Effect of Cognitive Behavioral Therapy on Reducing Symptoms and Modifying Dysfunctional Attitudes in Patients with Type I and II Bipolar Disorder

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Clinical Psychology, Isfahan (Khourasgan) Branch, Islamic Azad University, Isfahan, Iran

2 Associate Professor, Behavioral Sciences Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The effect of mood disorders on cognitive and metacognitive processes and large association of dysfunctional attitudes with longer periods of bouts of depression is proven. This study aimed to evaluate the effect of cognitive behavioral therapy on reducing symptoms and adjusting dysfunctional attitudes in patients with bipolar disorder, in order to reach an adjuvant treatment for medical treatments in such patients.Methods: In this quasi-experimental study with pretest, posttest and control group, 30 patients, 10 men and 20 women, selected through convenience sampling from psychiatric clinics in Isfahan, Iran. They were diagnosed to have bipolar disorder (types I or II), according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), received standard medical treatment with mood stabilizers and were randomly put in two groups. Test group received medical treatment along with cognitive-behavioral therapy (10 individual sessions) and the control group received only medical treatment. Young’s mania rating scale (YMRS), bipolar depression rating scale (BDRS) and dysfunctional attitudes scale (DAS) were used before and right after the termination of treatment. Data were analyzed using multivariate analysis of variance and covariance test.Findings: Controlling the covariate variables, differences between the medians of test and control groups for all three variables of symptoms of mania, depression and adjustment of dysfunctional attitudes were significant (P < 0.01 for all).Conclusion: Cognitive-behavioral therapy as an adjuvant psychological treatment can be effective in reducing symptoms and adjusting dysfunctional attitudes in patients with bipolar disorder. Therefore, providing regular protocols of cognitive behavioral therapy and adding them to medical treatment of these patients and also comparing the effect of this therapy and other psychological treatments is suggested for future studies.

Keywords

References

  1. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 9th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2003.
  2. Brissos S, Dias VV, Kapczinski F. Cognitive performance and quality of life in bipolar disorder. Can J Psychiatry 2008; 53(8): 517-24.
  3. Rashedi E, Sohrabi F, Shams J. A study of the efficacy of cognitive behavior therapy in relapse prevention of bipolar disorder. Iran J Psychiatry Clin Psychol 2011; 2(5): 49-64. [In Persian].
  4. Harrow M, Goldberg JF, Grossman LS, Meltzer HY. Outcome in manic disorders. A naturalistic follow-up study. Arch Gen Psychiatry 1990; 47(7): 665-71.
  5. Gitlin MJ, Swendsen J, Heller TL, Hammen C. Relapse and impairment in bipolar disorder. Am J Psychiatry 1995; 152(11): 1635-40.
  6. Goldberg JF, Harrow M. Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis. J Affect Disord 2005; 89(1-3): 79-89.
  7. Michalak EE, Yatham LN, Lam RW. Quality of life in bipolar disorder: a review of the literature. Health Qual Life Outcomes 2005; 3: 72.
  8. de Andres RD, Aillon N, Bardiot MC, Bourgeois P, Mertel S, Nerfin F, et al. Impact of the life goals group therapy program for bipolar patients: an open study. J Affect Disord 2006; 93(1-3): 253-7.
  9. Hawke LD, Provencher MD. Early Maladaptive Schemas among patients diagnosed with bipolar disorder. J Affect Disord 2012; 136(3): 803-11.
  10. Zaretsky A. Targeted psychosocial interventions for bipolar disorder. Bipolar Disord 2003; 5(Suppl 2): 80-7.
  11. Patelis-Siotis I, Young LT, Robb JC, Marriott M, Bieling PJ, Cox LC, et al. Group cognitive behavioral therapy for bipolar disorder: a feasibility and effectiveness study. J Affect Disord 2001; 65(2): 145-53.
  12. Lam DH, Jones SH, Hayward P, Bright JA. Cognitive therapy for bipolar disorder: A therapist's guide to concepts, methods and practice. London, UK: Wiley; 1999. p. 324.
  13. Ebrahimi A, Neshatdoost HT, Kalantari M, Molavi H, Asadollahi GH. Contributions of dysfunctional attitude scale and general health subscales to prediction and odds ratio of depression. J Shahrekord Univ Med Sci 2008; 9 (4): 52-8. [In Persian].
  14. Hawton K, Salkovskis PM, Kirk J, Clark DM. Cognitive behaviour therapy for psychiatric problems: A practical guide. Oxford, UK: Oxford University Press; 1989.
  15. Leahy RL. Cognitive therapy techniques: A practitioner's guide. New York, NY: Guilford Press; 2003.
  16. Baratian H, Barekatain M, Molavi H, Mosavi N. A six months follow up of symptom severity and quality of life in bipolar I patients after discharge. J Res Behav Sci 2013; 11(1): 10-7. [In Persian].
  17. Ebrahimi A, Barekatain M, Bornamanesh A, Nassiri H. Psychometric properties of the Persian version of Bipolar Depression Rating Scale (BDRS) in patients and general population. Iran J Psychiatry Clin Psychol 2015; 21(1): 60-8. [In Persian].
  18. Berk M, Malhi GS, Cahill C, Carman AC, Hadzi-Pavlovic D, Hawkins MT, et al. The bipolar depression rating scale (BDRS): Its development, validation and utility. Bipolar Disord 2007; 9(6): 571-9.
  19. Shabani A, Akbari M, Dadashi M. Reliability and validity of the Bipolar Depression Rating Scale on an Iranian sample. Arch Iran Med 2010; 13(3): 217-22.
  20. Ebrahimi A, Moosavi SGh. Development and validation of the Dysfunctional Attitude Scale-26 items: factor structure, reliability and validity in psychiatric outpatients. J Ilam Univ Med Sci 2013; 21(5): 20-8. [In Persian].
  21. Gonzalez IA, Echeburua E, Liminana JM, Gonzalez-Pinto A. Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: a 5-year controlled clinical trial. Eur Psychiatry 2014; 29(3): 134-41.
  22. Masoudi Sh, Tabatabaei SM, Modarres Gharavi M, Ghanbari Hashemabadi BA. The effect of cognitive behavioral group therapy on bipolar disorder type I. J Fundam Ment Health 2009; 10(4): 289-98. [In Persian].
  23. Otto MW, Reilly-Harrington N, Sachs GS. Psychoeducational and cognitive-behavioral strategies in the management of bipolar disorder. J Affect Disord 2003; 73(1-2): 171-81.
  24. Kazemi H, Rasoulzade-Tabatabaei S.K, Dezhkam M, Azad-Fallah P, Momeni Kh. Comparison of cognitive analytic therapy, cognitive therapy and medication on emotional instability, impulsivity and social instability in bipolar II disorder. J Res Behav Sci 2011; 5(2): 91-9. [In Persian].
  25. Hojati H, Akhondzadeh G, Sharifnia H, Nazari R, Asaiesh H. Effect of cognitive -behavioral group therapy on mental health of patients with type I bipolar disorder. Iranian Journal of Health and Care 2000; 3(2): 25-32. [In Persian].
  26. Pourkamali T, Zargar, F. The comparison of medical therapy and cognitive behavior medical therapy on the memory positive bias of bipolar patients in Isfahan city. New Educational Approaches 2009; 4(2):11-20. [In Persian].
  27. Docteur A, Mirabel-Sarron C, Guelfi JD, Rouillon F, Gorwood P. The role of CBT in explicit memory bias in bipolar I patients. J Behav Ther Exp Psychiatry 2013; 44(3): 307-11.
Journal of Isfahan Medical School
Volume 33, Issue 358 - Serial Number 358
September and October 2016
Pages 1936-1942

Files

History

  • Receive Date: 08 July 2015
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics