Abstract
BackgroundBipolar disorder (BD) is one of the most burdensome mental disorder, with a lifetime prevalence of 2.4%, with a prevalence of 0.6% for bipolar type I and 0.4% for bipolar type II. Several interventions have been developed to implement the treatment strategy of bipolar disorder, including the Interpersonal and Social Rhythm Therapy (IPSRT). This intervention has been specifically developed to manage patients’ stressful life events, improve the disruptions of social and circadian rhythms and increase adherence to medications. The aim of the present study is to assess the efficacy of IPSRT on affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI) in BD patients.MethodsBD patients were consecutively recruited at the Mood Disorder Unit of the University of Campania “Luigi Vanvitelli” and randomly assigned to the experimental group receiving the IPSRT or to the Treatment as Usual (TAU) group. Patients were assessed at baseline, after 3 and 6 months with several validated assessment tools and with the affective morbidity index.ResultsAt the end of the intervention, compared to controls, patients from the experimental group reported a significant improvement in anxious depressive and manic symptomatology, global functioning; and response to mood stabilizers. Patients in the IPSRT group reported a reduction at the AMI score.ConclusionsIPSRT has been confirmed to be effective in improving the clinical symptomology of BD patients and in improving the affective morbidity index. Further studies with longer follow-up are needed in order to assess the stability of the results.Trial registration The study was approved by the local ethical review board (N001567/28.01.2018)
Highlights
Bipolar disorder is one of the most burdensome mental disorder, with a lifetime prevalence of 2.4%, and a prevalence of 0.6% for bipolar I and 0.4% for bipolar II subtypes [1]
We evaluated the efficacy of Interpersonal and Social Rhythm Therapy (IPSRT) in terms of reduction of levels of patients’ affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI), compared to a group of patients receiving standard care
Patients were included in the study if they met the following criteria: (1) age between 18 and 70 years; (2) a DSM-5 diagnosis of type-I or type-II bipolar disorder, confirmed through Structured Clinical Interview for DSM-5 disorders, clinician version—SCID-5-CV [27]; (3) stable treatment with mood stabilizers; (4) willingness to participate in the study, expressed by written informed consent provided upon complete description of the protocol
Summary
Bipolar disorder is one of the most burdensome mental disorder, with a lifetime prevalence of 2.4%, and a prevalence of 0.6% for bipolar I and 0.4% for bipolar II subtypes [1] It poses a significant burden on patients, their relatives and the society at large. Several international guidelines [13,14,15,16] recommend their use as adjunctive interventions to pharmacological treatment for the long-term management of bipolar disorder in both the acute and maintenance phases [17, 18] These different approaches share several aims, including: (1) the improvement of sleep disturbances; (2) the promotion of healthy lifestyle behaviors; (3) the monitoring of mood shifts; (4) the early recognition of patients’ warning signs; (5) the improvement of problem-oriented coping strategies [19]. The aim of the present study is to assess the efficacy of IPSRT on affective and anxiety psychopathology, social functioning, response to pharmacological treatment and affective morbidity index (AMI) in BD patients
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