Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis

Matthijs Oud; Evan Mayo-Wilson; Ruth Braidwood; Peter Schulte; Steven H Jones; Richard Morriss; Ralph Kupka; Pim Cuijpers; Tim Kendall

doi:10.1192/bjp.bp.114.157123

Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis

Br J Psychiatry. 2016 Mar;208(3):213-22. doi: 10.1192/bjp.bp.114.157123.

Authors

Matthijs Oud¹, Evan Mayo-Wilson², Ruth Braidwood², Peter Schulte², Steven H Jones², Richard Morriss², Ralph Kupka², Pim Cuijpers², Tim Kendall²

Affiliations

¹ Matthijs Oud, MSc, Department of Care Innovation, Trimbos Institute, Utrecht, The Netherlands; Evan Mayo-Wilson, MPA, DPhil, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Ruth Braidwood, MSc, Department of Clinical, Educational and Health Psychology, University College London, UK; Peter Schulte, MD, PhD, Treatment Centre for Bipolar Disorders, Mental Health Service Noord-Holland-Noord, Alkmaar, The Netherlands; Steven H. Jones, PhD, Department of Clinical Psychology, Spectrum Centre for Mental Health Research, Lancaster University, UK; Richard Morriss, MD, FRCPsych, Department of Psychiatry and Community Mental Health, Institute of Mental Health, University of Nottingham, UK; Ralph Kupka, MD, PhD, Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands; Pim Cuijpers, PhD, Faculty of Psychology and Education, VU University Amsterdam, The Netherlands; Tim Kendall, FRCPsych, National Collaborating Centre for Mental Health, London, UK moud@trimbos.nl.
² Matthijs Oud, MSc, Department of Care Innovation, Trimbos Institute, Utrecht, The Netherlands; Evan Mayo-Wilson, MPA, DPhil, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Ruth Braidwood, MSc, Department of Clinical, Educational and Health Psychology, University College London, UK; Peter Schulte, MD, PhD, Treatment Centre for Bipolar Disorders, Mental Health Service Noord-Holland-Noord, Alkmaar, The Netherlands; Steven H. Jones, PhD, Department of Clinical Psychology, Spectrum Centre for Mental Health Research, Lancaster University, UK; Richard Morriss, MD, FRCPsych, Department of Psychiatry and Community Mental Health, Institute of Mental Health, University of Nottingham, UK; Ralph Kupka, MD, PhD, Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands; Pim Cuijpers, PhD, Faculty of Psychology and Education, VU University Amsterdam, The Netherlands; Tim Kendall, FRCPsych, National Collaborating Centre for Mental Health, London, UK.

PMID: 26932483
DOI: 10.1192/bjp.bp.114.157123

Abstract

Background: Psychological interventions may be beneficial in bipolar disorder.

Aims: To evaluate the efficacy of psychological interventions for adults with bipolar disorder.

Method: A systematic review of randomised controlled trials was conducted. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE method.

Results: We included 55 trials with 6010 participants. Moderate-quality evidence associated individual psychological interventions with reduced relapses at post-treatment (risk ratio (RR) = 0.66, 95% CI 0.48-0.92) and follow-up (RR = 0.74, 95% CI 0.63-0.87), and collaborative care with a reduction in hospital admissions (RR = 0.68, 95% CI 0.49-0.94). Low-quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psychoeducation with reduced symptoms of depression and mania.

Conclusions: There is evidence that psychological interventions are effective for people with bipolar disorder. Much of the evidence was of low or very low quality thereby limiting our conclusions. Further research should identify the most effective (and cost-effective) interventions for each phase of this disorder.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Bipolar Disorder / therapy*
Cognitive Behavioral Therapy / methods*
Counseling
Depression / therapy*
Family / psychology
Family Therapy / methods*
Humans
Mental Health / standards*
Randomized Controlled Trials as Topic
Recurrence
Treatment Outcome