Effect of combining social rhythm therapy to treatment of bipolar disorder versus treatment as usual: a comparative study on a sample of Egyptian patients

Bipolar disorder (BD) is a common mental illness that is usually associated with significant morbidity causing critical impairment in socio-occupational functioning and even mortality. Social rhythm therapy (SRT) has been suggested as an adjunctive psychotherapy in BD treatment protocols, with its proposed benefits of accelerating recovery from bipolar episodes, delaying relapses, and upgrading patients’ functioning. This study aimed to investigate the outcomes of combining SRT with pharmacological treatment, as compared to pharmacotherapy alone, in a sample of Egyptian BD patients. Sixty eligible bipolar patients were enrolled in this comparative study by convenience sampling and randomly divided into two groups for comparison; group I included 30 BD-I patients treated as usual (TAU) with pharmacological treatment only, while group II included 30 BD patients treated with social rhythm therapy in addition to the traditional psychotropic medications. Manic and depressive symptoms as well as socio-occupational functioning were assessed at baseline and after 3 months of treatment using the Mood Disorder Questionnaire (MDQ), Hamilton Depression Rating Scale (HDRS), and Socio-occupational Functioning Assessment Scale (SOFAS). Patients treated with SRT therapy showed significant improvement in their manic and depressive symptoms as well as socio-occupational functioning after 3 months of treatment by 65.76%, 55.87%, and 52.5%, respectively. Linear regression analysis showed that the gender and age of the patient could significantly predict improvement of MDQ% in group II, while none of the studied variables could significantly predict the percentage of change in HDRS or SOFAS. SRT could be a promising adjunctive therapy promoting early recovery of BD patients compared to standalone pharmacological treatment.