Two forms of psychotherapy, SEKT and FEST, were shown to be equally effective in preventing relapse in bipolar disorder, according to a new study.

Published in JAMA Psychiatry, a new randomized clinical trial and the A2 BipoLife Consortium provided insights into adjuvant psychotherapies for preventing relapse in bipolar disorder (BD) patients.

This large, observer-blind trial included 305 patients with euthymic bipolar disorder types 1 and 2, randomly assigned to one of two psychotherapy approaches: skill-oriented, material-based cognitive behavioral therapy (SEKT) or supportive, patient-centered, emotion-focused therapy (FEST). Over an 18-month period, participants received psychiatric care alongside 24 hours of group psychotherapy, delivered in four full-day sessions spread across five months. Independent clinicians, blinded to treatment type, conducted assessments using structured interviews and self-rating scales.

Both SEKT and FEST were found to be equally effective in preventing the recurrence of new affective episodes. The study did not find a significant difference in relapse rates between the two therapies, with 49% of SEKT participants and 46% of FEST participants experiencing a relapse. However, several factors influenced outcomes, including the type of bipolar disorder, comorbidities, session attendance, and the interaction between treatment type and bipolar disorder subtype.

Patients with bipolar disorder type 2 (BD 2) had the highest relapse rate (61%), particularly those treated with SEKT (70% relapse rate). This indicated that patients with BD 2 might require more specific and tailored therapeutic interventions.

The study highlighted the role of empathy, emotion verbalization, and support in preventing relapse among BD patients, suggesting that both structured cognitive behavioral approaches and supportive, emotion-focused therapies could be beneficial. However, the findings also emphasized the need for more targeted treatment strategies for BD 2 patients, who demonstrated a different relapse pattern compared to those with BD 1.

This trial provided data on the potential of intensive group psychotherapy formats in managing bipolar disorder. While both SEKT and FEST showed promise, the distinct needs of BD 2 patients called for further investigation and specialized therapeutic adaptations.

Conflict of interest disclosures can be found in the study.