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Cognitive Behavioral Therapy for Rapid-Cycling Bipolar Disorder: A Pilot Study

REILLY-HARRINGTON, NOREEN A., PhD; DECKERSBACH, THILO, PhD; KNAUZ, ROBERT, PhD; WU, YELENA; TRAN, TANYA; EIDELMAN, POLINA; LUND, HANNAH G.; SACHS, GARY, MD; NIERENBERG, ANDREW A., MD

Journal of Psychiatric Practice®: September 2007 - Volume 13 - Issue 5 - p 291-297
doi: 10.1097/01.pra.0000290667.02484.3d
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Bipolar disorder is characterized by depressive and/or manic episodes that interfere with daily functioning. Between 10%-24% of bipolar patients experience a rapid-cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood stabilizing medications, patients with rapid-cycling bipolar disorder are particularly in need of effective, adjunctive treatments. Adjunctive cognitive-behavioral therapy (CBT) has been shown to improve adherence to medication and reduce relapse rates in patients with bipolar disorder. However, no published trials to date have examined the application of CBT to the treatment of patients with a rapid-cycling course of illness, with only a single case study published in the literature. We recently developed a CBT protocol that addresses the specific needs of bipolar patients with rapid cycling. The present study was designed to investigate outcomes with this CBT protocol. Study participants were 10 patients with rapid-cycling bipolar disorder, 6 of whom completed the study. Completers showed significant decreases in depressive mood, and improvements remained stable during the 2-month follow-up. This suggests that CBT for rapid cycling may have beneficial effects.

REILLY-HARRINGTON, DECKERSBACH, KNAUZ, WU, TRAN, EIDELMAN, LUND, SACHS, and NIERENBERG: Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School.

Please send correspondence and reprint requests to: Noreen A. Reilly-Harrington, PhD, Bipolar Disorder Clinic and Research Program, Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580 Boston, MA 02114. nhreilly@partners.org

This research was supported by the Clinical Research Training Program (CRTP) fellowship grant, a young investigator award by the National Alliance for Research in Schizophrenia and Depression to Thilo Deckersbach, and a grant by the Stanley Foundation to the Bipolar Clinic and Research Program at the Massachusetts General Hospital.

Copyright © 2007 Wolters Kluwer Health, Inc. All rights reserved.