Cognitive-Psychoeducative Therapy Compared to Bilbliotherapy in Bipolar Disorder: A Controlled Group Therapy Study

Background: There is evidence for the efficacy of cognitive behavioural therapy in addition to pharmacotherapy in patients with bipolar disorder. But until now, there is only a limited number of studies with therapy manuals in the German language. Patients and Methods: The efficacy of cognitive psychoeducative therapy (CPT) according to the manual of Schaub et al. [2004] versus bibliotherapy (BT) on the relapse rates in patients with bipolar disorder was evaluated in a controlled group therapy study. Results: 100 patients on prophylactic medication were treated over 14 weeks: 52 in the CPT group and 48 in the BT group. At the 12-month follow-up after start of treatment, the patients of the CPT group had a significantly better outcome in the Clinical Global Impression (CGI) scale than those in the BT group. There was a significant reduction in the overall number of episodes in both groups (but only for manic episodes in the BT group) and also in the number and duration of hospital admissions in the 12 months after start of treatment compared to the 12 months before. In both groups, there was a positive effect on illness concepts (Linden scale) and a reduction of disability (Sheehan scale). Conclusions: Both kinds of therapy were successful in relapse prevention of manic episodes; the CPT group also showed an inhibitory influence regarding depressive episodes, and CPT was generally more effective.