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Vol. 82, No. 5, 2013
Issue release date: August 2013
Section title: Innovations
Psychother Psychosom 2013;82:292-298
(DOI:10.1159/000348447)

Polarity Index of Psychological Interventions in Maintenance Treatment of Bipolar Disorder

Popovic D. · Reinares M. · Scott J. · Nivoli A. · Murru A. · Pacchiarotti I. · Vieta E. · Colom F.
aBipolar Disorders Unit, Department of Psychiatry, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; bDepartment of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy; cAcademic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK

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Article / Publication Details

First-Page Preview
Abstract of Innovations

Received: 9/30/2012 11:29:03 AM
Accepted: 12/29/2012 9:43:03 PM
Published online: 8/9/2013

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: Although several adjunctive psychological interventions are effective in the maintenance of bipolar disorders (BD), no attempt has been made to classify them according to their ability to prevent manic versus depressive episodes. Our study aims to rank the adjunctive psychotherapies for the prophylaxis of BD by means of their polarity index (PI). Methods: Randomized controlled trials comparing the efficacy of a psychological intervention with a comparator in BD maintenance treatment in patients aged over 18 were systematically reviewed. Exclusion criteria were a small sample size, a study sample not exclusively composed of bipolar patients and the absence of a control group. PI is a novel metric indicating the relative antimanic versus antidepressive preventive efficacy of treatments. PI was retrieved by calculating the ratio of the number needed to treat (NNT) for prevention of depression and the NNT for prevention of mania. PI >1.0 indicates a relatively higher antimanic prophylactic efficacy and PI <1.0 a greater antidepressive efficacy. Results: A total of 9 studies were included. PI was 0.33, 0.63 and 0.89 for cognitive-behavioral therapy, 0.42 for family-focused therapy, 0.73 and 0.78 for psychoeducation, 1 for enhanced relapse prevention, 1.78 for caregiver group psychoeducation and 3.36 for brief technique-driven interventions. With regard to the PI for 1 cognitive-behavioral study, enhanced relapse prevention and brief technique-driven interventions may not be reliable since those trials were negative. Conclusions: The PI provides a measure of how much depression-preventive or (hypo) mania-preventive an intervention is and may guide the choice of adjunctive psychotherapy in the context of individualized long-term treatment of BD.


  

Author Contacts

Eduard Vieta
Hospital Clinic
170 Villarroel
ES-08036 Barcelona (Spain)
E-Mail evieta@clinic.ub.es

  

Article Information

Received: September 30, 2012
Accepted after revision: December 29, 2012
Published online: August 9, 2013
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 1, Number of References : 38
Additional supplementary material is available online - Number of Parts : 1

  

Publication Details

Psychotherapy and Psychosomatics

Vol. 82, No. 5, Year 2013 (Cover Date: August 2013)

Journal Editor: Fava G.A. (Bologna)
ISSN: 0033-3190 (Print), eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


Article / Publication Details

First-Page Preview
Abstract of Innovations

Received: 9/30/2012 11:29:03 AM
Accepted: 12/29/2012 9:43:03 PM
Published online: 8/9/2013

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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