PSYCHOSOCIAL INTERVENTIONS AS AN ADJUNCT TO PHARMACOTHERAPY IN BIPOLAR DISORDER

Objective: To summarize the evidence and make treatment recommendation s regarding the use of psychosocial interventions as an adjunct to pha rmacotherapy for bipolar disorder. Methods: We reviewed published outc ome studies since 1975 identified in MEDLINE and PsychLIT searches. Re sults: Available studies are initial and of highly variable methodolog ical rigour. Evidence is most robust for the efficacy of psychoeducati on and family therapy, and these received the highest level of recomme ndation as interventions Group therapy, cognitive-behavioural therapy, and behavioural family management therapy are supported by weaker evi dence and received a lower-level treatment recommendation. Availabilit y of only a single interpersonal and social rhythms therapy trial limi ted the confidence of the recommendation for this intervention. Conclu sions: Controlled trials are needed to replicate early outcome studies and guide treatment recommendations. A accumulated evidence of favour able psychosocial intervention outcomes supports, with variable confid ence, their use as adjuncts to pharmacotherapy in the treatment of bip olar disorder.