Acceptance and Commitment Therapy (ACT) for Bipolar Mood Disorder: A Review

Abstract

Bipolar Mood Disorder (TB) is a severe psychiatric disorder characterized by episodes of mania and depression, associated with high morbidity and mortality. Although pharmacological treatments and traditional psychotherapies are effective, the Acceptance and Commitment Therapy (ACT) appears as a promising approach, still little explored in this population. The present study presents a narrative review with a directed search of articles in PubMed, focused on published clinical trials that implemented ACT in individuals with TB, evaluating its effectiveness, challenges, and applicability. Fourteen articles were identified, of which seven met the inclusion criteria. The studies were analyzed for their methodological rigor, evaluated for their outcomes, and assessed for the interventions employed. Of the seven studies included in this review, five employed self-guided interventions via mobile applications, while only two studies described interventions performed directly by psychotherapists. Most interventions focused on comorbid conditions, especially smoking and anxiety, rather than the central symptoms of TB, such as depression and mania. In addition, studies using asynchronous digital interventions have highlighted aspects related mainly to the acceptability and applicability of these applications, presenting few results on the clinical efficacy of these interventions. No study has provided evidence on the superiority of one intervention format over another, and more specific and controlled future trials are needed to clarify this issue. Although the studies provide an initial overview, the heterogeneity of the studies limits the ability to draw consistent conclusions about the effectiveness of ACT in treating TB. Future studies should prioritize larger methodological designs, including TB-specific interventions conducted by trained psychotherapists, with standardized measures of outcomes and comparisons between different therapeutic formats.