Positive Psychology Intervention Improves Well-Being in Euthymic Bipolar Disorder

Patients with euthymic BD who receive an 8-week group multicomponent positive psychology intervention have improved personal recovery and mental well-being.

Mental well-being and personal recovery improve among patients with euthymic bipolar disorder (BD) following multicomponent positive psychology intervention, according to study results published in Bipolar Disorders.

This pragmatic, parallel-group, randomized controlled trial was conducted at 6 sites in the Netherlands between 2018 and 2020. Patients (N=97) with BD in a euthymic phase were randomly assigned to receive 8 weeks of multicomponent positive psychology intervention (n=54) in addition to treatment as usual or treatment as usual alone (n=43). The positive psychology intervention was called “Living well with bipolar disorder” and comprised 8 group sessions delivered by 2 therapists and based on the well-being theory by Seligman and psychological well-being theory by Ryff. The primary outcome was well-being measured using the 14-item Mental Health Continuum-Short Form (MHC-SF). A reliable change in MHC-SF total scores was defined as a 0.75-point change.

Patients had a mean age of 47.42 (SD, 10.33) years, 71.1% were women, 44.3% had a high level of education, 47.4% were working, 53.6% had BD-I, and 42.3% had BD-II.

Between baseline and after treatment, the treatment as usual group did not have a significant change to MHC-SF total scores (mean, 2.13 vs 2.15 points) whereas there was an improvement among the positive psychology intervention recipients (mean, 2.09 vs 2.62 points). In addition, the scores at the end of treatment were maintained through the final follow-up at 12 months among the treatment as usual (mean, 2.18 points) and positive psychology intervention (mean, 2.55 points) cohorts.

The findings of this study show that a multicomponent PPI [positive psychology intervention] can be an effective intervention for patients with BD in euthymic phases.

A reliable change in MHC-SF score was observed among 33.3% of the intervention group and 16.7% of the control group. The reliable change rates were 29.7% and 12.1% at 6 months and 34.5% and 18.2% at 12 months, respectively.

Overall, significant group-by-time effects were observed for the primary outcome of MHC-SF total scores (F, 9.20; P <.01), as well as for the following secondary outcomes:

  • MHC-SF social score (F, 7.11; P <.01)
  • MHC-SF psychological score (F, 8.42; P <.01)
  • Questionnaire About the Process of Recovery score (F, 4.32; P <.05)
  • Quick Inventory of Depressive Symptomatology-Self Report score (F, 4.32; P <.05)
  • Responses to Positive Affect Questionnaire emotion-focus score (F, 6.48; P <.05)
  • Positive and Negative Affect Schedule score (F, 4.00; P <.05)

No group effects for recurrence of depression (β, 0.39; P =.24) or mania (β, -0.08; P =.86) were observed.

These findings may have been biased by the choice to use a noninterventional control group.

This study found that well-being improved among patients with BD in a euthymic phase with a multicomponent positive psychology intervention, leading the study authors to write, “Current treatment guidelines for BD primarily focus on symptomatic and functional recovery, but there is a growing interest in mental well-being and personal recovery as important treatment goals for people with severe mental illness. The findings of this study show that a multicomponent PPI [positive psychology intervention] can be an effective intervention for patients with BD in euthymic phases.”

This article originally appeared on Psychiatry Advisor


Kraiss JT, ten Klooster PM, Chrispijn M, et al. A multicomponent positive psychology intervention for euthymic patients with bipolar disorder to improve mental well-being and personal recovery: a pragmatic randomized controlled trial. Bipolar Disord. Published online March 1, 2023. doi:10.1111/bdi.13313