Jun 20, · Research also shows that childhood trauma is a risk factor for bipolar disorder and for more severe symptoms. Childhood trauma can include Apr 04, · The second type of paper is a literature review that summarizes the research conducted by other people on a particular topic. If you are writing a psychology research paper in this form, your instructor might specify the number of studies that you need to cite as well as the length Sep 19, · Nevertheless, developing or choosing medical research paper topics is sometimes challenging than the actual writing task. In some cases, professors provide a scope within which to choose topics. What’s more, there are different categories of interesting medical topics for research paper for students to choose from
Examples of Medical Research Paper Topics
Try out PMC Labs and tell us what you think. Learn More. Although cognitive bipolar research paper therapy CBT is considered a promising adjuvant to pharmacotherapy for treating bipolar disorder BDits efficacy is unproven. The present review and meta-analysis evaluated the treatment outcomes of patients with BD treated with CBT plus medication and compared these data with the outcomes of those who received standard care alone.
Electronic searches from inception to July 31,were performed using PubMed, Medline OVID, Cochrane Library, EMBASE, CINAHL plus, and PsycINFO. Further subgroup analyses were conducted according to the characteristics of the CBT approaches, patients, and therapists, if the data were available. A total of 19 RCTs comprising patients with type I or II BD were enrolled in our systematic review and meta-analysis.
CBT is effective in decreasing the relapse rate and improving depressive symptoms, mania severity, and psychosocial functioning, with a mild-to-moderate effect size. Bipolar disorder BD is a severe mental disease with a lifelong course and considerable morbidity and mortality. BD can cause bipolar research paper cognition [ 2 ], functional decline [ 3 ], poor health outcomes [ 4 ], and a high frequency of suicidal behavior [ 5 ].
In the United States, the direct and indirect costs of BD were estimated to be USD billion in [ 7 ]. Millions of patients worldwide are affected by this severe mood illness, incurring costs of billions of USD for the years lived with disability [ 8 ]. Given the biological and hereditary underpinning of BD, pharmacotherapy is the first-line treatment. However, a growing body of literature suggests that combined pharmacotherapy and psychotherapy is more effective in treating patients with BD than is medication alone [ 9 ].
As an adjuvant therapy, psychotherapy helps patients with BD in improving their compliance, awareness, and coping skills for life events, which collectively results in an improved response to pharmacotherapy [ 10 — 1332 ]. Among the psychological therapies bipolar research paper are potential adjuncts to medications for patients with BD, bipolar research paper, cognitive-behavioral therapy CBT is a promising treatment option but has inconclusive bipolar research paper [ 14 ].
In clinical settings, CBT bipolar research paper the non-pharmaceutical intervention of choice for patients with depression and anxiety, bipolar research paper, the core concept and treatment practice model were developed by Beck et al. more than 40 years previously [ 1516 ].
Randomized controlled trials RCTs published within the past 10 years have disclosed the potential benefits of CBT as an adjunct to mood stabilizers for preventing relapse, relieving symptoms, and enhancing drug adherence [ 9 ]. Currently, some meta-analyses have evaluated the efficacy of CBT for BD [ 17 — 23 ], bipolar research paper. These studies have demonstrated that CBT has a small impact on clinical symptoms [ 17 — 19 ], but the evidence remains incomprehensive and inconclusive due to limited data, bipolar research paper.
In a meta-analysis, Ye et al described the short-term efficacy of CBT in lowering the relapse rate of BD [ 19 ]. In our study, an in-depth subgroup analysis of the meta-analyses on this topic was conducted to provide insights for psychiatrists and psychologists.
Accordingly, we performed a meta-analysis, as well as extensive searches of multiple databases and further subgroup analysis, to determine the efficacy of CBT in improving depressive symptoms, mania severity, relapse rates and social functioning. This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA statement for the meta-analyses of RCTs. The PRISMA checklist S1 Checklist is provided as Supplementary Material.
Electronic searches from the date of inception to July 31, were performed using PubMed, Medline OVID, the Cochrane Library, EMBASE, CINAHL Plus, and PsycINFO. To identify specific bipolar research paper relevant studies, we developed a search strategy based on the patient population BDtreatment CBTand study design RCT; S1 Table.
The references from selected articles were also accessed for eligibility in the review process. All the candidate articles were evaluated by two independent reviewers through systematic approaches involving the inclusion and exclusion criteria. The depressive symptoms were assessed using the Hamilton Rating Scale for Depression HRSDBeck Hopelessness Scale BHSBeck Depression Inventory BDIor Montgomery—Asberg Depression Rating Scale MADRS bipolar research paper the mania severity was assessed using the Mania Rating Scale MRS or Young Bipolar research paper Rating Scale YMRS ; and the level of psychosocial functioning was assessed using the Global Assessment of Functioning GAFDysfunctional Attitude scale DASor Social Performance Scale SPS.
The exclusion criteria were as follows: 1 no relevant data were available for further meta-analysis and 2 article types other than RCTs, such as comments, letters, and reviews. In addition, for duplicated publications with the same study participants, only those studies with the most relevant and comprehensive data were considered, and the other studies were discarded.
Furthermore, during the selection process for systematic reviews, we verified whether CBT or the relevant variants were included in the bipolar research paper interventions of each study.
However, bipolar research paper, some studies used psychological therapies based on CBT or CBT-modified programs. After careful discussion, we included such studies because their core psychological intervention was CBT. Data extraction was performed by two independent reviewers who used a specific work sheet designated before the literature search.
A consensus meeting was held with a third researcher to resolve disparities between the two reviewers. Data extraction was conducted from full-text versions of the RCTs, where available. A quality-control process for the data extraction was undertaken by another researcher to verify all the extracted data against the original sources, bipolar research paper.
The data regarding basic characteristics and outcome measures, including the study identity first author plus publication yearcountry, study design, number of study participants, mean or median age, gender, intervention characteristics, and all relevant outcomes, were extracted for all studies.
If the study populations were duplicated, bipolar research paper, the most updated findings or most comprehensive outcome measures were chosen. Some of the follow-up studies of the original RCTs focused on cost-effectiveness and could not be included in this meta-analysis. All data analyses were performed using Comprehensive Bipolar research paper, Version 3.
The efficacy of CBT in lowering the relapse rate was evaluated from the overall odds ratio OR. The average changes in the scores for depressive symptoms, mania severity, and psychosocial functioning were calculated from baseline to the study end. Data from individual RCTs were summarized using a random-effects model for obtaining more statistically conservative estimates compared with those obtained using a fixed-effects model.
In addition, further subgroup analysis was conducted according to the characteristics of CBT approaches, patients, bipolar research paper therapists, if the data were available for assessing the impact of different characteristics on the efficacy bipolar research paper CBT in treating BD.
Sensitivity analyses were performed using the leave-one-out approach to elevate the robustness of the pooled estimates. Fig 1 depicts the entire literature review process. Initially, research reports were identified. Of the 19 RCTs, three included only patients with BD I, and other studies bipolar research paper patients with BD I or II.
The mean age of the patients at enrollment ranged from The number of CBT sessions ranged from 8 to 30, and the duration of each session ranged from 45 to min. All the included RCTs were published between and Other details are summarized in Table 1.
CBT: cognitive-behavioral therapy, TAU: treatment as usual, WLC: waiting list control, bipolar research paper, MM: medication monitoring, SC: standard care, SUD: substance use disorder, IPT: intensive psychosocial treatment, CC: collaborative care, MBCT: mindfulness-based cognitive therapy, PE: psychoeducation, FF-CBT: family-focused, cognitive behavioral therapy, treatment-health promoting intervention, HE: health education, ST: supportive therapy.
A total of 10 RCTs provided adequate statisticsal data for calculating the relapse rate [ 25 — 293235 — 38 ]. In summary, the overall effect size of CBT for patients with BD is shown in Table 2. Bipolar research paper Fig displays the effect of removing every single study on the overall estimate.
These findings consolidate the robustness of this meta-analysis, indicating that none of the studies would dominate the summarized results. S2 Fig illustrates the funnel plot for evaluating potential publication bias. P Abipolar research paper, subgroup effect on outcome variable; P Bheterogeneity among subgroups moderator ; CI, confidence interval, bipolar research paper.
In the current study, we systematically reviewed the results of 19 RCTs and compared the treatment outcomes obtained by using CBT as an adjuvant therapy to pharmacotherapy and those obtained by using standard care for treating patients with BD. The research quality of the selected studies, including the quality of the study design, patients, outcome measures, statistical analysis, and results, was assessed using the approach described by Brodaty, Green, and Koschera [ 44 ].
According to bipolar research paper guidelines of the Cochrane Collaboration, bipolar research paper, a research quality score of 6—10 is acceptable. The meta-analysis indicated that CBT has a positive impact on patients with BD in terms of reducing depression levels, improving mania severity, decreasing relapse rates and increasing psychosocial functioning, with a moderate effect size. Our findings were similar to those of Jan [ 20 ] and Lam [ 21 ]. Compared to previous meta-analyses [ 17 — 19 ], we considered a greater number of databases and identified more RCTs that included four outcome measures depression, mania, relapse rate, and psychosocial functioning in the meta-analysis.
In addition, we performed subgroup analyses of various characteristics, including disease type, bipolar research paper, therapists background, and treatment characteristics such as therapy delivery type and session frequency and duration. Taken together, this meta-analysis derived more insights than previous studies through a comprehensive search and sophisticated analytic approaches.
Similar to that in unipolar patients, the underlying hypothesis for CBT application in BD is that these patients have distorted cognitions, which might lead to negative mood states.
Although the role of regular treatment of BD episodes with antidepressants has yet to be established, the impressive results obtained for the use of CBT as an acute phase therapy for BD episodes suggest a critical avenue for future studies.
Our findings suggest that CBT demonstrated greater effectiveness for reducing the relapse rate in patients with BD I compared with that in patients with Bipolar research paper I and II.
This might be due to the relative homogeneity of the treatment population within these studies [ 252737 ]. One possible explanation is the difference in disease course between BD I and BD II. The relapse rate for major depression tends to be higher in BD II than in BD I. In particular, determining the efficacy or effectiveness of CBT in real-world practice—both alone and as an adjuvant to monotherapy—for patients with BD II, in whom pharmaceutical therapy with mood stabilizers have unclear benefits, moreover, only one second-generation antipsychotic drug, bipolar research paper, quetiapine, has received Food and Drug Administration approval [ 14 ], bipolar research paper.
Previous studies on CBT with intervention durations ranging from 45 to min per session have reported different extents of reduction in depression or mania levels [ 25 — 43 ], implying that the treatment duration is a potential moderator for treatment efficacy. Because CBT is a form of psychotherapy, it relies on a strong collaborative relationship between therapists and patients; this connection is strengthened by a more thorough process and longer treatment duration.
Among the 19 selected RCTs, patients with refractory BD were reported in two studies [ 3943 ]. In the meta-analysis for determining the effect of CBT treatment on reducing depression and mania levels, the findings suggested that CBT had an impressive effect in patients with refractory BD [ 39 ].
Clearly, pharmacotherapy is an absolute necessity in this clinical syndrome, although this is not sufficient, at least in treatment-resistant patients.
Combined CBT and pharmacotherapy might be an effective treatment strategy among patients with refractory BD. Similar to most meta-analysis studies, the current study has some limitations. First, some comparisons were limited by the sample size. Only four studies [ 27bipolar research paper, 293038 ] had more than patients, and the other RCTs involved small samples. Nonsignificant findings might not have been published, thus biasing the present results in a favorable direction for CBT.
Although we conceive that this is not the case here for example, the largest published RCTs of CBT in BD [ 29 ] had null bipolar research paperwe calculated the number of studies with an effect size of zero that would be needed to reduce the present bipolar research paper size to zero [ 46 ].
For the four different outcomes, depressive level, mania severity, relapse rate, bipolar research paper, and psychosocial functioning, 58, 43, 28, and 28 studies with no effect, respectively, would be needed to reduce the observed effect size to zero.
These numbers are unlikely, considering that many of the published studies reported nonsignificant results. Collectively, more RCTs with larger sample sizes are warranted in the future to overcome these limitations, and the optimized and systematic approaches of CBT should be further investigated to prevent the effect of these factors in future studies. In addition, bipolar research paper, international, multicenter studies of a BD cohort with CBT might be valuable in establishing a database for the long-term evaluation of patient outcomes to facilitate evidence-based practices [ 47 ].
In conclusion, this meta-analysis recommends the use of CBT as an adjunctive therapy to medications in patients with BD because of the positive effects observed post-treatment and at follow-up. The benefits include decreased levels of depression and mania, decreased relapse rates, and increased levels of psychosocial functioning.
Additional studies should investigate optimal patient selection strategies to bipolar research paper the benefits of adjunctive CBT and thereby the cost-effectiveness of treatment for patients with BD who do not rapidly respond to first-line interventions, bipolar research paper. Sensitivity bipolar research paper with leave-one-out approach of meta-analysis for a relapse rate, b level of depression, c severity of mania, and d level of psychosocial functioning of bipolar disorder among patients treated with CBT compared to control group.
This study was supported by Ministry of Science and Technology project no National Science Concil NSC -NSCBTaiwan. The findings and conclusions in this document are those of the authors, who are responsible for its contents.
Understanding Bipolar Disorder
, time: 3:54Bipolar Disorder: All You Need to Know | Psych Central
Jun 20, · Research also shows that childhood trauma is a risk factor for bipolar disorder and for more severe symptoms. Childhood trauma can include Feb 12, · Introduction. Bipolar disorder is a severe and common mental disorder. It is present in approximately million American adults, or percent of the US population aged 18 years and older in any given year.1 At the core of the disease are dramatic and unpredictable mood swings between mania and depression. The diagnosis is usually made based on a combination of clinical indicators from a Aug 07, · Depression is a common topic for research papers in psychology classes. It's a very complex subject and one that offers many possible topics to focus on, which may leave you wondering where to begin. If you are writing a paper on depression,
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