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Effectiveness of cognitive behavioral therapy in treating bipolar disorder: A n updated meta‐analysis with randomized controlled trials
Author(s) -
Ye BiYu,
Jiang ZeYu,
Li Xuan,
Cao Bo,
Cao LiPing,
Lin Yin,
Xu GuiYun,
Miao GuoDong
Publication year - 2016
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12399
Subject(s) - young mania rating scale , mania , bipolar disorder , randomized controlled trial , medicine , meta analysis , beck depression inventory , rating scale , hamilton rating scale for depression , confidence interval , psychology , cognitive behavioral therapy , subgroup analysis , psychiatry , major depressive disorder , cognition , anxiety , developmental psychology
Aim The aim of this updated meta‐analysis was to further assess the effectiveness of cognitive behavioral therapy ( CBT ) in treating bipolar disorder ( BD ). Methods We carried out a literature search on P ubMed, E mbase, and the C ochrane L ibrary up to O ctober 2015. We calculated the pooled relative risk of relapse rate and standard mean difference ( SMD ) of mean change (data at a follow‐up time‐point – baseline) of the Beck Depression Inventory, Beck Hopelessness Scale, Hamilton Rating Scale for Depression, Young Mania Rating Scale (YMRS) and Mania Rating Scale scores with their 95% confidence interval (95% CI ). Subgroup analyses based on follow‐up time were performed. Results Nine randomized controlled trials with 520 bipolar I or II disorder patients were reanalyzed. Overall analysis showed that CBT did not significantly reduce the relapse rate of BD or improve the level of depression. However, significant efficacy of CBT in improving severity of mania was proved based on the YMRS ( SMD = −0.54, 95% CI , −1.03 to −0.06, P = 0.03) but not based on MRS . Subgroup analyses showed that CBT had short‐term efficacy in reducing relapse rate of BD (at 6 months’ follow‐up: relative risk = 0.49, 95% CI : 0.29–0.81, P = 0.006) and improving severity of mania based on YMRS score (post‐treatment: SMD = −0.30, 95% CI , −0.59 to −0.01, P = 0.04). Conclusion Short‐term efficacy of CBT in reducing relapse rate of BD and improving the severity of mania was proved. But these effects could be weakened by time. In addition, there was no effect of CBT on level of depression in BD .