ABSTRACT Background BD is a chronic, cyclical condition marked by severe mood instability and significant impairment. Although pharmacological and psychotherapeutic interventions have demonstrated efficacy, challenges remain in preventing relapse and sustaining long‐term euthymia. This study evaluates a CBT‐based intervention designed to reduce symptom severity and recurrence by targeting three core maintenance factors: intolerance of anergic states, addiction to mania, and meta‐emotional problems. Method Four individuals diagnosed with BD participated in a one‐year CBT intervention tailored to address these key vulnerabilities. Assessments were conducted at baseline, post‐treatment, and at 18‐ and 24‐month follow‐ups, measuring depression, mania, quality of life, and personality functioning. Changes were evaluated with RCI and repeated measures ANOVA. Results All four patients showed a marked reduction in depressive symptoms at the end of treatment and at the 24‐month follow‐up, with a large effect size (η 2 = 0.83). Improvements were also observed in the quality of life and maladaptive personality traits over time. Notably, euthymia was maintained throughout the follow‐up period, with no recurrence of manic episodes or new affective cycles. Conclusion Despite limitations, these preliminary findings suggest that this three‐goal CBT intervention targeting core maintenance factors in bipolar disorder may promote sustained clinical improvements, increase long‐term stability, and reduce reliance on medication.
Gragnani et al. (2026) studied this question.