Various therapies have been recognized as adjuncts to pharmacotherapy for bipolar disorder patients. However, their efficacy has not been well studied. This study aims to evaluate how using manualized psychotherapies and therapy components can reduce the recurrences of symptoms in patients with bipolar disorder.

This systematic review and network meta-analysis consisted of 39 randomized clinical trials that compared pharmacotherapy plus manualized psychotherapy with pharmacotherapy plus a control intervention in patients with bipolar disorder. A total of 3,863 participants were identified. The researchers compared binary outcomes across different treatments using odds ratios, along with standardized mean differences (SMDs). The primary outcome of the study was illness recurrence, along with depressive and manic symptoms at 12 months.

The findings suggested that manualized treatments were associated with a lower incidence of illness recurrence than control treatments. In addition, psychoeducation with the guided practice for illness management was also associated with reduced recurrences. Cognitive-behavioral therapy, interpersonal therapy, and conjoint therapy led to the stabilization of depressive symptoms compared with standard treatment. The researchers also discovered a positive association between conjoint therapy and study retention.

The research concluded that skill-based psychosocial interventions combined with pharmacotherapy were associated with reduced illness recurrences in patients with bipolar disorder.