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Q In patients with bipolar disorder, is the addition of cognitive therapy to standard care cost effective?
Clinical impact ratings Psychiatry ★★★★★★☆
METHODS
Design:
randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with 30 months’ follow up.
Setting:
Maudsley and Bethlem NHS Trust, London, UK.
Patients:
103 outpatients who were 18–70 years of age (mean age 44 y, 56% women), had DSM-IV bipolar I disorder, relapsed frequently despite the use of mood stabilisers (ie, ⩾2 episodes in previous 2 y or ⩾3 episodes in 5 y), and did not currently fulfil criteria for a bipolar episode. Exclusion criteria: actively suicidal (Beck Depression Inventory suicide item scored 3) or met criteria for substance use disorder.
Intervention:
51 patients received cognitive therapy plus standard care, and 52 patients received standard care alone.
Outcomes:
number of bipolar free days. Costs related to cognitive therapy and contact with mental …
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