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Journal article : Review

Psychological and behavioural interventions in bipolar disorder that target sleep and circadian rhythms: a systematic review of randomised controlled trials

Abstract:
Sleep and circadian disruptions are prominent symptoms of bipolar disorder (BD) and potential targets for adjunctive interventions. The aim of this review was to appraise the effectiveness of psychological and behavioural interventions in BD that target sleep and circadian rhythms, as reported by randomised controlled trials. Nineteen studies met the inclusion/exclusion criteria. They were summarised via narrative synthesis and meta-analysis wherever appropriate. Six studies delivered bright light therapy, five interpersonal and social rhythm therapy, two blue-light blocking glasses, one cognitive behavioural therapy for insomnia, one total sleep deprivation, and four combination treatments. More than half of the studies (N = 10, 52 %) did not measure sleep or circadian rhythms despite being the principal target of the intervention. Overall, the evidence base for the effectiveness of these interventions was limited. There was a small number of studies for each intervention, and a lack of consistency in protocols and outcomes. Meta-analysis was possible for the effect of bright light therapy on depression, revealing a medium-to-large post-treatment effect (Nc = 6; g=-0.74 [95 % CI=-1.05 to -0.42], p < 0.001).
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1016/j.neubiorev.2021.12.002

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Oxford college:
Brasenose College
Role:
Author
ORCID:
0000-0001-8815-9486


Publisher:
Elsevier
Journal:
Neuroscience and Biobehavioral Reviews More from this journal
Volume:
132
Pages:
378-390
Publication date:
2021-12-03
Acceptance date:
2021-12-01
DOI:
EISSN:
1873-7528
ISSN:
0149-7634
Pmid:
34871635


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