Psychological therapies for bipolar disorder in later life: Current evidence, practice and future directions

Purpose: Bipolar disorder (BD) is a severe and enduring mental health condition that persists into older adulthood. The number of people living with BD into later life is set to increase as our population ages and awareness of the condition increases. BD in later life may present with additional challenges, such as increased physical health comorbidities and poorer cognitive function. Despite these additional challenges, there has been a paucity of research focused specifically on the treatment needs of older people with BD, highlighted by several review papers. In comparison, the last 30 years have witnessed a rapid development of psychological treatments for younger people with BD. Methods: The authors completed a literature review of peer-reviewed journal articles reporting on psychological therapies developed specifically for older adults with BD. The authors also considered adaptations to psychological therapies that may benefit this population. Results: This review highlighted that there is limited available research investigating the efficacy of psychological treatments for older adults with BD, despite their unique care needs. The available evidence demonstrated the importance of adapting psychological interventions to meet this client group's needs and outlined potentially beneficial adaptations, such as increasing the flexibility of treatment, taking into account health-related and symptom changes, and developing treatments in consultation with older adults with BD. Conclusions: Improved attention and awareness of the challenges faced by older adults with BD is warranted. The development of tailored psychological treatments for this group may help reduce the significant inequalities they currenty face.