Few trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies.
To combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA).
Systematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF).
Carer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive–behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores.
Only interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required.
This project was funded by the National Health and Medical Research Council (NHMRC grant APP1041131); E.S. and C.M. are supported by NHMRC Early Career Fellowships (1104600 and 1035887 respectively) and M.B. is supported by a NHMRC Senior Principal Research Fellowship1059660. The views expressed in this paper are solely those of the authors and do not reflect the views of the NHMRC. The funder of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.
- © The Royal College of Psychiatrists 2017.
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