Improved Functioning in Bipolar Depression

Intensive psychosocial intervention was found to improve overall functioning in patients with bipolar depression, concluded researchers of the Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) trial. Results were reported in the September 2007 issue of the American Journal of Psychiatry.

The study included 152 patients who met DSM-IV criteria for bipolar disorder. All participants met baseline Longitudinal Interval Follow-Up Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT) scores and were followed up at 3, 6, and 9 months. Patients were randomly assigned to intensive psychosocial intervention (n = 84), including 30 sessions of interpersonal and social rhythm therapy, cognitive behavioral therapy, or family-focused therapy; or collaborative care (n = 68), including a 3-session psychoeducational treatment, a self-care workbook and an educational videotape.

It was found that patients in intensive psychosocial treatment had better LIFE-RIFT scores than patients in collaborative care (P = .04) over the 9-month period of the study, independent of bipolar 1 disorder versus bipolar 2 disorder status, randomized acute depression versus psychosocial acute depression, and study site. Patients in intensive treatment were also found to have better relationship functioning over 9 months (P = .02) than patients in collaborative care, irrespective of bipolar 1 disorder versus bipolar 2 disorder status, randomized acute depression versus psychosocial acute depression, and study site.

The investigators suggested that because these psychosocial interventions were found to improve functioning, other therapies, such as cognitive remediation, social skills, or vocational rehabilitation, that have been found effective in patients with schizophrenia may be useful in the treatment of patients with bipolar disorder as well.***

--Cortney Mears