Restructuring mood in cyclothymia using cognitive behavior therapy: an intensive time‐sampling study

Abstract

Hypotheses predicting how cognitive behavioral therapy (CBT) would change the daily pattern of mood and sleep in a patient with cyclothymia were formulated based on circadian processes. Using a prospective single-case experimental design, the patient provided mood ratings every 4 hours and sleep reports daily for 49 weeks, including a 4-week baseline, a 20-session CBT intervention, and a follow-up period. Improvements in mood during and after therapy were accounted for by reduced daily mood variability and extended sleep. The patient's energy at different times of day was explained by adjusting the endogenous rhythm in a mathematical circadian model. Treatment of cyclothymia and related bipolar disorders may be enhanced by integrating understanding of circadian mood regulation into CBT treatment.

The Sequential Combination of Cognitive Behavioral Treatment and Well-Being Therapy in Cyclothymic Disorder

“…Substantial comorbidity (including substance and alcohol abuse, anxiety disorders and personality disturbances) is often associated [3,4,5,6,7,8]. Cyclothymia has been identified as having a circadian component [5,6,7,8,9]. Seventy-one students exhibiting cyclothymic mood and behavior patterns were randomly assigned to an experimental group – in which they were encouraged to regulate their daily routines – or to a control group.…”

Cyclothymic disorder in youth: why is it overlooked, what do we know and where is the field headed?

“…As a result, although there is growing evidence for the efficacy of psychosocial treatment combined with pharmacotherapy for the treatment of bipolar disorder, we do not know the extent to which psychotherapy would benefit youth with cyclothymic disorder [81,82]. There are two published studies that evaluate the use of cognitive behavioral therapy techniques to improve the symptoms of cyclothymic disorder in adults [83,84]. Both produced results suggesting that the prognosis and quality of life for people with cyclothymic disorder could be enhanced through augmented cognitive behavioral therapy.…”

Treatment of Cyclothymic Disorder: Commentary

“…In addition, there is a small, but growing body of studies of psychosocial treatments in both type II BPD and cyclothymic disorder [3,[31][32][33][34][35] . Particularly promising results have been associated with applications of CBT and supportive groups in conjunction with mood-stabilizing medication [31,32] , although efforts to adjust the scheduling of circadian activities have had less benefit on mood stabilization [33] .…”

“…Particularly promising results have been associated with applications of CBT and supportive groups in conjunction with mood-stabilizing medication [31,32] , although efforts to adjust the scheduling of circadian activities have had less benefit on mood stabilization [33] . Psychoeducational group treatments have demonstrated mood-stabilizing value in type II BPD [35] , but require specific study in cyclothymic disorder.…”