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Background Psychological interventions may be beneficial in bipolar disorder. Aims To evaluate the efficacy of psychological interventions for adults with bipolar disorder. Method A systematic review of randomised controlled trials was conducted. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE method. Results We included 55 trials with 6010 participants. Moderate-quality evidence associated individual psychological interventions with reduced relapses at post-treatment (risk ratio (RR) = 0.66, 95% CI 0.48–0.92) and follow-up (RR = 0.74, 95% CI 0.63–0.87), and collaborative care with a reduction in hospital admissions (RR = 0.68, 95% CI 0.49–0.94). Low-quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psychoeducation with reduced symptoms of depression and mania. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Much of the evidence was of low or very low quality thereby limiting our conclusions. Further research should identify the most effective (and cost-effective) interventions for each phase of this disorder.

It is important that depressed patients receive adequate and safe care as described in clinical guidelines. The aim of this study was to evaluate the implementation of the Dutch depression guideline for children and adolescents, and to identify factors that were associated with the uptake of the guideline recommendations. The study took place in specialised child and adolescent mental healthcare. An implementation project was initiated to enhance the implementation of the guideline. An evaluation study was performed alongside the implementation project, using structured registration forms and interviews with healthcare professionals. Six multidisciplinary teams participated in the implementation study. The records of 655 patients were analysed. After 1 year, 72 % of all eligible patients had been screened for depression and 38 % were diagnosed with the use of a diagnostic instrument. The severity of the depression was assessed in 77 % of the patients during the diagnostic process, and 41 % of the patients received the recommended intervention based on the depression severity. Of the patients that received antidepressants, 25 % received weekly checks for suicidal thoughts in the first 6 weeks. Monitoring of the patients' response was recorded in 32 % of the patients. A wide range of factors were perceived to influence the uptake of guideline recommendations, e.g. the availability of capable professionals, available time, electronic tools and reminders, and the professionals' skills and attitudes. With the involvement of the teams, recommendations were provided for nationwide implementation of the guideline. In conclusion, a systematic implementation programme using stepped care principles for the allocation of depression interventions seems successful, but there remains room for further improvement.

Background Psychological interventions may be beneficial for bipolar disorder. Aims Efficacy evaluation of psychological interventions for adults with bipolar disorder. Methods A systematic review of randomised controlled trials.. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE-method. Results We included 55 trials with 6010 participants. Moderate quality evidence associated individual psychological interventions with reduced relapses at post-treatment and follow-up, and collaborative care with a reduction in hospitalisations. . Low quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psycho-education with reduced symptoms of depression and mania at post-treatment. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Limits were the very low quality of much of the evidence and therefore inconclusive. Further research should identify the most (cost)-effective interventions for each phase of this disorder.

Background Psychological interventions may be beneficial for bipolar disorder. Aims Efficacy evaluation of psychological interventions for adults with bipolar disorder. Methods A systematic review of randomised controlled trials.. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE-method. Results We included 55 trials with 6010 participants. Moderate quality evidence associated individual psychological interventions with reduced relapses at post-treatment and follow-up, and collaborative care with a reduction in hospitalisations. . Low quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psycho-education with reduced symptoms of depression and mania at post-treatment. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Limits were the very low quality of much of the evidence and therefore inconclusive. Further research should identify the most (cost)-effective interventions for each phase of this disorder.

Background Psychological interventions may be beneficial for bipolar disorder. Aims Efficacy evaluation of psychological interventions for adults with bipolar disorder. Methods A systematic review of randomised controlled trials.. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE-method. Results We included 55 trials with 6010 participants. Moderate quality evidence associated individual psychological interventions with reduced relapses at post-treatment and follow-up, and collaborative care with a reduction in hospitalisations. . Low quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psycho-education with reduced symptoms of depression and mania at post-treatment. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Limits were the very low quality of much of the evidence and therefore inconclusive. Further research should identify the most (cost)-effective interventions for each phase of this disorder.

Background Psychological interventions may be beneficial for bipolar disorder. Aims Efficacy evaluation of psychological interventions for adults with bipolar disorder. Methods A systematic review of randomised controlled trials.. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE-method. Results We included 55 trials with 6010 participants. Moderate quality evidence associated individual psychological interventions with reduced relapses at post-treatment and follow-up, and collaborative care with a reduction in hospitalisations. . Low quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psycho-education with reduced symptoms of depression and mania at post-treatment. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Limits were the very low quality of much of the evidence and therefore inconclusive. Further research should identify the most (cost)-effective interventions for each phase of this disorder.

Background Psychological interventions may be beneficial for bipolar disorder. Aims Efficacy evaluation of psychological interventions for adults with bipolar disorder. Methods A systematic review of randomised controlled trials.. Outcomes were meta-analysed using RevMan and confidence assessed using the GRADE-method. Results We included 55 trials with 6010 participants. Moderate quality evidence associated individual psychological interventions with reduced relapses at post-treatment and follow-up, and collaborative care with a reduction in hospitalisations. . Low quality evidence associated group interventions with fewer depression relapses at post-treatment and follow-up, and family psycho-education with reduced symptoms of depression and mania at post-treatment. Conclusions There is evidence that psychological interventions are effective for people with bipolar disorder. Limits were the very low quality of much of the evidence and therefore inconclusive. Further research should identify the most (cost)-effective interventions for each phase of this disorder.