Search

Affective mixed states in bipolar disorders are a current matter of scientific debate and represent a complex clinical picture with coexisting manic and depressive symptoms. Treatment of mixed states is regarded as an important challenge. As diagnostic uncertainties complicate systematic clinical evaluations of this patient group, generally accepted clinical treatment guidelines are lacking yet. In this review the significance as well as the problems and risks of new treatment options are discussed.

The controlled study presented here was designed to examine the influence of the degree of structure of a coping-orientated therapy, the changes between the beginning and the end of therapy concerning satisfaction with therapy, psychopathology, attitude towards medication, coping behaviour and social variables, the effects on the days of hospitalisation within one year after the end of treatment and the relevant variables to predict the outcome twelve months later. It could be shown that patients in a relatively unstructured supportive group therapy wished to discuss topics that are very similar to those of coping-orientated therapy, that coping-orientated therapy results especially in an increase in knowledge about illness and treatment and that the therapeutic outcome after a one-year period can best be predicted by the degree of active coping strategies, social adaptation, trust in medication and cognitive variables.