This paper explores the development of psychological treatments as an adjunct to
medication in bipolar disorders. Randomized controlled treatment trials of specific
therapy models, such as cognitive therapy, that tackle a spectrum of complex
psychological and social problems associated with bipolar disorders are reviewed. A
systematic review of the most recent treatment outcome studies suggest that
adjunctive psychological therapies reduce overall rates of relapse, but are more
effective for depression than for mania. There is no evidence that any particular
therapy has a unique mechanism of action or any specific advantages over any other
approach. Finally, it is suggested that gaps in the theory and available evidence
for effectiveness need to be addressed if we are to enable clinicians to target
psychological therapies towards those individuals with bipolar disorder who are most
likely to benefit.
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