The Package of Care for Patients With Bipolar Depression

Although pharmacotherapy is the mainstay of the comprehensive program of medical care for themanagement of patients with bipolar disorder, the additional benefits of psychosocial interventionsfor the patient, family, and caregivers are now being recognized and increasingly adopted. Severalfacets of bipolar disorder can be addressed more effectively by instituting adjunctive psychosocial interventions.Recent clinical evidence indicates that combining pharmacotherapy with psychosocial interventions,which are tailored to patients’ individual needs, may decrease the risk of relapse, improvepatient adherence, and decrease the number and length of hospitalizations. A multidisciplinary approachmay also enhance long-term patient outcomes such as mood stability, enhanced occupationaland/or social functioning, and overall quality of life. Psychoeducation helps individuals become activeand informed participants in the management of their illness, promoting a collaborative relationshipbetween patients and their caregivers. However, psychosocial interventions are not useful for allpatients with bipolar illness and may be more useful in addressing some problems than others. Evidencewould suggest that psychosocial interventions, with continuing pharmacotherapy, are best usedas prophylaxis and during periods of remission to prevent further episodes. Further randomized, clinicaltrials will help to define which components of psychosocial intervention are most effective in patientswith bipolar disorder.