Bipolar Disorders Research Program, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
Psychother Psychosom. 2011;80(3):144-50. doi: 10.1159/000320738. Epub 2011 Mar 3.
This study evaluated the effectiveness of adjunctive cognitive behavioral group therapy (CBGT) to prevent recurrence of episodes in euthymic patients with bipolar disorder.
A randomized controlled single-blind trial was conducted with 50 patients with bipolar disorder types I and II followed up for at least 12 months in an outpatient service and whose disease was in remission. An experimental CBGT manual was developed and added to treatment as usual (TAU), and results were compared with TAU alone.
Intention-to-treat analysis showed that there was no difference between groups in terms of time until any relapse (Wilcoxon = 0.667; p = 0.414). When considering type of relapse, there was still no difference in either depressive (Wilcoxon = 3.328; p = 0.068) or manic episodes (Wilcoxon = 1.498; p = 0.221). Although occurrence of episodes also did not differ between groups (χ(2) = 0.28; p = 0.59), median time to relapse was longer for patients treated with CBGT compared to TAU (Mann-Whitney = -2.554; p = 0.011).
Time to recurrence and number of episodes were not different in the group of patients treated with CBGT. However, median time to relapse was shorter in the TAU group. Studies with larger samples may help to clarify whether our CBGT approach prevents new episodes of bipolar disorder. Our findings also indicated that CBGT is feasible in euthymic patients with bipolar disorder and should be investigated in future studies. To our knowledge, this is the first publication of a controlled trial of CBGT for euthymic patients with bipolar disorder.
本研究评估了辅助认知行为团体治疗（CBGT）对预防双相情感障碍缓解期患者发作复发的有效性。
采用随机对照单盲试验，对 50 例 I 型和 II 型双相情感障碍患者进行研究，这些患者在门诊接受至少 12 个月的随访，且疾病处于缓解期。制定了实验性 CBGT 手册，并将其添加到常规治疗（TAU）中，将结果与单独 TAU 进行比较。
意向治疗分析显示，两组在任何复发时间方面无差异（Wilcoxon = 0.667；p = 0.414）。当考虑复发类型时，抑郁发作（Wilcoxon = 3.328；p = 0.068）或躁狂发作（Wilcoxon = 1.498；p = 0.221）也无差异。尽管两组之间发作次数也无差异（χ²= 0.28；p = 0.59），但接受 CBGT 治疗的患者复发时间中位数长于接受 TAU 治疗的患者（Mann-Whitney = -2.554；p = 0.011）。
接受 CBGT 治疗的患者复发时间和发作次数无差异。然而，TAU 组的复发时间中位数更短。更大样本量的研究可能有助于阐明我们的 CBGT 方法是否可以预防双相情感障碍的新发作。我们的研究结果还表明，CBGT 对双相情感障碍缓解期患者是可行的，应在未来的研究中进行探讨。据我们所知，这是第一篇关于 CBGT 治疗双相情感障碍缓解期患者的对照试验出版物。
