Efficacy of supportive family interventions in bipolar disorder: A review of the literature

Background: To review the efficacy of supportive family interventions for bipolar disorder on patients' clinical and social outcome and family functioning. Methods: A review of the studies on supportive family interventions in bipolar disorder carried out in the last 20 years has been performed using the main databases. Searched keywords include "psychoeducational family intervention", "family therapy", "family supportive interventions", "caregivers"; these terms have been matched with "bipolar disorder", "affective disorders" or with "manic-depressive illness". Results: The different approaches developed, alone or integrated with more complex treatment strategies, can improve the course of bipolar disorder, reduce the risk of relapses and hospitalizations and improve patient adherence to pharmacological treatment. Only few studies have tested the efficacy of these interventions on the reduction of suicidal ideation or in patients with an early onset of the disease. Supportive family interventions improve coping strategies of relatives and family burden. Conclusions: Supportive family interventions should be an integral part of optimal management of bipolar disorder. Studies on the implementation of these interventions in routine practice are needed.