Feasibility and acceptability of Interpersonal Social Rhythm Therapy (IPSRT) for perinatal bipolar disorder

The perinatal period, pregnancy through postpartum, is destabilizing for people with bipolar disorder (BD). Few studies have examined adjunctive psychotherapy for perinatal BD despite its potential benefits for managing symptoms, psychosocial stress, sleep disturbance, and medication adherence. The goal of this pilot study was to develop an adaptation of Interpersonal and Social Rhythm Therapy (IPSRT) as an intervention for perinatal BD and test feasibility and acceptability (primary) and mood symptom change (secondary) outcomes in an open trial design. Modifications to the 20-session IPSRT included perinatal specific psychoeducation, strategies to increase social support, and focus on sleep-wake interruptions associated with newborn care. Participants were enrolled during pregnancy. Depressive and manic symptoms were assessed at the end of treatment (4 months postpartum) and at 2-month follow-up (6 months postpartum). Feasibility and participant satisfaction were also assessed. A total of 14 pregnant women were enrolled and ten (71%) completed follow-up assessments. The average number of sessions attended was 14 out of 20. Participant satisfaction was high (31.25 out of 32). Depressive symptoms were significantly lower at the end of treatment and 2-month follow-up relative to baseline. IPSRT shows potential as an adjunctive intervention for managing mood in patients with perinatal BD. Future research is needed to examine benefits of flexible intervention delivery and patient engagement. IPSRT for BD directly targets known correlates of mood destabilization during the perinatal period, interpersonal functioning and circadian rhythm disruption. Further examination of IPSRT during the perinatal period is imperative. • We adapted Interpersonal Social Rhythm Therapy by including perinatal specific psychoeducation, skills, and strategies. • Participants were highly satisfied with the intervention, and most were able to complete the minimum number of sessions. • Improvements in depressive and manic symptoms were observed, though interpreted cautiously in this pilot study. • Future trials of IPSRT for perinatal bipolar disorder will likely require multi-site collaboration to increase feasibility.