Academic journal article International Journal of Yoga

Effectiveness of Mindfulness-Based Cognitive Therapy in Patients with Bipolar Affective Disorder: A Case Series

Academic journal article International Journal of Yoga

Effectiveness of Mindfulness-Based Cognitive Therapy in Patients with Bipolar Affective Disorder: A Case Series

Article excerpt

Byline: Suvarna. Joshi, Mahendra. Sharma, Shivarama. Varambally

The present investigation was undertaken to examine the effects of mindfulness-based cognitive therapy (MBCT) on interepisodic symptoms, emotional regulation, and quality of life in patients with bipolar affective disorder (BPAD) in remission. The sample for the study comprised a total of five patients with the diagnosis of BPAD in partial or complete remission. Each patient was screened to fit the inclusion and exclusion criteria and later assessed on the Beck Depressive Inventory I, Beck Anxiety Inventory, Difficulties in Emotion Regulation Scale, Acceptance and Action Questionnaire-II, and The World Health Organization Quality of Life Assessment-BREF. Following preassessments, patients underwent 8-10 weeks of MBCT. A single case design with pre- and post-intervention assessment was adopted to evaluate the changes. Improvement was observed in all five cases on the outcome variables. The details of the results are discussed in the context of the available literature. Implications, limitations, and ideas for future investigations are also discussed.

Introduction

Bipolar affective disorder (BPAD) is a chronic, severe mental disorder that usually lasts lifelong, with devastating consequences for the affected individuals and society. The deleterious effects of this condition impact various domains of one's life including social, occupational, economic, and interpersonal.[1],[2],[3] Although many patients with bipolar disorder are free of symptoms when in remission, a substantial number of them continue to experience mild clinical symptoms in the form of anxiety and depression and show functional impairments on psychosocial outcome variables.[4],[5],[6]

Psychosocial treatments have found to be important as adjuncts to medication in the treatment of BPAD to address maintaining factors and prevent relapse. These include psychoeducation, cognitive behavioral therapy, Interpersonal and Social Rhythm Therapy, and Family Focused Therapy.[7],[8],[9] Mindfulness-based cognitive therapy (MBCT) developed by Teasdale, Segal, and Williams is one of the new generation of cognitive behavioral therapies, which involves mindfulness-based interventions.[10],[11] A few studies have explored the feasibility and potential benefits of MBCT in patients with bipolar disorder and have reported positive effects on interepisodic functioning and reduction in the residual symptoms of depression and anxiety.[12],[13] Psychological benefits of mindfulness are thought to be in terms of better regulation of one's emotions and increased acceptance of one's life situations, resulting in enhanced quality of life. Hence, the present investigation was undertaken to examine the effects of MBCT on interepisodic symptoms, emotional regulation, and quality of life in patients with BPAD.

Settings and Design

A single case design with pre- and post-assessments was adopted for the study. Five patients with a diagnosis of BPAD, according to the International Classification of Diseases-10 criteria,[14] were recruited from the outpatient services of the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India. The research protocol was reviewed and approved by the protocol Review Committee of the Department of Clinical Psychology for technical and ethical purposes. Written Informed consent for participation was obtained from all of them. These patients were in partial remission and were stabilized on medication. The cutoff scores for inclusion were determined as 18 or less on the Beck Depression Inventory-I (BDI-I) and <4 on the Young Mania Rating Scale. Patients having a history suggestive of organicity, neurological disorders, comorbid personality disorders, and those having undergone any structured psychological intervention in the past 1 year were excluded from the study.

Tools

A sociodemographic and clinical data sheet were developed for the study to gather information about patients and their illness history. …

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