Predominant polarity as a potential moderator of group CBT outcomes in bipolar disorder: an exploratory post-hoc analysis

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Introduction Bipolar disorder (BD) is a chronic and severe mood disorder, characterized by recurrent episodes of mania, hypomania, and depression. Adjacent to pharmacotherapy, positive evidence has been found for the benefit of adding cognitive behavioral therapy (CBT), family-focused therapy (FFT), interpersonal and social-rhythm therapy (IPSRT) and Group Psychoeducation for treating BD. Objective CBT is well established as a form of psychotherapy for bipolar disorders, although variables that may affect its results are still poorly studied. The present study aimed to investigate Predominant Polarity (PP) as a possible moderator of response to group CBT for BD. Methods The original controlled study included 50 bipolar patients, divided into two groups: one was maintained on treatment as usual (TAU) solely, and a second group was assigned to 18 weekly group CBT sessions as an add-on treatment to TAU. A 16-month follow-up was conducted after the sessions, as patients were evaluated by phone by two psychiatrists, blind to the patients’ condition. We have conducted a post-hoc analysis including solely individuals assigned to group CBT, dividing patients according to predominant manic or depressive polarity. Results Log-rank survival analysis revealed manic predominant polarity patients as maintaining an episode-free status for a longer amount of time in comparison to depressive predominant polarity patients. Conclusion The results suggest predominant polarity may be an important moderator of CBT response in BD. Further studies should include larger samples.

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