{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:37:24Z","timestamp":1773041844133,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bipolar disorder (BD) is a chronic and severe mood disorder, characterized by recurrent episodes of mania, hypomania, and depression. Adjacent to pharmacotherapy, positive evidence has been found for the benefit of adding cognitive behavioral therapy (CBT), family-focused therapy (FFT), interpersonal and social-rhythm therapy (IPSRT) and Group Psychoeducation for treating BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>CBT is well established as a form of psychotherapy for bipolar disorders, although variables that may affect its results are still poorly studied. The present study aimed to investigate Predominant Polarity (PP) as a possible moderator of response to group CBT for BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The original controlled study included 50 bipolar patients, divided into two groups: one was maintained on treatment as usual (TAU) solely, and a second group was assigned to 18 weekly group CBT sessions as an add-on treatment to TAU. A 16-month follow-up was conducted after the sessions, as patients were evaluated by phone by two psychiatrists, blind to the patients\u2019 condition. We have conducted a\n                      <jats:italic>post-hoc<\/jats:italic>\n                      analysis including solely individuals assigned to group CBT, dividing patients according to predominant manic or depressive polarity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Log-rank survival analysis revealed manic predominant polarity patients as maintaining an episode-free status for a longer amount of time in comparison to depressive predominant polarity patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results suggest predominant polarity may be an important moderator of CBT response in BD. Further studies should include larger samples.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1697134","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:47:09Z","timestamp":1773038829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predominant polarity as a potential moderator of group CBT outcomes in bipolar disorder: an exploratory post-hoc analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Tatiana","family":"Cohab","sequence":"first","affiliation":[{"name":"Bipolar Disorder Program (PROMAN), Department & Institute of Psychiatry, University of S\u00e3o Paulo Medical School","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Okawa","family":"Beliz\u00e1rio","sequence":"additional","affiliation":[{"name":"Bipolar Disorder Program (PROMAN), Department & Institute of Psychiatry, University of S\u00e3o Paulo Medical School","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beny","family":"Lafer","sequence":"additional","affiliation":[{"name":"Bipolar Disorder Program (PROMAN), Department & Institute of Psychiatry, University of S\u00e3o Paulo Medical School","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardo Carram\u00e3o","family":"Gomes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Universidade Federal de S\u00e3o Paulo","place":["S\u00e3o\u00a0Paulo, Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00241-X","article-title":"Bipolar disorder","volume":"387","author":"Grande","year":"2016","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.3.430","article-title":"Defining clinical phenotypes of juvenile mania","volume":"160","author":"Leibenluft","year":"2003","journal-title":"Am J Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbm057","article-title":"Deconstructing bipolar disorder: A critical review of its diagnostic validity and a proposal for DSM-V and ICD-11","volume":"33","author":"Vieta","year":"2007","journal-title":"Schizophr Bull"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1590\/1516-4446-2020-1627","article-title":"Treatment-resistant bipolar depression: concepts and challenges for novel interventions","volume":"44","author":"Diaz","year":"2021","journal-title":"Braz J Psychiatry"},{"key":"B5","first-page":"396","article-title":"Brexpiprazole augmentation in treatment resistant OCD: safety and efficacy in an italian sample","volume":"36","author":"Martiadis","year":"2024","journal-title":"Psychiatr Danubina"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1617345","article-title":"Efficacy and tolerability of vortioxetine monotherapy in SSRI-resistant OCD: a retrospective multicenter study","volume":"16","author":"Martiadis","year":"2025","journal-title":"Front Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14030954","article-title":"Efficacy and safety of adjunctive aripiprazole LAI or paliperidone LAI for the management of patients suffering from bipolar I disorder with comorbid obsessive-compulsive disorder","volume":"14","author":"Martiadis","year":"2025","journal-title":"J Clin Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.660432","article-title":"Comorbid bipolar and alcohol use disorder\u2014A therapeutic challenge","volume":"12","author":"Grunze","year":"2021","journal-title":"Front Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1299368","article-title":"Cariprazine augmentation in patients with treatment resistant unipolar depression who failed to respond to previous atypical antipsychotic add-on. 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