Psychosocial Therapy Plus Maintenance Pharmacotherapy for Treating Bipolar Disorder
Psychosocial Therapy Plus Maintenance Pharmacotherapy for Treating Bipolar Disorder
This study will evaluate the effectiveness of interpersonal and social rhythm therapy (IPSRT)
 versus clinical status and symptom response therapy (CSSRT) in reinforcing the treatment of
 bipolar disorder in individuals who are currently undergoing medication treatment for the
 disorder.
Bipolar disorder is a serious medical illness that causes shifts in a person's mood, energy,
 and ability to function. These changes are drastic, and can result in damaged relationships,
 poor job or school performance, and suicide. Bipolar disorder is also known as
 manic-depressive disorder because it is characterized by episodes of mania and depression.
 Some signs and symptoms of a manic episode include the following: increased energy, activity,
 and restlessness; excessively "high," overly good mood; and extreme irritability. Some signs
 and symptoms of a depressive episode include the following: sad, anxious, or empty mood;
 feelings of hopelessness or pessimism; and feelings of guilt, worthlessness, or helplessness.
 Bipolar disorder is most effectively treated using a strategy that combines medication and
 psychosocial treatment. This study will evaluate the effectiveness of IPSRT versus CSSRT in
 reinforcing the treatment of bipolar disorder in individuals who are currently undergoing
 maintenance medication treatment for the disorder.

 Participants in this open-label study will be randomly assigned to one of two treatment
 strategies: IPSRT or CSSRT. All participants will attend study visits once a week until they
 have been stable for 4 weeks (acute phase). At this point, they will attend study visits
 every other week for 12 weeks (continuation phase), and then once a month for 18 months or
 until another depressive or mixed episode occurs (maintenance phase). Participants who
 experience a recurrence will be treated with medication and the type of therapy they were
 assigned upon study entry (IPSRT or CSSRT). These participants will continue to be followed
 for a period of time equivalent to their remainder of time in the study had they not
 experienced a recurrence. Outcomes will be measured at Week 12 of the continuation phase and
 Week 18 of the maintenance phase.
Inclusion Criteria:

 -  Diagnosis of bipolar disorder

 -  Currently in the third episode of mania or major depression

 -  History of one other episode of major depression within 5 years prior to study entry

 Exclusion Criteria:

 -  Currently in the first episode of mania or schizo-affective disorder (manic type)

 -  Rapid cycling drug or alcohol abuse

 -  Unstable medical illness

 -  Pregnant

 -  Index episode caused by medically prescribed drugs