What is the role of psychotherapy in the treatment of bipolar disorder?

Background: The authors review and criticize the different roles developed by psychotherapy in the treatment of bipolar disorder, from psychodynamic conceptions to a biopsychosocial model. Methods: The main computerized database (Medline, Current Contents, Psychological Abstracts) have been consulted, using the terms 'psychotherapy', 'psychosocial' and 'bipolar disorder' as key words. Results: Psychoanalysis, psychoeducation, family therapy, cognitive-behavioral therapy and interpersonal therapy have been used in the treatment of bipolar patients. To date, none have established efficacy in controlled clinical trials regarding aspects such as hospitalization, recurrences or suicidal behavior, as medication alone does. Research on this issue usually undergoes methodological pitfalls. Nonetheless, the psychoeducative approach combined with several cognitive-behavioral techniques, either in group or individually, seem to be the most promising, focusing on information, treatment compliance, and illness management skills. Conclusions: There is a need for systematic clinical research on psychotherapy applied to bipolar disorder in order to show its true usefulness. Psychoeducation should prove its positive influence on the course and outcome of bipolar disorder.