Psychotherapies for comorbid anxiety in bipolar spectrum disorders.
Study Goal
The researchers aimed to review the literature on psychological treatments, including mindfulness-based cognitive-behavioral therapy, for anxiety comorbid with bipolar disorder.
Results Summary
Preliminary results suggest mindfulness-based cognitive-behavioral therapy can effectively treat comorbid anxiety in bipolar patients, though long-term benefits may require adaptations. Other therapies like interpersonal or family therapy were not beneficial for anxiety.
Population
Patients with bipolar disorder and comorbid anxiety disorders.
Effective Dosage
Not available
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
cognitive-behavioral therapy | decrease | comorbid anxiety disorders | a bipolar clientele | - | can be effectively treated | #1 |
mindfulness-based cognitive-behavioral therapy | decrease | comorbid anxiety disorders | a bipolar clientele | - | can be effectively treated | #2 |
relaxation training | decrease | comorbid anxiety disorders | a bipolar clientele | - | can be effectively treated | #3 |
interpersonal therapy | no change | anxiety | - | - | would not seem to be beneficial | #4 |
family therapy | no change | anxiety | - | - | would not seem to be beneficial | #5 |
psychoeducation alone | no change | anxiety | - | - | would not seem to be beneficial | #6 |
Cognitive-behavioral therapy | decrease | symptoms of obsessive-compulsive disorder | patients with bipolar disorder | - | appears to reduce | #7 |
Cognitive-behavioral therapy | decrease | symptoms of generalized anxiety disorder | patients with bipolar disorder | - | appears to reduce | #8 |
Cognitive-behavioral therapy | decrease | symptoms of panic disorder | patients with bipolar disorder | - | appears to reduce | #9 |
Cognitive-behavioral therapy | decrease | symptoms of post-traumatic stress disorder | patients with bipolar disorder | - | appears to reduce | #10 |
Cognitive-behavioral therapy | decrease | general symptoms of anxiety | patients with bipolar disorder | - | appears to reduce | #11 |
- | decrease | long-term maintenance of anxiety treatment effects | - | - | may be somewhat reduced | #12 |
BACKGROUND: Comorbid anxiety disorders are highly prevalent in bipolar disorder and have been shown to have serious negative impacts on the course of illness. The pharmacological treatment of anxiety can interact with the bipolar disorder and has not been proven effective. As such, many have recommended the psychological treatment of anxiety. This paper reviews the literature on psychological treatments for anxiety comorbid to bipolar disorder. METHOD: The Medline, PsychInfo and Web of Science databases were thoroughly examined for relevant treatment studies. RESULTS: Despite frequent recommendations in the literature, surprisingly few have studied the psychological treatment of comorbid anxiety in bipolar disorders. Nevertheless, preliminary results suggest that comorbid anxiety disorders can be effectively treated in a bipolar clientele using cognitive-behavioral therapy, mindfulness-based cognitive-behavioral therapy or relaxation training. In contrast, interpersonal, family therapy and psychoeducation alone would not seem to be beneficial treatment alternatives for anxiety. Cognitive-behavioral therapy appears to reduce the symptoms of obsessive-compulsive disorder, generalized anxiety disorder, panic disorder, post-traumatic stress disorder and general symptoms of anxiety among patients with bipolar disorder. However, the long-term maintenance of anxiety treatment effects may be somewhat reduced and adaptations may be called for to augment and sustain benefits. CONCLUSIONS: There is an urgent need for randomized controlled trials of different forms of psychotherapy for anxiety disorders comorbid to bipolar disorder. Until such trials are available, the most promising approach would appear to be the sequential or modular CBT-based treatment of the anxiety disorder.