Probing the impact of psychoanalytic therapy for bipolar disorders: A scoping review

Abstract

No systematic review has been conducted to provide an overview of the effectiveness of psychoanalysis for treatment outcomes in bipolar depression and mania. The present study undertakes a scoping review of the effectiveness of psychoanalysis for bipolar disorder (BD), provides a summary of the evidence base, and identifies issues for future research in this area. A thorough search of journal articles in MEDLINE, PEP-Web, PsycINFO, Scopus, and the Web of Science was carried out to obtain available studies on psychoanalytic treatment for BD published from 1990 to 2021. We searched for either quantitative or single-case studies. Twenty-six single-case reports from 21 articles and no quantitative studies met the inclusion criteria. A qualitative analysis suggests efficacy and cost-effectiveness but thus far there is no scientific evidence in support of psychoanalysis. Although these pilot findings suggest that psychoanalysis may impact symptoms and global functioning in individuals with BD, the underlying evidence is poor and should be confirmed by experimental studies.

Key words:

• psychoanalysis
• psychoanalytic psychotherapy
• bipolar disorder
• effectiveness

Author contribution statement

A.S. contributed to study design and drafted the study report. All authors reviewed the manuscript critically for important intellectual content and approved the submitted version.

Supplemental data

Supplemental data for this article can be accessed here https://doi.org/10.1080/0803706X.2022.2097307

Additional information

Funding

The first author has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No. 101030608.

Notes on contributors

Alberto Stefana

Alberto Stefana PsyD, PhD, is a clinical psychologist, psychotherapist, and researcher. His main clinical area of interest is the psychotherapy of adults with psychological or psychiatric conditions or illness. He has worked as a psychotherapist at the psychiatric unit of the Spedali Civili Hospital of Brescia, still works in private practice, and is currently the recipient of a Marie Skłodowska-Curie Global Fellowship on the project “Evidence-based assessment in psychotherapy.” The main areas of scientific interest focus on the history and epistemology of psychoanalysis, evidence-based assessment and treatment, therapeutic relationship, and psychopathology. He has published more than 70 articles in international journals such as the International Journal of Psychoanalysis, Journal of Affective Disorders, and Bipolar Disorders, and the monograph History of counter transference: from Freud to the British Object Relations School (Routledge, 2017).

Daniela D’Imperio

Daniela D’Imperio PhD, PsyD, is a clinical psychologist, specialized in neuropsychology and psychotherapy. In her clinical and research activities, she mainly focuses on neuropsychological manifestations of adult neurological patients. Her interest ranges over all psychological aspects of the patients for a complete clinical view.

Antonios Dakanalis

Antonios Dakanalis MD, PsyD, PhD is a medical doctor specialised in mental health disorders research and psychotherapy practice. He currently works as a senior researcher at the psychiatric unit, Department of Medicine and Surgery, University of Milano Biccoca, where he also runs several funded cutting-edge and translational mental health research projects. He has published more than 150 scientific publications in the field of mental disorders, evidence-based practice and e-mental health services.

Eduard Vieta

Eduard Vieta MD, PhD, is Professor of Psychiatry and Chair at the University of Barcelona and Head of the Department of Psychiatry and Psychology at the Hospital Clinic, where he also leads the Bipolar and Depressive Disorders Program in Barcelona, Catalonia, Spain. His unit is one of the worldwide leaders in clinical care, teaching and research on affective disorders. Dr. Vieta is also the current Scientific Director of the Spanish Research Network on Mental Health (CIBERSAM). He has received the Aristotle award (2005), the Mogens Schou award (2007), the Strategic Research award of the Spanish Society of Biological Psychiatry (2009), the Official College of Physicians award to Professional Excellence (2011), the Colvin Price on Outstanding Achievement in Mood Disorders Research by the Brain and Be.

Paolo Fusar-Poli

Paolo Fusar-Poli MD, PhD, is a Professor of Preventive Psychiatry at the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), where he heads the Early Psychosis: Intervention and Clinical-detection Laboratory (EPIC Lab). He is also a consultant psychiatrist in the Outreach And Support In South-London (OASIS) mental health service at the South London and Maudsley NHS Foundation Trust. He is also associate professor at the University of Pavia, Italy. Much of his research utilises evidence-based medicine, clinical prediction, neuroscience and experimental therapeutics and aims to develop new and effective strategies to improve the prevention of mental disorders.

Eric Youngstrom

Eric Youngstrom Ph.D., is a professor of Psychology and Neuroscience, and Psychiatry at the University of North Carolina at Chapel Hill and an adjunct professor of Psychology at the Korea University in Seoul, South Korea. He is also the Acting Director of the Center for Excellence in Research and Treatment of Bipolar Disorder. He is a two-time Past President of the Society of Clinical Child and Adolescent Psychology and served as president of Division 5 of the American Psychological Association (Qualitative & Quantitative Methods). His research improves clinical assessment instruments for making better differential diagnoses, predictions about future functioning, and monitoring of treatment progress, especially for bipolar disorder. Since 2018, in an effort for open science, he has served as an editor on the Wiki Journal of Medicine Editorial Board. Most notably, Dr. Youngstrom is the proud Co-Founder, and Executive Director of Helping Give Away Psychological Science (HGAPS) (https://www.hgaps.org/). This 501c3 nonprofit service-based education organization brings the best psychological information to the most who will benefit from it.