Psychotherapeutic interventions in individuals at risk of developing bipolar disorder: a systematic review
Article first published online: 22 AUG 2013
© 2013 Wiley Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 8, Issue 1, pages 3–11, February 2014
How to Cite
Pfennig, A., Correll, C. U., Marx, C., Rottmann-Wolf, M., Meyer, T. D., Bauer, M. and Leopold, K. (2014), Psychotherapeutic interventions in individuals at risk of developing bipolar disorder: a systematic review. Early Intervention in Psychiatry, 8: 3–11. doi: 10.1111/eip.12082
- Issue published online: 27 JAN 2014
- Article first published online: 22 AUG 2013
- Manuscript Accepted: 15 JUL 2013
- Manuscript Received: 15 MAY 2013
- Eli Lilly and Company
- Bristol-Myers Squibb
- The Stanley Medical Research Institute
- bipolar disorder;
- early intervention;
- early recognition;
Accumulating data show that patients with bipolar disorder (BD) experience substantial symptomatology months or years before full manifestation. Based on the need for early preventive interventions in BD as well as data suggesting effectiveness of psychotherapeutic interventions for BD, we aimed to review the evidence for psychotherapeutic treatments in help-seeking individuals considered at risk for BD (At-Risk-BD).
Searching PubMed and PsycINFO, clinical trial registries and recently published systematic reviews, a systematic review was performed of psychoeducational and psychotherapeutic intervention studies in At-Risk-BD individuals.
Only three completed studies were identified, two of which were randomized trials (n = 77) and one was an open pilot study (n = 13). Two ongoing studies (projected n = 150 and n = 100, respectively) were found in trial registries. The available evidence suggests potential effectiveness of multi-family psychoeducational psychotherapy and family-focussed therapy for symptom reduction and prevention of BD conversion.
Psychotherapeutic treatments are a reasonable starting point for At-Risk-BD subjects when symptom severity, distress and impairment are sufficiently significant to initiate treatment. Ongoing studies will further clarify the effectiveness and timing of psychotherapeutic interventions for At-Risk-BD individuals and whether or not they should be given alone or in conjunction with other treatments. Large multi-site studies with standardized procedures/manuals are needed to advance the field.