Magazine article Clinical Psychiatry News

Rhythm Therapy Can Stabilize Bipolar Patients. (Encourage Gradual Lifestyle Changes)

Magazine article Clinical Psychiatry News

Rhythm Therapy Can Stabilize Bipolar Patients. (Encourage Gradual Lifestyle Changes)

Article excerpt

PITTSBURGH -- Taking steps as simple as going to bed and waking up at consistent times each day helps some bipolar patients maintain mood stability, especially in the face of psychosocial stress.

Ellen Frank, Ph.D., described interpersonal and social rhythm therapy as "a disorder-specific adjunctive psychotherapy for patients with bipolar disorder" at the Fifth International Conference on Bipolar Disorder.

"At the system level, the fundamental dysregulation in bipolar disorder is a dysregulation in the circadian system," said Dr. Frank, professor of psychiatry and psychology at the University of Pittsburgh. That dysregulation can lead to the behavioral disturbances that are symptoms of bipolar disorder. Interpersonal Social Rhythm Therapy (IPSRT) focuses on mitigating the extent to which psychosocial stress can enhance the circadian dysregulation.

In a recent and ongoing study, Dr. Frank and her colleagues randomized 175 bipolar patients (76 men and 99 women) to receive either IPSRT plus pharmacotherapy or intensive clinical management and pharmacotherapy. The patients' mean age was 36 years, 90% were white, and 36% were married. They were well educated (mean 14.8 years). The researchers sought out patients experiencing recurrences--the average patient had been ill for 18 weeks, with four previous depressive episodes and three manic episodes. On average, the patients had their first depressive episode at 20 years old and their first manic episode at 23 years old.

Overall, both IPSRT and intensive clinical management protected patients from symptom recurrence. One of the most interesting findings was that those patients whose treatment was switched between the acute phase and maintenance phase of treatment were much more likely to recur compared with those who stayed in the same treatment group, Dr. Frank said at the meeting, which was sponsored by the University of Pittsburgh. …

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