Abstract
Stress-vulnerability models are increasingly viewed as plausible explanations of recurrence in severe affective disorders. This has promoted greater interest in the application of evidence-based psychological treatments, such as cognitive therapy, as an adjunct to medication for patients with bipolar disorder. This paper reviews the results from outcome studies of combined treatment approaches. Preliminary findings indicate that cognitive therapy reduces symptoms, enhances social adjustment and functioning and reduces relapses and hospitalizations in patients with bipolar disorder. However, the lack of published data from large scale randomized controlled trials and the absence of an adequate psychological model of manic relapse means that the role of cognitive therapy in bipolar disorders will be the subject of intense debate for some time to come.