For adults with bipolar disorder who are either in a manic or depressive episode, how effective is Cognitive Behavioural Therapy, compared to any other intervention, for improving patient outcomes?
There was evidence from one high-quality systematic review that
CBT reduced the number of relapses compared to treatment as usual.
However this was based on a small number of studies (up to five)
and none of them reported other outcomes such as suicide or adverse
events of treatment. Another, lower quality review, also found
significant benefits across various outcomes for CBT, but this
evidence was less reliable. In terms of clinical trial evidence,
one poor quality trial found a longer time to the first episode of
depression with CBT, but no differences when compared to treatment
as usual for relapses or the number of depressive episodes. Two
other trials (one poor and one moderate quality) did not find any
evidence of a difference between CBT and supportive care or
There was a small amount of evidence favouring CBT, however as
stated by some of the authors, more research is needed. Ideally
this should involve high-quality randomised controlled trials with
a sufficiently large sample size to capture clinically relevant
treatment differences and a long period of follow-up.
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