Bipolar Disorder

The essential characteristic of bipolar I disorder is the existence of at least one lifetime manic episodes. Mania is diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a detach period of abnormally and persistently excited or irritable mood that lasts at least 1 week .According to the DSM, mood changes come with by at least 3 or 4  of the following symptoms: excessively confident self-esteem, racing thoughts, distractibility, too much participation in gratifying activities that can result in negative consequences, extreme chattiness, lessen need for sleep, and increases in goal-directed activities. DSM criterion specify that the symptoms lead to clear impairment. The DSM includes several milder forms of bipolar disorder, including bipolar II disorder and cyclothymia, but psychological treatment research has paying attention on bipolar I disorder.


Although bipolar I disorder is defined by at least one lifetime episode of mania, at least two-thirds of diagnosed persons report a history of major depressive episodes (Karkowski & Kendler, 1997; Kessler, Rubinow, Holmes, Abelson, & Zhao, 1997; Weissman & Myers, 1978). Longitudinal data suggests that subsyndromal symptoms are present during at least 47% of weeks among persons with bipolar I disorder, and that subsyndromal depressive symptoms are particularly common (Judd et al, 2002). Given these symptom patterns, there is a need for psychosocial treatments that can provide aid to mania as well as treatments that can grant relief for depression.
Treatment outcomes for mania and depression are examined one by one. It is worth noting that some trials provided evidence that treatments could produce better medication adherence, lower relapse rates, or improvements in social domains, but did not measure or obtain effects specifically for mania versus depression (Cochran, 1984; van Gent & Zwart, 1991; Fristad et al., 2003; Volkmar et al., 1981).

Psychological Treatments

Treatment	Research Support for Mania	Research Support for Depression
Psychoeducation	Strong	Modest
Systematic Care	Strong	No
Cognitive Therapy (CT)	Modest	Modest
Family-Focused Therapy (FFT)	No	Strong
Interpersonal and Social Rhythm Therapy (IPSRT)	No	Modest