were selected for analysis on the basis of these criteria.
Data Extraction: Effect sizes (Cohen d) were calculated according to published procedures.
Data Synthesis: We found a low to medium overall effect size of CBT at posttreatment (d = –0.42, P < .05) and follow-up (d = –0.27, P < .05), and we found a positive impact of CBT on clinical symptoms (posttreatment d = –0.44, P < .05), cognitive-behavioral etiopathogenetic mechanisms (posttreatment d = –0.49, P < .05), treatment adherence (posttreatment d = –0.53, P < .05), and quality of life (posttreatment d = –0.36, P < .05). The impact was less evident in the case of relapse and/or recurrence (posttreatment d = –0.28). These effects on outcome categories were more evident at posttreatment compared
Conclusions: Cognitive-behavioral therapy can be used as an adjunctive treatment to medication for patients with bipolar disorder, but new CBT strategies are needed to increase and enrich the impact of CBT at posttreatment and to maintain
its benefits during follow-up.
Submitted: July 23, 2008; accepted November 5, 2008.
Online ahead of print: October 20, 2009
Corresponding author: Aurora Szentagotai, PhD, No. 37 Republicii St 400015, Cluj-Napoca, Romania (email@example.com).