Disorders - Bipolar Disorders
Findling, R.L., McNamara, N.K., Pavuluri, M., Frazier, J.A., Rynn, M., Scheffer, R., Kafantaris, V., Robb, A., DelBello, M., Kowatch, R.A., Rowles, B.M., Lingler,
J., Zhao, J., Clemons, T., Martz, K., Anand, R., Taylor-Zapata, P.
Objective: This study
examined the role of lithium in the maintenance treatment of pediatric patients with bipolar I disorder (BP-I). Method: Participants aged 7 to 17
years who presented with a manic or mixed episode received 24 weeks of lithium treatment in one of two multiphase studies, the Collaborative Lithium
Trials (CoLT 1 and CoLT 2). Responders were randomized to continue lithium or to be cross-titrated to placebo for up to 28 weeks. The primary outcome
measure was relative risk of study discontinuation for any reason. Results: A Cox regression analysis found that those who continued treatment with
lithium (n = 17) had a lower hazard ratio compared to those who received placebo (n = 14) (p = .015)]. The vast majority of discontinuations were due
to mood symptom exacerbations, with most of these occurring in the placebo-treated group. Discontinuation for other reasons occurred at similarly low
rates across both group. Most adverse events were mild to moderate in severity, and only one study participant was discontinued from the trial owing
to a serious adverse event (aggression). There was no statistically significant difference with respect to weight gain in participants receiving
lithium compared to those receiving placebo. Conclusion: This randomized, double-blind, placebo-controlled Discontinuation Trial builds support for
the role of lithium as a maintenance treatment in pediatric patients with bipolar disorder and for the safety and tolerability of 28 weeks of
maintenance lithium treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of the American Academy of Child & Adolescent
Psychiatry, 58(2) : 287-296
- Year: 2019
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium, Medication dose
reduction/discontinuation
Putignano, D., Clavenna, A., Reale, L., Bonati, M.
Purpose: Drug use in the pediatric population
still often features off-label prescriptions, particularly for psychotropic drugs. We reviewed the registration status, scientific evidence, and
recommendations from the guidelines for antipsychotics used for psychiatric disorders in children. Method(s): Antipsychotic drugs marketed in Italy,
the United Kingdom (UK) and United States (US) were identified with the ATC Classification System. The licensing status and Summary of Product
Characteristics (SPC) were taken from the national formularies. We analyzed reviews and guidelines on antipsychotics use in children and adolescents
in the MEDLINE, EMBASE, and PsycINFO databases. Result(s): Out of 67 drugs, 19 were marketed with a pediatric license in at least one country: three
in all the selected countries, and only paliperidone with the same indications. Haloperidol was the only antipsychotic authorized for autism in Italy
and the UK, and as well as risperidone and aripiprazole in the US. Aripiprazole and paliperidone were licensed in all three countries for
schizophrenia. Aripiprazole was licensed for bipolar disorders in all three countries. Haloperidol was licensed for Tourette syndrome in Italy and
the UK, and pimozide and aripiprazole in the US. We retrieved 21 pertinent reviews and 13 guidelines for the management of neuropsychiatric disorders
in pediatrics. There was a complete overlap between the authorized therapeutic indications and the available scientific evidence for autism in the
US, for conduct disorders and bipolar disorders in the UK, and for Tourette syndrome and tics in the UK and Italy. Conclusion(s): These results
highlight the different regulatory processes that deny to many children and adolescents the most appropriate and rational antipsychotic therapy.
Copyright © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
European
Journal of Clinical Pharmacology, 75(6) : 769-776
- Year: 2019
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Lithium
Kazempour, V., Ebrahimi, H., Jafarabadi, M. A., Nourazar, S. G., Zamani, H.
Background and Objectives: Bipolar
disorder (BD) is defined as emotion dysregulation. Since such dysregulation is also present during remission, it may be a risk factor for the
development of further affective episodes. Therefore, the current study aimed at examining the impact of group cognitive behavioral therapy (GCBT),
in comparison to treatment as usual (TAU), on the cognitive emotion regulation strategies of patients with BD. Patients and Methods: The current
single-blind, randomized, controlled trial (RCT) was performed from 2015 to 2017 at the Psychiatric Clinic of Razi Hospital affiliated to Tabriz
University of Medical Sciences, Tabriz, Iran. A total of 70 adolescents with early-onset BD were selected by the convenience sampling method based on
the diagnostic and statistical manual of mental disorders-fourth edition-text revision (DSM-IV-TR) and allocated into receive either 12 sessions of
GCBT (N = 35) or TAU (N = 35). Cognitive emotion regulation strategies were evaluated by cognitive emotion regulation questionnaire (CERQ) at
baseline, after the intervention, and at 3-month follow-up. Efforts were made to follow up all randomized participants even if they withdrew from the
assigned treatment prior to completion of GCBT sessions. Result(s): Compliance with treatment was moderate and the mean number of GCBT sessions that
the participants attended was 6.97 (2.81). The 2 groups had significant differences in terms of post-test scores for other-blame (P = 0.001),
rumination (P = 0.049), positive refocus (P = 0.008), positive reappraisal (P = 0.005), and putting into perspective (P = 0.001). In the 3-month
follow-up, the 2 groups were significantly different only in other-blame (P = 0.001), positive reappraisal (P = 0.001), and putting into perspective
subscales (P = 0.001). Therefore, the effects of the intervention were not effectively sustained after 3 months and there was room for improvement in
terms of both outcome and compliance. Conclusion(s): The GCBT is more effective when the participants are involved in the study and get instructions
on emotion regulation. However, since the effects of the intervention were not sustained for most of the subscales after 3 months, booster sessions
might improve and prolong the impact of psychotherapies. Copyright © 2018, Iranian Red Crescent Medical Journal.
Iranian Red Crescent Medical Journal, 20 (S1) (no
pagination)(e61555) :
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Lee, E. S., Vidal, C., Findling, R. L.
Objectives: The use of atypical antipsychotic medications in pediatric patients has become more prevalent in recent years.
The purpose of this review is to provide a clinically relevant update of recent selected key publications regarding the use of atypical
antipsychotics in this population. Method(s): Studies reviewed included randomized, double-blind, placebo-controlled medication trials conducted
within the past 5 years. A PubMed search was conducted for each of the 11 second-generation antipsychotic medications currently approved by the Food
and Drug Administration for use in the United States: Clozapine, risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, paliperidone,
asenapine, iloperidone, lurasidone, and cariprazine. Trials published in English with subjects 18 years of age and younger were included in this
review. Additional studies, chosen for their significance to clinical practice, were also included at the discretion of the authors. Result(s): This
review demonstrates that more empiric data are available regarding both the acute efficacy and, to a lesser extent, the longer-term efficacy and
tolerability for several of the considered antipsychotic medications. The clinical conditions for which these medications have been studied include
schizophrenia, bipolar disorder, Tourette's disorder, and autism spectrum disorder. They have also been used as an adjunctive treatment for
disruptive behavior disorders with aggression, which have not responded to treatment with stimulants. Conclusion(s): Evidence regarding the efficacy
and tolerability of antipsychotic medications for mental health disorders in children and adolescents has expanded exponentially in recent years.
However, more information is needed so that evidence-based comparisons between medications can be made. In the future, data enabling the selection of
medications based upon individual patient characteristics could potentially lead to greater efficacy and efficiency in treating what are frequently
debilitating medical conditions. Maladaptive aggression in children, often treated with antipsychotics, is one such area in which there is a dearth
of actual information available to the clinician. It is to be hoped that additional, longer-term studies of these medications will further inform
evidence-based practice in clinical settings. Copyright © 2018 Mary Ann Liebert, Inc. publishers.
Journal of Child and Adolescent
Psychopharmacology, 28(9) : 582-605
- Year: 2018
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Fristad, M. A., Roley-Roberts, M., Myers, N., Black, S. R., Arnold, L. E.
Objective: Examine long-term outcomes for 95 youth with mood disorders who completed a 12-week
randomized controlled trial (RCT) of omega3 fatty acids (OMEGA3) or placebo (PBO) and psychoeducational psychotherapy (PEP) or active monitoring
(AM). Methods: Youth/parents were reassessed 2-5 years later regarding current functioning, treatment utilization and beliefs regarding utility and
mechanisms of change from OATS interventions. Results: Thirty-eight youth/parents participated (40% retention); assessments were 3.4+/-0.7 years
later (range: 2.2-4.7). Returners, compared to the original sample, were significantly more likely to have: completed OATS (92%); non-biracial/black
caregiver; annual family income $80-100 K; and unimproved manic symptoms. The Half started or continued OMEGA3 after the RCT; over half started or
continued psychotherapy. A majority believed study participation led to the continued improvement of the child (82%, parents; 68%, youth) and family
(74%, parents; 68%, youth). Over 45% of parents reported ongoing improved child coping, child mood, family communication, and increased hope, which
they attributed to improved understanding; for those on OMEGA3, pills; and for those in PEP, learning new skills and feeling supported. Over 45% of
children reported improved mood, self-concept, coping, and family communication, which those in PEP attributed to learning new skills, a caring
therapist, better self-understanding, and those on OMEGA3, pills. Conclusions: Two to five years after a 12-week RCT for mood-disordered youth,
parents/youth reported ongoing improvement in mood, coping, and family communication. Increased understanding of the child was endorsed regardless of
initial treatment assignment. Those in PEP frequently endorsed learning new skills and caring/supportive therapists while those on OMEGA3 believed it
was beneficial.
Nutritional Neuroscience, 21 (Supplement
1) : S4
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Fish oil (Omega-3 fatty acids), Omega 3 fatty
acids (e.g. fish oil, flax oil)
Goldstein, T. R., Merranko, J., Krantz, M., Garcia, M., Franzen, P., Levenson, J., Axelson, D., Birmaher, B., Frank, E.
Objective: To conduct a pilot randomized trial of Interpersonal and Social Rhythm Therapy plus Data-Informed Referral (IPSRT + DIR) versus
DIR-alone for adolescents at-risk for bipolar disorder (BP). Method: Eligible participants included youth (12-18) with a BP parent; youth with BP
were excluded. Participants (n = 42) were randomized to receive IPSRT + DIR to treat any psychiatric disorders present at baseline, or DIR-alone. A
blind evaluator assessed outcomes at baseline, 3- and 6-months. Participants wore an actigraph to measure sleep/wake patterns for 7 days at baseline
and 6-months. Primary outcomes included mood and non-mood symptoms and sleep disturbance. Results: Youth randomized to IPSRT + DIR attended
approximately half of scheduled IPSRT sessions. Although 33% of DIR-alone youth were referred for mental health services at intake (another 33% were
already engaged in services), none initiated new services over follow-up. No youth developed new-onset mood disorder over follow-up. Self- and
parent-reported mood and non-mood psychiatric symptoms did not distinguish the groups, although youth in DIR-alone tended to have higher baseline
scores on most measures. Per clinician ratings, 1 youth receiving IPSRT + DIR displayed subthreshold hypo/manic symptoms, versus 2 receiving DIR-
alone (OR = 14.7, p = 0.03), possibly signaling less subthreshold hypo/manic symptoms, and for fewer weeks (chi2 = 11.06, p = 0.0009), over 6-months
with IPSRT + DIR. We found a small effect for youth in the IPSRT + DIR group to evidence more WASO at pre-treatment, but less at follow-up (cohen's
d = 0.28). Limitations: Small sample size limits statistical power, and we are unable to definitively attribute group differences to IPSRT versus
greater clinical contact. Ability to examine distal/rare (i.e., BP onset) outcomes was limited. Conclusions: Adolescents at-risk for BP present
challenges to psychosocial treatment engagement and retention. IPSRT merits further study as an acceptable intervention for at-risk youth, though
necessary frequency and intensity to affect outcomes should be examined. The potential to delay or prevent subthreshold hypo/manic symptoms via
enhanced sleep continuity is an area for further examination. Future studies with larger samples and extended follow-up can help determine whether
IPSRT may delay or prevent syndromal hypo/mania in youth at-risk. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Affective
Disorders, 235 : 348-356
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Singh, M., Goldman, R., Tocco, M., Pikalov, A., Deng, L., Cucchiaro, J., Loebel, A.
Background and Aims: To evaluate change in specific depressive symptoms in children and
adolescents presenting with bipolar depression who received short-term treatment with lurasidone. Method: Data in this secondary analysis were
derived from a study of patients 10-17 years (N=343) with a DSM-5 diagnosis of bipolar I depression who were randomized to 6 weeks of double-blind
treatment with lurasidone 20-80 mg/d or placebo. The primary endpoint was change from Baseline to Week 6 on the Children's Depression Rating Scale,
Revised (CDRS-R) total score. Change from Baseline to Week 6 for each individual CDRS-R item was assessed with an ANCOVA using an LOCF approach.
Cohen's deffect sizes were also calculated at Week 6. Results: At the primary Week 6 endpoint, treatment with lurasidone was associated with
significant improvement vs. placebo in the CDRS-R total score (-21.0 vs. -15.3; P<0.0001; effect size [d]=0.45). A total of 13 CDRS-R items (76%)
were significantly improved on lurasidone: impaired school work (P=0.023; d=0.25), difficulty having fun (P=0.004; d=0.31), social withdrawal
(P<0.0001; d=0.43), sleep disturbance (P=0.0001; d=0.43), appetite disturbance (P<0.05; d=0.22), irritability (P=0.026; d=0.24), excessive guilt
(P=0.0032; d=0.32), low self-esteem (P=0.012; d=0.27), depressed feelings (P=0.0068; d=0.29), excessive weeping (P=0.014; d=0.27), depressed facial
affect (P=0.0009; d=0.36), listless speech (P<0.0001; d=0.43), and hypoactivity (P=0.012; d=0.27). The remaining CDRS-R items were not significant.
Conclusion: In this placebo-controlled study of children and adolescents with bipolar depression, 6 weeks of treatment with lurasidone was effective
in treating a wide range of depressive symptoms assessed by the CDRS-R.
Bipolar Disorders, 20 (Supplement 1) : 66
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Tocco, M., Pikalov,
A., Siu, C., Loebel, A.
Background and Aims: To evaluate the efficacy and safety of lurasidone in the treatment of
children and adolescents with bipolar depression presenting with mixed (subsyndromal hypomanic) features. Method: Patients 10-17 years of age with a
DSM-IV-TR diagnosis of bipolar I depression, were randomized to 6 weeks of double-blind treatment with flexible dose lurasidone 20-80 mg/d or
placebo. The presence of mixed features was defined as a YMRS score >=5 at study baseline. Efficacy analyses included change from baseline to week 6
in Children Depression Rating Scale, Revised (CDRS-R) score, and Clinical Global Impressions-Bipolar Severity of Depression Score (CGI-BP-S).
Results: Treatment with lurasidone (vs placebo) was associated with significantly greater reduction in CDRS-R score at week 6 in pediatric bipolar
depressed patients with mixed features (-21.5 vs -15.9; P<0.01; effect size, 0.45), and without mixed features (-20.4 vs -14.8; P<0.01; effect size,
0.45). Similar significant improvement was observed for reduction in CGI-BP-S score at week 6 in the mixed features group (-1.6 vs -1.1; P<0.001;
effect size 0.57), and in the group without mixed features (-1.3 vs -1.0; P=0.05; effect size 0.30). Rates of protocol-defined treatment-emergent
hypomania or mania were comparable for lurasidone and placebo in patients with and without mixed features. Conclusion: In this post-hoc analysis of a
placebo controlled trial, lurasidone was found to be efficacious in the treatment of child and adolescent patients with bipolar depression presenting
with and without mixed (subsyndromal hypomanic) features.
Bipolar Disorders, 20 (Supplement 1) : 66-67
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Amerio,
A., Ossola, P., Scagnelli, F., Odone, A., Allinovi, M., Cavalli, A., Iacopelli, J., Tonna, M., Marchesi, C., Ghaemi, S. N.
Introduction: Many clinicians
are reluctant to use traditional mood-stabilizing agents, especially lithium, in children and adolescents. This review examined the evidence for
lithium's safety and efficacy in this population. Methods: A systematic review was conducted on the use of lithium in children and adolescents with
bipolar disorder (BD). Relevant papers published through June 30th 2018 were identified searching the electronic databases MEDLINE,
Embase, PsycINFO and the Cochrane Library. Results: 30 articles met inclusion criteria, including 12 randomized controlled trials (RCTs). Findings
from RCTs demonstrate efficacy for acute mania in up to 50% of patients, and evidence of long-term maintenance efficacy. Lithium was generally safe,
at least in the short term, with most common side effects being gastrointestinal, polyuria, or headache. Only a minority of patients experienced
hypothyroidism. No cases of acute kidney injury or chronic kidney disease were reported. Conclusions: Though the available literature is mostly
short-term, there is evidence that lithium monotherapy is reasonably safe and effective in children and adolescents, specifically for acute mania and
for prevention of mood episodes. Copyright © 2018 Elsevier Masson SAS
European Psychiatry, 54 : 85-97
- Year: 2018
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium
Channing, J., Mitchell, M., Cortese, S.
Objective: To perform a systematic review
of studies of lurasidone in children and/or adolescents and to present a case report aimed to add further insights into its use in clinical practice
with youth. Methods: We searched the following databases for empirical studies, of any design, focusing on the pharmacokinetics, efficacy, or safety
of lurasidone in children and/or adolescents: Pubmed (Medline), OVID (PsycInfo, EMBASE+EMBASE classic, OVID Medline), Web of Knowledge, and
ClinicalTrials.gov (last search January 23, 2018). Results: From a pool of 301 potentially relevant references, we retained 12 pertinent studies
(reported in 28 references), including 1 pharmacokinetics study, 1 double blind randomized controlled trial (RCT) for bipolar depression (BD) with 1
related interim analysis study of its extension phase and 1 related external posterior predictive check study, 1 double blind RCT for schizophrenia
with 3 related interim analyses of its extension phase, 1 RCT and 1 case report for autism spectrum disorder, and 2 open-label studies focusing on a
variety of disorders. Overall, these studies show that lurasidone is significantly more efficacious than placebo, with moderate effect sizes, and is
well tolerated for BD and schizophrenia in youth. Published studies in youth have in general used doses up to 80 mg/day. Our case report suggests
that high doses of lurasidone (148 mg/day) were well tolerated and might have contributed to substantial functional improvement in a 14-year old girl
with psychosis and a previous history of anorexia nervosa, who had not responded to previous antipsychotics (olanzapine, risperidone, aripiprazole).
Conclusions: There is increasing evidence that lurasidone may be moderately effective and well tolerated for the treatment of BD and psychosis in
youth and may have procognitive effects. Our case report suggests that future RCTs should assess the efficacy and tolerability of high doses (>80
mg/day) of lurasidone in youth. © Copyright 2018, Mary Ann Liebert, Inc., publishers 2018.
Journal of Child and Adolescent Psychopharmacology, 28(7) : 428-
436
- Year: 2018
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Duffy,
A., Heffer, N., Goodday, S. M., Weir, A., Patten, S., Malhi, G. S., Cipriani, A.
Objectives: To assess the efficacy and tolerability of lithium for the treatment of acute mania
in children and adolescent diagnosed with bipolar disorder. Methods: A systematic literature search up to August 2017 was conducted for clinical
trials that included lithium in males and females up to 18 years of age with a diagnosis of bipolar disorder and experiencing a manic or mixed
episode according to standardized diagnostic criteria. The protocol was registered in PROSPERO (CRD42017055675). Results: Four independent studies
described in seven manuscripts met the inclusion criteria. Overall, 176 patients were treated with lithium either as a monotherapy or adjunct to
risperidone. Efficacy results suggest that lithium may be superior to placebo (standardized mean difference [SMD] -0.42, 95% confidence interval [CI]
-0.88 to 0.04), comparable to sodium divalproex (SMD -0.07, 95% CI: -0.31 to 0.18), but significantly less effective than risperidone for treating
protracted manic/mixed episodes and comorbid attention-deficit hyperactivity disorder (ADHD) in prepubertal children (SMD 0.85, 95% CI: 0.54 to
1.15). Lithium was not associated with serious adverse events, and was generally well tolerated with common side effects similar to those reported in
adults. Conclusions: Limited data suggests that lithium may be an effective and tolerable treatment for some forms of paediatric mania. However,
lithium is clearly inferior in efficacy to risperidone in prepubertal patients diagnosed with protracted manic/mixed episodes and comorbid ADHD.
There is a lack of data concerning the efficacy and tolerability of lithium as an acute treatment for classical mania in adolescents and important
clinical issues remain unaddressed. Copyright © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Bipolar
Disorders., 20 : 583 - 593
- Year: 2018
- Problem: Bipolar Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium
Kazempour, V., Ebrahimi, H., Jafarabadi, M. A., Nourazar, S. G., Zamani, H.
Background and Objectives: Bipolar
disorder (BD) is defined as emotion dysregulation. Since such dysregulation is also present during remission, it may be a risk factor for the
development of further affective episodes. Therefore, the current study aimed at examining the impact of group cognitive behavioral therapy (GCBT),
in comparison to treatment as usual (TAU), on the cognitive emotion regulation strategies of patients with BD. Patients and Methods: The current
single-blind, randomized, controlled trial (RCT) was performed from 2015 to 2017 at the Psychiatric Clinic of Razi Hospital affiliated to Tabriz
University of Medical Sciences, Tabriz, Iran. A total of 70 adolescents with early-onset BD were selected by the convenience sampling method based on
the diagnostic and statistical manual of mental disorders-fourth edition-text revision (DSM-IV-TR) and allocated into receive either 12 sessions of
GCBT (N = 35) or TAU (N = 35). Cognitive emotion regulation strategies were evaluated by cognitive emotion regulation questionnaire (CERQ) at
baseline, after the intervention, and at 3-month follow-up. Efforts were made to follow up all randomized participants even if they withdrew from the
assigned treatment prior to completion of GCBT sessions. Result(s): Compliance with treatment was moderate and the mean number of GCBT sessions that
the participants attended was 6.97 (2.81). The 2 groups had significant differences in terms of post-test scores for other-blame (P = 0.001),
rumination (P = 0.049), positive refocus (P = 0.008), positive reappraisal (P = 0.005), and putting into perspective (P = 0.001). In the 3-month
follow-up, the 2 groups were significantly different only in other-blame (P = 0.001), positive reappraisal (P = 0.001), and putting into perspective
subscales (P = 0.001). Therefore, the effects of the intervention were not effectively sustained after 3 months and there was room for improvement in
terms of both outcome and compliance. Conclusion(s): The GCBT is more effective when the participants are involved in the study and get instructions
on emotion regulation. However, since the effects of the intervention were not sustained for most of the subscales after 3 months, booster sessions
might improve and prolong the impact of psychotherapies. Copyright © 2018, Iranian Red Crescent Medical Journal.
Iranian Red Crescent Medical Journal, 20 (S1) (no
pagination)(e61555) :
- Year: 2018
- Problem: Bipolar Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)