A Brief Comparison Between Psychosocial Intervention and Pharmacotherapy for Patients with Bipolar Disorder and Effect on Their Clinical Outcomes

Background: Bipolar affective disorder causes fluctuating mood and functional impairment; while medication is central, structured psychosocial therapy like IPSRT may enhance outcomes, with evidence from low-resource settings, especially India, still limited. Aim: To assess the efficacy of adjunctive IPSRT in people with BPAD taking pharmacotherapy compared to pharmacotherapy alone. Methods: In this prospective, comparative, pre-post study, 82 persons with BPAD (as per DSM-V) were randomised to the two groups (n = 41 each). The intervention was 12 weeks long in psychiatric hospital at Ahmedabad. Outcomes assessed were depressive symptoms (HAMD-17), manic symptoms (YMRS), functional disability (WHODAS 2.0), and systemic inflammation (CRP), which were measured at baseline, 6 weeks, and 12 weeks. Results: Both groups were comparable in sociodemographic characteristics, and adjusted analyses accounted for baseline variations in clinical measures. At 3 months, the experimental arm showed significantly greater improvement in depression (HAMD-17: 19.75 → 12.00; p < 0.001) and mania (YMRS: 18.24 → 12.37; p < 0.001) than controls (p < 0.05). Functional disability decreased substantially (WHODAS: 78.56 → 55.11; p = 0.048), and CRP levels were significantly reduced (12.05 → 8.26 mg/L; p = 0.031) in the experimental group. Control group changes were modest. Gender and age subgroup analyses indicated uniform benefits, though middle-aged participants showed a trend toward more consistent improvements. Conclusion: IPSRT, when combined with pharmacotherapy, produces superior outcomes in mood stabilization, functional recovery, and reduction of systemic inflammation in BPAD compared to pharmacotherapy alone. These findings support IPSRT as an effective, holistic adjunctive treatment, potentially addressing both psychosocial and biological aspects of bipolar disorder.