Psychosocial Interventions for Bipolar Disorder and Coping Style Modification: Similar Clinical Outcomes, Similar Mechanisms?

Author:

Parikh Sagar V1,Hawke Lisa D2,Zaretsky Ari3,Beaulieu Serge4,Patelis-Siotis Irene5,MacQueen Glenda6,Young L Trevor7,Yatham Lakshmi8,Velyvis Vytas9,Bélanger Claude10,Poirier Nancy11,Enright Jean12,Cervantes Pablo13

Affiliation:

1. Deputy Psychiatrist-in-Chief, University Health Network, Toronto, Ontario; Professor of Psychiatry, University of Toronto, Toronto, Ontario

2. Postdoctoral Research Fellow, University of Toronto, Toronto, Ontario; Postdoctoral Research Fellow, University Health Network, Toronto, Ontario

3. Psychiatrist-in-Chief, Sunnybrook Health Sciences Centre, Toronto, Ontario; Associate Professor of Psychiatry, University of Toronto, Toronto, Ontario

4. Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Medical Chief, Mood, Anxiety and Impulsivity Disorders Program, Douglas Mental Health University Institute, Montreal, Quebec

5. Associate Professor, McMaster University, Hamilton, Ontario; Psychiatrist, Mood Disorders Program, St Joseph's Healthcare, Hamilton, Ontario

6. Vice Dean, Faculty of Medicine, University of Calgary, Calgary, Alberta

7. Professor of Psychiatry, University of Toronto, Toronto, Ontario

8. Professor of Psychiatry, University of British Columbia, Vancouver, British Columbia

9. Student, York University, Toronto, Ontario; Lecturer, Adler International Learning, Toronto, Ontario

10. Professor of Psychology, Université du Québec à Montréal, Montreal, Quebec

11. Psychologist, Douglas Mental Health University Institute, Montreal, Quebec

12. Case Manager, Clinical-Administrative Professional Coordinator, McGill University Health Centre, Montreal, Quebec

13. Psychiatrist, McGill University, Montreal, Quebec

Abstract

Objective: To investigate changes in the use of coping styles in response to early symptoms of mania in cognitive-behavioural therapy (CBT), compared with psychoeducation, for bipolar disorder. Method: Data were drawn from a randomized controlled trial comparing CBT and psychoeducation. A subsample of 119 participants completed the Coping Inventory for the Prodromes of Mania and symptom assessments before treatment and 72 weeks later. Results: Both CBT and psychoeducation were associated with similar improvements in symptom burden. Both treatments also produced equivalent improvements in stimulation reduction and problem-directed coping styles, but no statistically significant change on the endorsement of help-seeking behaviours. A treatment interaction showed that a reduction in denial and blame was present only in the CBT treatment condition. Conclusions: CBT and psychoeducation have similar impacts on coping styles for the prodromes of mania. The exception to this is denial and blame, which is positively impacted only by CBT but which does not translate into improved outcome. Given the similar change in coping styles and mood burden, teaching patients about how to cope in adaptive ways with the symptoms of mania may be a shared mechanism of change for CBT and psychoeducation.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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