DAS has received research support and honoraria from AstraZeneca, GlaxoSmithKline, Janssen, Pfizer, and Shire. GIK currently receives research support from AstraZeneca; has previously received such support from Bristol-Myers Squibb, Janssen, Eli Lilly & Co., Merck, Novartis, Organon, Pfizer, and Wyeth Ayerst; and is on the speakers bureau for Janssen. CER has received research support from AstraZeneca, Janssen, and Novartis. JK and IWM have no reported conflict of interest.
Preventing recurrence of bipolar I mood episodes and hospitalizations: family psychotherapy plus pharmacotherapy versus pharmacotherapy alone
Version of Record online: 1 OCT 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 10, Issue 7, pages 798–805, November 2008
How to Cite
Solomon, D. A., Keitner, G. I., Ryan, C. E., Kelley, J. and Miller, I. W. (2008), Preventing recurrence of bipolar I mood episodes and hospitalizations: family psychotherapy plus pharmacotherapy versus pharmacotherapy alone. Bipolar Disorders, 10: 798–805. doi: 10.1111/j.1399-5618.2008.00624.x
- Issue online: 1 OCT 2008
- Version of Record online: 1 OCT 2008
- Received 11 October 2006, revised and accepted for publication 28 March 2008
- bipolar I disorder;
- family psychotherapy;
Objectives: This study compared the efficacy of three treatment conditions in preventing recurrence of bipolar I mood episodes and hospitalization for such episodes: individual family therapy plus pharmacotherapy, multifamily group therapy plus pharmacotherapy, and pharmacotherapy alone.
Methods: Patients with bipolar I disorder were enrolled if they met criteria for an active mood episode and were living with or in regular contact with relatives or significant others. Subjects were randomly assigned to individual family therapy plus pharmacotherapy, multifamily group therapy plus pharmacotherapy, or pharmacotherapy alone, which were provided on an outpatient basis. Individual family therapy involved one therapist meeting with a single patient and the patient’s family members, with the content of each session and number of sessions determined by the therapist and family. Multifamily group psychotherapy involved two therapists meeting together for six sessions with multiple patients and their respective family members, with the content of each session preset. All subjects were prescribed a mood stabilizer, and other medications were used as needed. Subjects were assessed monthly for up to 28 months. Following recovery from the index mood episode, subjects were assessed for recurrence of a mood episode and for hospitalization for such episodes.
Results: Of a total of 92 subjects that were enrolled in the study, 53 (58%) recovered from their intake mood episode. The analyses in this report focus upon these 53 subjects, 42 (79%) of whom entered the study during an episode of mania. Of the 53 subjects who recovered from their intake mood episode, the proportion of subjects within each treatment group who suffered a recurrence by month 28 did not differ significantly between the three treatment conditions. However, only 5% of the subjects receiving adjunctive multifamily group therapy required hospitalization, compared to 31% of the subjects receiving adjunctive individual family therapy and 38% of those receiving pharmacotherapy alone, a significant difference. Time to recurrence and time to hospitalization did not differ significantly between the three treatment groups.
Conclusion: For patients with bipolar I disorder, adjunctive multifamily group therapy may confer significant advantages in preventing hospitalization for a mood episode.