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Psychosocial interventions for the prevention of relapse in bipolar disorder: systematic review of controlled trials

Centre for Reviews and Dissemination, University of York, York, UK

John R. Geddes, MD, FRCPsych

Department of Psychiatry, University of Oxford, Oxford, UK

Correspondence: Nerys Woolacott, Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK. Email: nw11{at}york.ac.uk

Declaration of interest

J.G. has received research funding from GlaxoSmithKline, Sanofi-Aventis, the UK Department of Health and Medical Research Council, the Stanley Medical Research Institute, and advisory committee payments from Bristol Myers Squibb.

Background

Pharmacological interventions alone do not provide sufficient benefit for some individuals with bipolar disorder.

Aims

To determine the effectiveness of psychosocial interventions for the prevention of relapse in bipolar disorder.

Method

A systematic review and meta-analysis of randomised or quasi-randomised controlled trials were conducted.

Results

Cognitive–behavioural therapy or group psychoeducation may be effective for relapse prevention in stable individuals. Family therapy was no more or less effective than individual psychosocial therapy or crisis management. There is no evidence that care management or integrated group therapy is effective in the prevention of relapse.

Conclusions

Cognitive–behavioural therapy, group psychoeducation and possibly family therapy may be beneficial as adjuncts to pharmacological maintenance treatments.

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