Routine aids manic depressives

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PITTSBURGH - Patients suffering from bipolar disorder who underwent therapy to help them maintain a normal daily routine and cope with stress were able to avoid relapses over a two-year period, a study has found.

The study, published in the September issue of Archives of General Psychiatry, examined a therapy developed by researchers at the University of Pittsburgh School of Medicine.

Using what researchers dubbed interpersonal and social rhythm therapy, patients were taught how to keep to normal sleeping, eating and other daily routines. They also were shown how to anticipate and cope with stress just as a diabetic who would be taught, for example, how to cook and eat differently.

"This is really a disorder characterized by massive disturbances in the body's clock and in all the things the body's clock controls," said Ellen Frank, lead author of the study. "Their clocks need to be very carefully protected, and we need to do everything we can to shore up and protect that fragile clock."

Bipolar disorder, also commonly referred to as manic depression, is a brain disorder in which sufferers experience cycles of mania, depression or mixed states. Treatment for the disorder varies by patient, but often involves some type of medication combined with therapy.

Miss Frank, a professor of psychiatry and psychology at the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, said doctors for years have counseled bipolar sufferers about managing their lives, but no one had systematically put that information together. She said social rhythm therapy does that, and teaches patients to identify the triggers in their relationships that can cause relapses.

In the study, 175 patients suffering from the most severe form of bipolar disorder were divided into several groups. All the patients were given medication for the disorder, but only some received interpersonal and social rhythm therapy.

The researchers found those who received the therapy were more likely not to have relapses of their illness during a two-year maintenance phase.