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Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis

  • Matthijs Oud (a1), Evan Mayo-Wilson (a2), Ruth Braidwood (a3), Peter Schulte (a4), Steven H. Jones (a5), Richard Morriss (a6), Ralph Kupka (a7), Pim Cuijpers (a8) and Tim Kendall (a9)...

Psychological interventions may be beneficial in bipolar disorder.


To evaluate the efficacy of psychological interventions for adults with bipolar disorder.


A systematic review of randomised controlled trials was conducted. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE method.


We included 55 trials with 6010 participants. Moderate-quality evidence associated individual psychological interventions with reduced relapses at post-treatment (risk ratio (RR) = 0.66, 95% CI 0.48–0.92) and follow-up (RR = 0.74, 95% CI 0.63–0.87), and collaborative care with a reduction in hospital admissions (RR =0.68, 95% CI 0.49–0.94). Low-quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psychoeducation with reduced symptoms of depression and mania.


There is evidence that psychological interventions are effective for people with bipolar disorder. Much of the evidence was of low or very low quality thereby limiting our conclusions. Further research should identify the most effective (and cost-effective) interventions for each phase of this disorder.

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Corresponding author
Matthijs Oud, Trimbos Institute, Department of Care Innovation, Da Costakade 45, 3521 VS, Utrecht, The Netherlands. Email:
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The National Collaborating Centre for Mental Health (NCCMH) receives £1.4 million per year from the National Institute for Health and Care Excellence (NICE) to develop guidelines for the treatment of mental health problems. Trimbos Institute received €242 562 from the Netherlands Psychiatric Association (NVvP) to develop the Guideline for the Diagnosis and Treatment of Bipolar Disorder. The views of the authors expressed in this paper do not necessarily reflect the views of NICE, NCCMH, the Royal College of Psychiatrists, Trimbos Institute or NVvP.

Declaration of interest

R.M. and S.H.J. are authors of three included studies.

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Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis

  • Matthijs Oud (a1), Evan Mayo-Wilson (a2), Ruth Braidwood (a3), Peter Schulte (a4), Steven H. Jones (a5), Richard Morriss (a6), Ralph Kupka (a7), Pim Cuijpers (a8) and Tim Kendall (a9)...
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