Comparing the Efficacy of Pharmacotherapy Versus Combined Treatment of Cognitive Emotional Regulation Group Therapy and Pharmacotherapy on Manic and Depressive Symptoms, and Suicidal Thoughts in Patients With Bipolar Disorder Type I

Montazer , Samaneh; Karbalaee Mohammad Meigouni , Ahmad; Seirafi , Mohammad Reza

Volume 15 - Articles-1404 MEJDS (2025) 15: 90 | Back to browse issues page

Ethics code: IR.IAU.K.REC.1403.200

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Montazer S, Karbalaee Mohammad Meigouni A, Seirafi M R. Comparing the Efficacy of Pharmacotherapy Versus Combined Treatment of Cognitive Emotional Regulation Group Therapy and Pharmacotherapy on Manic and Depressive Symptoms, and Suicidal Thoughts in Patients With Bipolar Disorder Type I. MEJDS 2025; 15 (0) :90-90
URL: http://jdisabilstud.org/article-1-3621-en.html

Comparing the Efficacy of Pharmacotherapy Versus Combined Treatment of Cognitive Emotional Regulation Group Therapy and Pharmacotherapy on Manic and Depressive Symptoms, and Suicidal Thoughts in Patients With Bipolar Disorder Type I

Samaneh Montazer¹

, Ahmad Karbalaee Mohammad Meigouni ^*²

, Mohammad Reza Seirafi²

1- PhD Student in General Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
2- Assistant Professor, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

Abstract: (787 Views)

Abstract
Background & Objectives: Bipolar disorder can have profound effects on various aspects of patients' lives. Among the different types of bipolar disorder, type I bipolar disorder is associated with greater vulnerability. If depressive and manic symptoms remain uncontrolled in individuals with bipolar disorder, the patients may exhibit isolative behaviors, including self–harming ones such as suicide. Given the significance of manic symptoms, depression, and suicidal ideation in individuals with bipolar disorder, identifying effective therapeutic approaches is crucial. The dominant approach for treating bipolar disorder is pharmacotherapy, primarily involving mood stabilizers.
Additionally, considering the prominent role of mood fluctuations in bipolar disorder, intervention programs focusing on emotion regulation appear to be beneficial. One widely used emotion regulation therapy is the Cognitive Emotion Regulation Program (CERP), which helps individuals better understand and manage their moods and emotions. Given that the cost–effectiveness of treatment programs is very important, this study aims to compare the effectiveness of pharmacotherapy versus combined group–based cognitive emotion regulation therapy with pharmacotherapy on manic and depressive symptoms and suicidal ideation in patients diagnosed with type I bipolar disorder.
Methods: This quasi–experimental research employed a pretest–posttest and follow–up design. The study population consisted of all patients diagnosed with bipolar disorder inpatients at Payambarān Hospital in Tehran City, Iran, in 2024. Thirty eligible individuals voluntarily participated in the study and were randomly assigned to either pharmacotherapy (n = 15) or combined treatment (n = 15) groups. The following inclusion criteria were considered for participants: 1) having a diagnosis of type I bipolar disorder, 2) age range of 20–40 years, 3) being hospitalized and receiving pharmacotherapy, and 4) not receiving electroconvulsive therapy. Additionally, the following exclusion criteria were applied: 1) missing more than two sessions and 2) having a history of participation in other individual or group therapy programs concurrently with the present study. To prevent sample loss or attrition, a briefing session was held with patients and their families, during which detailed explanations were provided about the importance of the study and the impact of their participation on the results, to increase their sense of responsibility and commitment. Telephone or text messages were also kept with participants and their families throughout the study.
Additionally, an effort was made to establish a strong therapeutic relationship, aiming to build trust between participants and the research team and increase their commitment to attending the sessions. Additionally, the session times were tailored to the participants' schedules. After evaluating the inclusion/exclusion criteria, eligible individuals participated in the study. Data collection was performed using structured diagnostic interviews, the Mania Rating Scale (Young et al., 1978), the Beck Depression Inventory–II (Beck et al., 1996), and the Beck Suicidal Ideation Scale (Beck et al., 1979). One experimental group received pharmacotherapy, and the second experimental group received Gross's Cognitive Emotion Regulation Protocol (2014) in addition to pharmacotherapy. Data were analyzed using the Student's t test, Chi–square test, repeated measures analysis of variance, and Bonferroni post hoc test at a significance level of 0.05 in SPSS software version 26.
Results: Results showed that the within–group time effect was significant for manic symptoms (p<0.001), death wish (p<0.001), suicidal preparedness (p<0.001), active suicidal ideation (p=0.011), and total suicide score (p<0.001). The group effect was significant for manic symptoms (p=0.009), depressive symptoms (p<0.001), death wish (p<0.001), suicidal preparedness (p=0.002), and actual suicidal tendencies (p<0.001), indicating there were significant differences between the two interventions and combined treatment was more effective than pharmacotherapy.
Conclusion: According to the research findings, it is recommended to develop structured treatment programs that incorporate both pharmacotherapy and group–based cognitive emotion regulation therapy as a primary approach for patients with type I bipolar disorder. Therefore, treatment teams should consider designing structured therapeutic protocols that integrate pharmacotherapy with cognitive emotion regulation group therapy as a first–line intervention for type I bipolar disorder.

Keywords: Pharmacotherapy, Cognitive emotional regulation, Mania, Depression, Suicide, Bipolar disorder type I

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Type of Study: Original Research Article | Subject: Psychology

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