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Bipolar depression remains a therapeutic challenge, and manual-based psychotherapies may prove useful additions to the armamentarium. In this 1-year STEP-BD study, 293 bipolar depressed patients without mixed hypomania were randomized to receive one of four psychotherapies added to guideline-based pharmacotherapy with mood stabilizers, with or without antidepressants.
The experimental psychotherapies (≤30 sessions over 9 months) were cognitive-behavioral therapy; interpersonal and social rhythm therapy (IPSRT), which focuses on regular daily schedules and social zeitgebers; and family-focused therapy (FFT), which involves education, intervention for prodromal symptoms of relapse, family communication skills, and problem solving. The control …