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World J Psychiatry. Aug 19, 2023; 13(8): 495-510
Published online Aug 19, 2023. doi: 10.5498/wjp.v13.i8.495
Role of adjunctive nonpharmacological strategies for treatment of rapid-cycling bipolar disorder
Subho Chakrabarti, Amal J Jolly, Pranshu Singh, Nidhi Yadhav
Subho Chakrabarti, Nidhi Yadhav, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Chandigarh UT, India
Amal J Jolly, Department of Psychiatry, Black Country Healthcare NHS Foundation Trust, Dudley DY2 8PS, West Midlands, United Kingdom
Pranshu Singh, Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India
Author contributions: Chakrabarti S, Jolly AJ and Singh P were involved in the planning of the manuscript and conducting the search; Chakrabarti S was involved in preparing the final version of the manuscript; Jolly AJ, Singh P and Yadhav N were involved in writing the patient summaries; Yadhav N helped in preparing the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Subho Chakrabarti, MD, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, Chandigarh 160012, Chandigarh UT, India.
Received: April 26, 2023
Peer-review started: April 26, 2023
First decision: June 14, 2023
Revised: June 23, 2023
Accepted: July 11, 2023
Article in press: July 11, 2023
Published online: August 19, 2023
Core Tip

Core tip: Rapid-cycling bipolar disorder (RCBD) is a common and highly disabling phase of bipolar disorder. The ineffectiveness of conventional pharmacological treatment for RCBD suggests that adjunctive nonpharmacological interventions could be useful. However, their role has not received much attention. This review carried out a comprehensive search to identify the existing evidence on the subject. We found that electroconvulsive therapy, chronotherapy, and psychotherapy could effectively augment medication treatment of RCBD. However, the evidence is limited and methodologically inadequate. Therefore, clinicians have to rely on general guidelines for the optimal use of the available nonpharmacological options while managing RCBD.