Therapeutic Relationship and Bipolar Disorder Outcomes

In what seems a reasonably well-designed study in Psychiatry Research, researchers found that therapeutic alliance (quality of relationship between treating psychiatrist and patient) predicted manic symptoms six months after the relationship quality was measured. In other words, patients who reported good relationships with their docs at the start of the study tended to have reduced manic symptoms, even when controlling for the initial level of manic symptoms. This fits nicely with other research suggesting that docs should be trained in how to develop and maintain therapeutic relationships with their patients.

As the view of psychiatric disorders becomes increasingly skewed toward biology at the exclusion of other factors, research like this should help to remind clinicians and researchers that there is more to treatment than simple pill dispensation.

Let me rephrase. It would help remind them if they were to actually notice studies such as this, but, unfortunately, this study will likely be read by few whereas poorly designed, tell us next to nothing clinical trials such as the recent Risperdal for depression study that I wrote much about (here, here, and here) will be read by thousands of docs. He who controls the distribution of information (via reprints, speakers, continuing medical education, etc.) controls clinical practice.