Adjunctive psychotherapy for bipolar disorder: Effects of changing treatment modality

In a randomized, controlled trial, the authors studied an adjunctive, indiv idual psychotherapy, interpersonal and social rhythm therapy (IPSRT) for bi polar disorder. After stabilizing participants with episode appropriate pha rmacotherapy and either IPSRT or intensive clinical management (CM), partic ipants were reassigned to IPSRT or CM in conjunction with pharmacotherapy f or 2 years of preventative treatment. Early results (n = 82) suggest that a ltering participants' treatment assignment at entry to the preventative pha se is related to risk of recurrence. Participants remaining in the same tre atment for both acute and preventative phases had lower rates of recurrence (<20% vs. >40%) and levels of symptomatology over the subsequent 52 weeks than those reassigned to the alternate modality. This finding, consistent w ith the authors' philosophy that bipolar patients benefit from stable routi nes, suggests that disruptions in the psychosocial treatment plan contribut e to worse outcomes.