Mindfulness-based cognitive therapy for bipolar disorder: A systematic review

Background: Persisting high levels of relapse, morbidity and mortality in bipolar disorder (BD) in spite of firstline, evidence-based psychopharmacology has spurred development and research on adjunctive psychotherapies. Mindfulness-based cognitive therapy (MBCT) is an emerging psychotherapy that has shown benefit in related and comorbid conditions such as major depressive, anxiety, and substance disorders. Furthermore, neurocognitive studies of MBCT suggest that it may have effects on some of the theorized pathophysiological processes in BD. Methods: We conducted a systematic literature review using PsychINFO and PubMed databases to identify studies reporting clinical and/or neurocognitive findings for MBCT for BD. Results: This search revealed 13 articles. There was a wide range in methodological quality and most studies were underpowered or did not present power calculations. However, MBCT did not appear to precipitate mania, and there is preliminary evidence to support a positive effect on anxiety, residual depression, mood regulation, and broad attentional and frontal-executive control. Limitations: As meta-analysis is not yet possible due to study heterogeneity and quality, the current review is a narrative synthesis, and therefore net effects cannot be estimated. Conclusions: MBCT for BD holds promise, but more high-quality studies are needed in order to ascertain its clinical efficacy. Recommendations to address the limitations of the current research are made.