Inpatient treatment for mania: A review and rationale for adjunctive interventions

Abstract

Objective: To examine the evidence for adjunctive non-pharmacological interventions in the treatment of mania in an acute inpatient setting.

Method: A selective review of original and review papers was conducted. The electronic databases PsycINFO and PubMed were searched using the following MeSH terms: mania, mania treatment and inpatient.

Results: Four studies were identified in the search for non-psychopharmacological interventions for mania that commenced in an inpatient setting: Interpersonal and Social Rhythm Therapy (IPSRT), Group Cognitive Behavioural Therapy (G-CBT), sensory room, and dark room therapy. Only two of these were designed exclusively for patients with bipolar disorder and the other two included these patients in a heterogeneous group of acute psychiatric inpatients.

Conclusions: Sleep and circadian regulation (Social Rhythm Therapy) that focuses on the establishment and maintenance of regular daily rhythms, particularly in relation to sleep-wake times, meal times and socialization, provides a potentially useful model for managing mania in the inpatient setting. However, there is an urgent need for further research into the effective treatment of mania.

Keywords: Circadian rhythms; inpatient; mania; sleep; social rhythms.