Controlled study of group cognitive behavioral therapy for bipolar disorder

  • Psych Bernardo Gomes, University of São Paulo School of Medicine, Brazil
  • MD Lena Abreu, Bipolar Disorder Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil, Brazil
  • MD Eliza Brietzke, Bipolar Disorder Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil, Brazil
  • MD Ana Kleinman, University of São Paulo School of Medicine, Brazil
  • MD Sheila Caetano, Bipolar Disorder Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil, Brazil
  • MD Beny Lafer, University of São Paulo School of Medicine, Brazil

Objectives: To evaluate the effectiveness of adding sessions of Cognitive Behavioral Therapy (CBT) in group format to treatment as usual (TAU) versus TAU alone in bipolar patients, in preventing new episodes of bipolar disorder.

Method: Forty euthimic patients with BD type I or II (DSM-IV) were randomized to receive 18 sessions of group CBT (N=18), or Treatment as Usual (TAU) (N=22) There were no statistical differences between groups for age, gender, YMRS scores (Z= -1,01, p= 0,313) and HAMD-17 (Z= -1,115 , p= 0,265) scores, bipolar diagnosis (X²= 0,83, p=0,565), and schooling (X²= 0,446, p= 0,931). Time to relapse, was the primary outcome measure. Survival analysis was carried out to evaluate the differences between groups.

Results: The CBT group presented a longer time to relapse which reached statistical significance after nine months (log rank = 4.73; p=0.03). This difference was sustained after one year of follow-up (log rank = 4.45; p= 0.035).

Conclusions: To our knowledge this is the first controlled group CBT study in Bipolar disorder. Our results are in accordance with the individual CBT studies which show an effectiveness of this intervention for relapse prevention.