Is Cognitive-Behavioural Therapy More Effective Than Psychoeducation in Bipolar Disorder?
Bibliographic record
Abstract
Objective: Psychosocial research in bipolar disorder (BD) has not yet assessed the relative benefits of a short course of psychoeducation (PE), compared with a longer course of cognitive-behavioural therapy (CBT) containing psychoeducational principles. This pilot study evaluated the efficacy and added benefit of adding a course of CBT to a standard course of brief PE, as maintenance therapy for BD. Method: Seventy-nine consenting adult men and women with BD on stable medication regimens, who were in full or partial remission from an index episode (BD I = 52; BD II = 27), were randomized to receive either 7 sessions of individual PE, or 7 sessions of PE followed by 13 additional individual sessions of CBT. Weekly mood and medication adherence was rated using the National Institute of Mental Health's Life Chart Method, while psychosocial functioning and mental health use were assessed monthly. Results: Forty-six participants completed the entire study. Participants who received CBT in addition to PE experienced 50% fewer days of depressed mood over the course of one year. Participants who received PE alone had more antidepressant increases compared with those who received CBT. There were no group differences in hospitalization rates, medication adherence, psychosocial functioning, or mental health use. Conclusions: Pilot data from this real-world study suggest that even after medication treatment has been optimized, a longer course of adjunctive CBT may offer some additional benefits over a shorter course of PE alone for the maintenance treatment of BD. Larger randomized controlled trials with equal treatment lengths are indicated. Objectif: La recherche psychosociale dans le trouble bipolaire (TB) n'a pas encore évalué les avantages relatifs d'un traitement abrégé de psychoéducation (PE), comparé à un traitement plus long de thérapie cognitivo-comportementale (TCC) contenant des principes psychoéducationnels. Cette étude pilote a évalué l'efficacité et l'avantage supplémentaire d'ajouter un traitement de TCC à un traitement standard de PE abrégé, comme traitement d'entretien du TB. Méthode: Soixante dix-neuf adultes, hommes et femmes, souffrant de TB et prenant des régimes de médicaments stables, qui étaient en rémission totale ou partielle d'un épisode indice (TB I = 52; TB II = 27), ont été randomisés pour recevoir soit 6 séances de PE individuelle, soit 6 séances de PE suivies de 14 séances individuelles additionnelles de TCC. L'humeur et l'observance de la médication étaient cotées une fois la semaine à l'aide de la Life Chart Method du National Institute of Mental Health, tandis que le fonctionnement psychosocial et l'usage des services de santé mentale étaient évalués une fois par mois. Résultats: Quarante-six participants ont terminé l'étude au complet. Les participants qui ont reçu la TCC en plus de la PE ont eu 50 % moins de journées d'humeur déprimée sur un an. Les participants qui ont reçu la PE seulement avaient plus d'augmentations d'antidépresseurs que ceux ayant reçu la TCC. Il n'y avait pas de différences entre les groupes en ce qui concerne les taux d'hospitalisation, l'observance des médicaments, le fonctionnement psychosocial ou l'usage des services de santé mentale. Conclusions: Les données pilotes de cette étude de monde réel suggèrent que même après que la médication est optimisée, un traitement plus long de TCC adjointe peut offrir certains avantages additionnels à un traitement abrégé de PE pour le traitement d'entretien du TB. Des essais randomisés contrôlés plus vastes avec des traitements d'égale longueur sont indiqués.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".