الفهرس 
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Abstract
Social rhythm therapy (SRT) is an intervention designed to regulate patients’ circadian rhythms. It has significant positive effects on the course of bipolar disorder. These effects were observed on acute management and long-term survival without a new mood episode. The aim of the present study was to estimate the outcome of social rhythm therapy in the management of patients with bipolar disorder & comparing it with the outcome of using the pharmacological treatment alone. To elucidate this aim sixty participants were recruited in the study, they were selected by convenience sampling and they were divided into two groups: - group I: (included thirty patients with bipolar treated as usual (TAU) with pharmacological treatment only (mood stabilizer and antipsychotic). - group II: (included thirty bipolar patients treated with social rhythm therapy in addition to pharmacological treatment) In the preset study the mean age of group I patients was 29.833 while the mean age of group II patients was 31.233.There was no significant difference in age among the two groups. group I patients comprised 12 females (40%), 18 males (60%) while group II patients comprised 15 males (50%), 15 females (50%). There was no significant difference between the studied groups as regard sex. The majority of the patients in group I & II (56.67%, 66.67% respectively) were unemployed. There was no significant difference in occupation among the two studied groups. About sixty seven percentage (66.67%) of group I patients were educated while fifty seven percentage (56.67%) of group II patients were educated. There was no significant difference in education among the two studied groups. More than half of the patients in both groups live in rural areas (53.3%, 56.6% respectively). There was no significant difference in residence among the two studied groups. The majority of patients in group I were single 63.3% while 30% were married & 6.67% were divorced. In group II, 50% of patients were single while 30% were married & 20% were divorced. There was no significant difference in marital status among the two groups. The mean duration of illness in group I was 7.968 years while in group II was 7.123 years .There was no significant difference in duration of illness between group I & II. Regarding mean HDRS score, there was no significant difference in initial assessment between both groups (it was about 20). While in follow up assessment after 3 months, the mean HDRS score in group I decreased only to 12 while in group II patients decreased to 9. Briefly, HDRS score decreased by 39.58% in group I patients & decreased by 55.87% in group II patients. There was significant decrement of HDRS in group II compared to group I (P<0.001*). The percentage of improvement in HDRS in group I was with no significant difference in gender, occupation, residence, education or marital status. While in group II, the percentage of improvement in HDRS was more significant in female gender than males, employed patients than unemployed, educated patients than uneducated & there was no significant difference in residence or marital status. Regarding MDQ, the mean score in initial assessment was 10.2 in group I patients & 11.25 in group II patients. While in follow up assessment after 3 months MDQ mean score was 6.25 in group I & significantly decreased to 3.95 in group II. In brief, MDQ scores decreased by 65.76 % in group II patients & decreased by 38.74% in group I patients.There was significant improvement of MDQ in group II compared to group I (P<0.001*). The percentage of improvement in MDQ in group I was more significant in educated patients more than uneducated & there was no significant difference in gender, occupation, residence or marital status. While in group II, the percentage of improvement was more significant in female gender than males, employed patients than unemployed, educated patients than uneducated while there was no significant difference in residence or marital status. According to SOFAS, There was no significant difference regarding SOFAS mean score in initial assessment in both groups(47.66 & 53 respectively). While in follow up assessment after 3 months SOFAS mean score was 56.667 in group I & significantly increased to 79.00 in group II. Briefly, SOFAS increased by 52.5% in group II & increased by 21.72 % in group I. There was significant increase of SOFAS scores after treatment in group II compared to group I (P<0.001*). Regarding the percentage of improvement in SOFAS score in group I, there was no significant difference in gender, occupation, education, residence or marital status. While in group II, percentage of improvement was higher in female patients than males, employed more than unemployed & educated more than uneducated but there was no significant difference in residence or marital status. In both groups, there were negative relationships between age, duration of illness & percentage of improvement in the psychometric scales mentioned above. Linear regression analysis was done to find if the disease variables could predict the percentage of improvement in the 3 studied psychometric scales. We found that both gender & age of the patient could significantly predict MDQ % of improvement. While none of the studied variables could significantly predict percentage of change in HDRS or SOFAS. Only 43.3 % of patients in group I were compliant on pharmacological treatment, while compliance significantly increased in group II including about 90% of patients. There was significant difference in the compliance between two studied groups.