Psychotherapies for the Treatment of Bipolar Disorder

Yıl 2024, , 373 - 382, 30.06.2024

Metin Çınaroğlu

https://doi.org/10.18863/pgy.1332919

Cited By: 1

Öz

Bipolar disorder is one of the major mental disorders leading to disability. This review aims to highlight the most effective psychotherapies used in the treatment of bipolar disorder. Across diverse schools of psychology, five psychotherapeutic approaches have emerged as both highly utilized and effective. These are interpersonal social rhythm therapy, psychoeducation, cognitive-behavioral therapy, family-focused therapy and mindfulness therapy. Multiple randomized controlled trials focusing on these psychotherapeutic interventions have provided strong evidence of their effectiveness when delivered alongside standard care. The results suggest that these approaches have a constructive role to play as adjunctive models of psychotherapy in the management of bipolar disorder. While the available evidence is robust, further randomized clinical trials are needed. Expanding these studies to sub-areas such as geriatrics and adolescents would provide more detailed information on the feasibility and efficacy of these psychotherapies among different demographic groups.

Anahtar Kelimeler

Bipolar disorder, interpersonal social rhythm therapy, cognitive behavioural therapy, psychoeducation, family focused therapy, mindfulness therapy

Bipolar Bozukluk Tedavisinde Uygulanan Psikoterapiler

Öz

Bipolar bozukluk, yetiyitimine yol açan önemli ruhsal bozukluklardan biridir. Bu derleme, bipolar bozukluğun tedavisinde kullanılan en etkili psikoterapileri vurgulamayı amaçlamaktadır. Farklı psikoloji ekolleri arasında, beş psikoterapi yaklaşımının hem yüksek oranda kullanıldığı hem de etkili olduğu saptanmıştır. Bunlar; kişilerarası sosyal ritim terapisi, psikoeğitim, bilişsel-davranışçı terapi, aile odaklı terapi ve farkındalık terapisidir. Bu psikoterapötik müdahalelere odaklanan çok sayıda randomize kontrollü çalışma, standart bakımla birlikte uygulandıklarında etkinliklerine ilişkin güçlü kanıtlar sunmuştur. Sonuçlar, bu yaklaşımların bipolar bozukluğun yönetiminde yardımcı psikoterapi modelleri olarak yapıcı bir rol oynadıklarını göstermektedir. Mevcut kanıtlar sağlam olmakla birlikte, daha fazla randomize klinik çalışmaların yapılmasına ihtiyaç duyulmaktadır. Bu araştırmaların geriatri ve ergenler gibi alt alanlara genişletilmesi, bu psikoterapilerin farklı demografik gruplar arasında uygulanabilirliği ve etkinliği hakkında daha detaylı bir bilgi sağlayacaktır.

Anahtar Kelimeler

Bipolar bozukluk, kişilerarası sosyal ritim terapisi, bilişsel davranışçı terapi, psikoeğitim, aile odaklı terapi, farkındalık terapisi

Kaynakça

• Abreu T (2016) Cognitive-behavioral therapy for bipolar disorder: Eur Psychiatry, 33(Suppl):S556.
• Ball J R, Mitchell PB, Corry JC, Skillecorn A, Smith M, Malhi GS (2006) A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change. J Clin Psychiatry, 67:277-286.
• Basco M, Rush A (1996) Cognitive-Behavioural Therapy for Bipolar Disorder, 1st ed. New York, Guilford Press.
• Basco MR, Rush AJ (2005) Cognitive-Behavioral Therapy for Bipolar Disorder, 2nd ed. New York, Guilford Press.
• Benazzi F, Koukopoulos A, Akiskal HS (2004) Toward a validation of a new definition of agitated depression as a bipolar mixed state (mixed depression). Eur Psychiatry, 19:85-90.
• Bordbar MR, Faridhosseini F (2012) Psychoeducation for bipolar mood disorder. In Clinical, Research and Treatment Approaches to Affective Disorders (Ed M Juruena):323-344. London, UK, Intech.
• Bostancı N (2008) Evre I-II meme kanseri hastalarına uygulanan psikoeğitimin kanser uyum, anksiyete, depresyon ve duygudurum profiline etkisi. (Doktora tezi). İstanbul, İ̇stanbul Üniversitesi.
• Çakır S, Özerdem A (2010) İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Turk Psikiyatri Derg, 21:143–154.
• Çelebi Gy, Odaci H (2018) Bağlanma stilleri, ilişkilere ilişkin bilişsel çarpıtmalar, kişilerarası ilişki tarzları ve kişilik özelliklerinin evlilik uyumunu yordamadaki rolünün incelenmesi. Sosyal Politika Çalışmaları Dergisi, 18:89-120.
• Colom F, Lam D (2005) Psychoeducation: improving outcomes in bipolar disorder. Eur Psychiatry, 20:359-364.
• Colom F, Vieta E, Martinez-Aran A, Reinares M, Benabarre A, Gasto C (2000) Clinical factors associated with treatment noncompliance in euthymic bipolar patients. J Clin Psychiatry, 61:549-555.
• Colom F, Vieta E, Tacchi MJ, Sánchez‐Moreno J, Scott J (2005) Identifying and improving non‐adherence in bipolar disorders. Bipolar Disord, 7:24-31.
• Deckersbach T, Hölzel BK, Eisner LR, Stange JP, Peckham AD, Dougherty DD et al. (2012) Mindfulness-based cognitive therapy for nonremitted patients withbipolar disorder. CNS Neurosci Ther,18:133–141.
• del Mar Bonnín C, González-Pinto A, Solé B, Reinares M, González-Ortega I, Alberich S (2014) Verbal memory a a mediator in the relationship between subthreshold depressive symptoms and functional outcome in bipolar disorder. J Affect Disord, 160:50-54.
• Dent J, Close H, Ryder J (2004) Bipolar affective disorders. In Oxford Guide to Behavioral Experiments in Cognitive Therapy (Eds J Bennett-Levy, G Butler, M Fennell, A Hackmann, M Meuller, D Westbrook):225-244. NewYork, Oxford University Press.
• Domic-Siede M, Guzmán-González M, Burgos J, Carvallo C, Flores-Guerra C, Fredes-Valenzuela C et al. (2023) Emotion regulation strategies and the two-dimensional model of adult attachment: a pilot study. Front Behav Neurosci, 17:12-19
• Falloon IRH, Boyd JL, McGill CW (1984) Family Care of Schizophrenia: A Problem-Solving Approach to the Treatment of Mental Illness. New York, Guilford Press.
• Ferrari AJ, Baxter AJ, Whiteford HA (2011) A systematic review of the global distribution and availability of prevalence data for bipolar disorder. J Affect Disord, 134:1-13.
• Frank E, Swartz HA, Kupfer DJ (2000) Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder Biol Psychiatry, 48:593–604.
• Frank E, Hlastala S, Ritenour A, Houck P, Tu XM, Monk TH et al. (1997) Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Biol Psychiatry, 41:1165-1173.
• Frank E, Kupfer D J, Thase ME, Mallinger AG, Swartz HA, Fagiolini AM et al. (2005) Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry, 62:996-1004.
• Frank E, Swartz HA, Boland E (2007) Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues Clin Neurosci, 9:325-332.
• Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Wampold BE, Kearney DJ et al. (2018) Mindfulness-based interventions for psychiatric disorders: a systematic review andmeta-analysis. Clin Psychol Rev, 13:52–60.
• Gümüş AB (2006) Şizofrenide hasta ve ailelerinin yaşadığı güçlükler, psikoeğitim ve hemşirelik. Hemşirelikte Araştırma Geliştirme Dergisi, 1:23–34.
• Hanssen I, van der Horst N, Boele M, Lochmann van Bennekom M, Regeer E, Speckens A (2020) The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study. Int J Bipolar Disord, 8:1-12.
• Hlastala SA, McClellan J (2005) Phenomenology and diagnostic stability of youths with atypical psychotic symptoms. J Child Adolesc Psychopharmacol, 15:497-509.
• Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD et al. (2003) A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry, 60:261-269.
• Juruena MFP (2012) Cognitive-behavioral therapy for the bipolar disorder patients. In Standard and Innovative Strategies in Cognitive Behavior Therapy (Ed De Oliveira IR):77-98, London, UK, InTech.
• Karl A, Schaefer M, Malta LS, Dörfel D, Rohleder N, Werner A (2006) A meta-analysis of structural brain abnormalities in ptsd. Neurosci Biobehav Rev, 30:1004-1031.
• Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N et al. (2003) A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. Arch Gen Psychiatry, 60:145-152.
• Maçkalı Z, Tosun A (2011) Bipolar bozuklukta bilişsel davranışçı terapi. Psikiyatride Güncel Yaklaşımlar, 3:571-594.
• Malkoff-Schwartz S, Frank E, Anderson B, Sherrill JT, Siegel L, Patterson D et al. (1998) Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes: a preliminary investigation. Arch Gen Psychiatry, 55:702-707.
• Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B et al. (2011) Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry, 50:32-45.
• Miklowitz DJ, George EL, Richards JA, Simoneau TL, Suddath RL (2003) A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry, 60:904-912.
• Monk TH, Flaherty JF, Frank E, Hoskinson K, Kupfer DJ (1990) The social rhythm metric: an instrument to quantify the daily rhythms of life. J Nerv Ment Dis, 178:120-126.
• Moon E, Chang JS, Kim MY, Seo MH, Cha B, Ha TH et al. (2012) Dropout rate and associated factorsin patients with bipolar disorders. J Affect Disord,141:47–54
• Nehir S (2011) Psikiyatri hemşireliğinde psikoeğitim. I. Uluslararası, V. Ulusal Psikiyatri Hemşireliği Kongresi:207–209. 22-24.09.2011, İstanbul, Türkiye.
• Nivoli AM, Pacchiarotti I, Rosa AR, Popovic D, Murru A, Valenti M et al. (2011) Gender differences in a cohort study of 604 bipolar patients: the role of predominant polarity. J Affect Disord, 133:443-449.
• Özcan Ö, Çelik GG (2017) Bilişsel davranışçı terapi. Turkiye Klinikleri J Child Psychiatry-Special Topics, 3(2):115-120.
• Phillips ML, Kupfer DJ (2013) Bipolar disorder diagnosis: challenges and future directions. Lancet, 381:1663-1671.
• Prien RF, Potter WZ (1990) NIMH workshop report on treatment of bipolar disorder. Psychopharmacol Bull, 26:409-427.
• Provencher MD, Hawke LD, Thienot E (2011) Psychotherapies for comorbid anxiety in bipolar spectrum disorders. J Affect Disord, 133:371-380.
• Rosenberg SD, Mueser KT, Jankowski MK, Salyers MP, Acker K (2004) Cognitive– behavioral treatment of ptsd in severe mental illness: Results of a pilot study. Am J Psychiatry Rehabil, 7:171–186.
• Roth A, Fonagy P (2005) What Works For Whom: A Critical Review of Psychotherapy Research, 2nd edition. New York, Guilford Press.
• Rothbaum BO, Astin MC (2000) Integration of pharmacotherapy and psychotherapy for bipolar disorder. J Clin Psychiatry, 61:68-75.
• Şafak Y, Karadere ME, Özdel K, Kuru E, Özcan T, Türkçapar MH et al. (2014) Obsesif kompulsif bozuklukta bilişsel davranışçı grup psikoterapisinin etkinliğinin değerlendirilmesi. Turk Psikiyatri Derg, 25:225-33
• Salvatore P, Tohen M, Khalsa HMK, Baethge C, Tondo L, Baldessarini RJ (2007) Longitudinal research on bipolar disorders. Epidemiol Psichiatr Soc, 16:109-117.
• Scott J (1995) Psychotherapy for bipolar disorder. Br J Psychiatry, 167:581-588.
• Scott JAN, Paykel E, Morriss R, Bentall R, Kinderman P, Johnson T et al (2006) Cognitive–behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial. BJPsych Open, 188:313-320.
• Scott J, Pope M (2003) Cognitive styles in individuals with bipolar disorders. Psychol Med, 33:1081-1088.
• Scott J, Colom F, Vieta E (2007) A meta-analysis of relapse rates with adjunctive psychological therapies compared to usual psychiatric treatment for bipolar disorders. Int J Neuropsychopharmacol, 10:123-129.
• Şirin T (2013) Bilişsel davranışçı psikoterapi yaklaşımıyla bütünleştirilmiş dini danışmanlık modeli (Doktora tezi). Sakarya, Sakarya Üniversitesi.
• Stafford N, Colom F (2013) Purpose and effectiveness of psychoeducation in patients with bipolar disorder in a bipolar clinic setting. Acta Psychiatr Scand, 127:11-18.
• Stahl SM (2002) Essential Psychopharmacology of Antipsychotics and Mood Stabilizers. Cambridge, Cambridge University Press.
• Stone L, Beck A, Hashempour F, Thwaites R (2018) Introduction to the special issue on cultural adaptations of CBT. Cogn Behav Therap, 3:11-15.
• Sublette ME, Carballo JJ, Moreno C, Galfalvy HC, Brent DA, Birmaher B et al. (2009) Substance use disorders and suicide attempts in bipolar subtypes. J Psychiatric Res, 43:230-238.
• Swartz HA, Swanson J (2014) Psychotherapy for bipolar disorder in adults: a review of the evidence. Focus, 12:251-266.
• Türkçapar MH, Sargın AE (2012) Bilişsel davranışçı psikoterapiler: tarihçe ve gelişim. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi, 1:7-14.
• Vieta E (2005) Improving treatment adherence in bipolar disorder through psychoeducation. J Clin Psychiatry, 66:24–29.
• Weissman MM, Markowitz JC, Klerman GL (2017) The Guide To Interpersonal Psychotherapy, 2nd Edition. Oxford, Oxford University Press.
• Worley P, Silagy C, Prideaux D, Newble D, Jones A (2000) The parallel rural community curriculum: an integrated clinical curriculum based in rural general practice. Med Educ, 34:558-565.