PMID- 25046246
OWN - NLM
STAT- MEDLINE
DCOM- 20160418
LR  - 20181202
IS  - 1399-5618 (Electronic)
IS  - 1398-5647 (Linking)
VI  - 17
IP  - 1
DP  - 2015 Feb
TI  - Combined treatment: impact of optimal psychotherapy and medication in bipolar 
      disorder.
PG  - 86-96
LID - 10.1111/bdi.12233 [doi]
AB  - OBJECTIVES: The current study investigated the longitudinal course of symptoms in 
      bipolar disorder among individuals receiving optimal treatment combining 
      pharmacotherapy and psychotherapy, as well as predictors of the course of 
      illness. METHODS: A total of 160 participants with bipolar disorder (bipolar I 
      disorder: n = 115; bipolar II disorder: n = 45) received regular pharmacological 
      treatment, complemented by a manualized, evidence-based psychosocial treatment - 
      that is, cognitive behavioral therapy or psychoeducation. Participants were 
      assessed at baseline and prospectively for 72 weeks using the Longitudinal 
      Interval Follow-up Evaluation (LIFE) scale scores for mania/hypomania and 
      depression, as well as comparison measures (clinicaltrials.gov identifier: 
      NCT00188838). RESULTS: Over a 72-week period, patients spent a clear majority 
      (about 65%) of time euthymic. Symptoms were experienced more than 50% of the time 
      by only a quarter of the sample. Depressive symptoms strongly dominated over 
      (hypo)manic symptoms, while subsyndromal symptoms were more common than full 
      diagnosable episodes for both polarities. Mixed symptoms were rare, but present 
      for a minority of participants. Individuals experienced approximately six 
      significant mood changes per year, with a full relapse on average every 
      7.5 months. Participants who had fewer depressive symptoms at intake, a later age 
      at onset, and no history of psychotic symptoms spent more weeks well over the 
      course of the study. CONCLUSIONS: Combined pharmacological and adjunctive 
      psychosocial treatments appeared to provide an improved course of illness 
      compared to the results of previous studies. Efforts to further improve the 
      course of illness beyond that provided by current optimal treatment regimens will 
      require a substantial focus on both subsyndromal and syndromal depressive 
      symptoms.
CI  - (c) 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Parikh, Sagar V
AU  - Parikh SV
AD  - University Health Network, Toronto, ON, Canada; Department of Psychiatry, 
      University of Toronto, Toronto, ON, Canada; Toronto Western Hospital, Toronto, 
      ON, Canada.
FAU - Hawke, Lisa D
AU  - Hawke LD
FAU - Velyvis, Vytas
AU  - Velyvis V
FAU - Zaretsky, Ari
AU  - Zaretsky A
FAU - Beaulieu, Serge
AU  - Beaulieu S
FAU - Patelis-Siotis, Irene
AU  - Patelis-Siotis I
FAU - MacQueen, Glenda
AU  - MacQueen G
FAU - Young, L Trevor
AU  - Young LT
FAU - Yatham, Lakshmi N
AU  - Yatham LN
FAU - Cervantes, Pablo
AU  - Cervantes P
LA  - eng
SI  - ClinicalTrials.gov/NCT00188838
GR  - MCT 55404/Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140721
PL  - Denmark
TA  - Bipolar Disord
JT  - Bipolar disorders
JID - 100883596
RN  - 0 (Psychotropic Drugs)
SB  - IM
MH  - Adult
MH  - *Bipolar Disorder/diagnosis/epidemiology/psychology/therapy
MH  - Canada/epidemiology
MH  - Cognitive Behavioral Therapy/*methods
MH  - Combined Modality Therapy
MH  - *Depression/diagnosis/therapy
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Psychiatric Status Rating Scales
MH  - Psychotropic Drugs/*therapeutic use
MH  - Socioeconomic Factors
OTO - NOTNLM
OT  - bipolar disorder
OT  - combined therapy
OT  - course of illness
OT  - depression
OT  - hypomania
OT  - mania
OT  - subsyndromal symptoms
EDAT- 2014/07/22 06:00
MHDA- 2016/04/19 06:00
CRDT- 2014/07/22 06:00
PHST- 2013/07/25 00:00 [received]
PHST- 2014/04/18 00:00 [accepted]
PHST- 2014/07/22 06:00 [entrez]
PHST- 2014/07/22 06:00 [pubmed]
PHST- 2016/04/19 06:00 [medline]
AID - 10.1111/bdi.12233 [doi]
PST - ppublish
SO  - Bipolar Disord. 2015 Feb;17(1):86-96. doi: 10.1111/bdi.12233. Epub 2014 Jul 21.