"Rhythm" Therapy Useful for Bipolar Disorder

NEW YORK (Reuters Health) - Interpersonal and social rhythm therapy appear to be a useful addition to drug therapy in the management of patients with bipolar disorder, also known as manic depression, researchers report in the Archives of General Psychiatry

"Our results suggest that a relatively short-term psychotherapy that focuses on leading a life characterized by regularity of routines -- especially a regular sleep-wake cycle -- can add significantly to the protective effect of medication," lead investigator Dr. Ellen Frank told Reuters Health.

Frank and colleagues at the University of Pittsburgh School of Medicine note that recent studies have suggested that psychoeducational or psychotherapeutic interventions may be useful in bipolar patients.

To investigate further, the researchers conducted a study of 175 patients, all of whom were receiving standard drug therapy. The subjects were randomly selected to receive rhythm therapy or participate in a clinical management program at the time of a disease flare-up.

Interpersonal and social rhythm therapy concentrated on factors such as the links between mood symptoms and quality of social relationships, as well as stressing the importance of daily routines.

The clinical management program included education about bipolar disorder and treatment and a careful review of symptoms and medication effects, as well as non-specific support.

Following stabilization, the patients went on to a 2-year preventative maintenance phase at the start of which they were randomly selected to continue with their initial protocol or switched to the alternative method.

The researchers saw no difference between treatment strategies in the time it took for patients to reach stabilization. However, those assigned to the rhythm therapy group during the flare-up phase went significantly longer without a new manic or depressive episode.

These patients were also more likely to remain well for the full 2 years of the maintenance phase. This effect, say the researchers, "appeared to be mediated by the substantially increased regularity of social routines."

SOURCE: Archives of General Psychiatry, September 2005.