Table 37Population and inclusion criteria for studies of CBT versus active comparators

Author, Year Single-Multisite Local/Continent Risk of Bias PMIDInterventionComparisonInclusion Criteria:

BD Type; Diagnostic

Criteria Current Episode
DemographicsKey Exclusions
Harvey, 2015221
Singlesite
United States
Moderate ROB

25622197
CBT for insomnia focusing on stimulus control, bed and sleep associations, regularizing sleep and wake times, sleep/circadian education, relaxing wind down, sleep-enhancing activities, and devising a wake-up routine. The module altered unhelpful beliefs about sleep, bedtime worry, rumination, and vigilance
-8 weekly 50-60 minute sessions with behavioral module
Psychoeducation sessions that provided information but no facilitation or plan for behavior change. Sessions focused on mood regulation, the etiology of bipolar disorders, symptoms, prodromes, medications, substance use, diet, physical activity, stress management, relaxation, and self-esteem and sleep in a social context

-8 weekly 50-60 minute sessions
BD-I ; DSM–IV–TR

No current bipolar episode (interepisode)
Mean Age 37 (18-62)
62% Female
64% White
N = 58
Substance Abuse;
Other Mental Health;
Neurological Disorders;
Pregnant/Nursing;
Labs/Other Conditions
Meyer, 2012217
Singlesite
Germany
Low ROB

22099722
CBT focused on understanding of BD, identifying early warning symptoms, strategies for management, communication and problem solving skills
-20 sessions over 9 months, 50-60 minutes each
Supportive Therapy: Client-centered focus; whatever problems the patient presented were dealt with by providing emotional support and general advice

-20 sessions over 9 months, 50-60 minutes each.
BD-I and BD-II; DSM-IV

Euthymic/Maintenance
Mean Age 44 (18-75)
50% Female
Race NR
N = 76
Schizoaffective;
Substance Abuse;
Other Mental Health;
Neurological Disorders;
Taking Other Medications
Parikh, 2012216
Multisite
Canada
Low ROB

22795205
CBT including psychoeducation, understanding of personal warning signs for onset and action plan, and cognitive restructuring of dysfunctional thoughts and assumptions
-20 individual 50-minute sessions
Group psychoeducation using Life Goals manual; focused on illness recognition, treatment approaches, and coping strategies and the creation of Personal Care Plan including action plan for both depression and mania

-6 sessions, 90 minutes each session
BD-I and BD-II DSM-IV

Euthymic/Maintenance
Mean Age 40.9 (18-64)
58% Female
Race NR
N = 204
First Manic Episode;
Substance Abuse;
Other Mental Health;
Neurological Disorders;
Labs/Other Conditions
Weiss, 2009214
Singlesite
United States
Low ROB

19573999
Integrated group CBT on the cognitive-behavioral relapse prevention model which focuses on the similarities between recovery and relapse processes in BD and substance abuse and their interaction

-12 weekly 60-minute sessions
Group Drug Therapy: Substance use disorders therapy sessions that focused on facilitating abstinence, encouraging mutual support, and teaching new ways to cope with substance-related problems

-12 weekly 60-minute sessions
BD-I, BD-II, and BD NOS DSM-IV

Non-manic
Mean Age 38 (18-58)
41% Female
92% White
N = 61
First Manic Episode;
Schizoaffective;
Other Mental Health;
Labs/Other Conditions
Weiss 2007213
Singlesite
United States
Moderate ROB

17202550
Integrated group CBT on cognitive-behavioral relapse prevention model which focuses on the similarities between recovery and relapse processes in BD and substance abuse and their interaction
-20 weekly 60-minute sessions
Group Drug Therapy: Focused on facilitating abstinence, encouraging mutual support, and teaching new ways to cope with substance-related problems

-20 weekly 60-minute sessions
BD-I, BD-II, and BD NOS; DSM-IV

Maintenance
Mean Age 41.9 (22-65)
52% Female
94% White
N = 62
First Manic Episode;
Schizoaffective;
Other Mental Health;
Labs/Other Conditions

BD=Bipolar Disorder; CBT=cognitive behavioral therapy; DSM= Diagnostic and Statistical Manual of Mental Disorders; N=number; NOS=Not Otherwise Specified; NR=not reported: ROB=risk of bias

From: Chapter 7, Psychosocial and Other Nondrug Treatments

Cover of Treatment for Bipolar Disorder in Adults: A Systematic Review
Treatment for Bipolar Disorder in Adults: A Systematic Review [Internet].
Comparative Effectiveness Review, No. 208.
Butler M, Urosevic S, Desai P, et al.

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