A pilot study of mindfulness-based cognitive therapy for bipolar disorder

Abstract

Background: Increasingly, bipolar disorder is being treated with maintenance combinations of medication and psychotherapy. We examined the feasibility and benefits associated with an 8-week mindfulness-based cognitive therapy (MBCT) class for bipolar patients who were between episodes. Participants (N = 22; mean age, 40.6 yrs; 14 bipolar I, 8 bipolar II) were existing patients in outpatient clinics at Oxford University (n = 14) or the University of Colorado, Boulder (n = 8), most undergoing pharmacotherapy with mood stabilizers and/or atypical antipsychotic agents. Patients underwent a pretreatment assessment of symptoms and then received the 8-week MBCT in four separate groups, two at each site. MBCT consisted of mindfulness meditation strategies and traditional cognitive-behavioral techniques to address the mode in which negative thoughts and feelings and emerging manic symptoms are processed. We examined within-group changes from pre-to posttreatment in the four aggregated groups. Of the 22 patients, 16 (72.7%) completed the groups. Reductions were observed in depressive symptoms and suicidal ideation, and to a lesser extent, manic symptoms and anxiety. A case study illustrating the effects of MBCT is given. In conclusion, MBCT is a promising treatment alternative for bipolar disorder, particularly for managing subsyndromal depressive symptoms. There is a need for larger-scale randomized trials that examine the cost-effectiveness and relapse-prevention potential of this modality.