Enhancing Resilience and Quality of Life in Bipolar Disorder Through Cognitive Behavioral Therapy

Summary

Bipolar disorder (BD) is a chronic and recurrent mood disorder characterized by alternating episodes of mania, depression, or mixed states, interspersed with periods of remission. These episodes can severely impair interpersonal relationships, occupational functioning, and overall quality of life. In 2019, approximately 40 million people worldwide were diagnosed with BD.

BD is a lifelong chronic condition despite pharmacotherapy and lifestyle changes. Traditional psychiatric care has primarily focused on symptom reduction and relapse prevention, often overlooking broader psychosocial aspects such as interpersonal functioning and life satisfaction. Recently, recovery has come to include living a meaningful life despite illness-related challenges.

Psychological resilience has gained prominence within this recovery framework. It refers to the capacity to adapt positively to adversity, shaped by both internal traits and external supports. Core elements include effective coping, adaptability, and recovery from stress, which support functional outcomes in mental illness.

Given the strong link between stress and relapse in BD, resilience is thought to play a critical role in illness trajectory. Research consistently shows that individuals with BD have lower resilience than healthy controls, and resilience is associated with fewer depressive symptoms and better quality of life.

Importantly, resilience is modifiable and can be enhanced through psychosocial interventions. Studies highlight the benefits of resilience-building programs in reducing depressive vulnerability and improving life satisfaction and emotion regulation. Among these, CBT effectively promotes cognitive and functional recovery in BD by targeting maladaptive thought patterns and building adaptive coping skills.

Despite growing evidence, few CBT-based interventions target resilience in individuals with BD. However, resilience is linked to key psychosocial competencies such as problem-solving, self-efficacy, assertiveness, and self-management. Based on this, the current study implemented a CBT-based Psychological Resilience Enhancement Program designed to strengthen adaptive coping and functional adjustment in individuals with BD.

Considering the substantial personal and societal burden of BD, enhancing psychological resilience is a critical therapeutic goal. This study aimed to evaluate the effects of a CBT-based intervention on psychological resilience and quality of life in individuals with BD.

Conditions

• Bipolar Affective Disorder; Remission in

Interventions

BEHAVIORAL

CBT-Based Psychological Resilience Enhancement Program for Individuals with BD

Session 1 (Psychoeducation): Enhancing knowledge and insight regarding Bipolar Disorder via Socratic questioning and case formulation. Session 2 (Locus of Control): Shifting belief from external determinism to an internal locus of control using pie charts and didactic instruction. Session 3 (Self-Management): Acquiring skills to manage early warning signs and high-risk behaviors. Session 4 (Coping with Stress): Developing and implementing effective coping strategies. Session 5 (Problem-Solving): Utilizing a structured approach to resolve daily life problems. Session 6 (Thoughts and Emotions): Identifying emotional reactions to stimuli using the downward arrow technique, playing devil's advocate, and imagery. Session 7 (Realistic Thoughts): Fostering cognitive flexibility through examining evidence and evaluating thought functionality. Session 8 (Social Skills): Establishing external support systems to reinforce self-esteem and self-efficacy via role-playing.

Sponsors & Collaborators

• Cumhuriyet University

  lead OTHER

Principal Investigators

• AYŞE AKSOY, Dr. · Karaman Training and Research Hospital

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-05-14

Primary Completion

2023-04-02

Completion

2023-04-03

Countries

• Turkey (Türkiye)

Study Locations