Daring to Feel: Emotion-Focused Psychotherapy Increases Amygdala Activation and Connectivity in Euthymic Bipolar Disorder—A Randomized Controlled Trial

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung


  • Kristina Meyer - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Catherine Hindi Attar - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Jana Fiebig - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Thomas Stamm - , Charité – Universitätsmedizin Berlin, Medizinische Hochschule Brandenburg Theodor Fontane (Autor:in)
  • Tyler R. Bassett - , Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Michael Bauer - , Klinik und Poliklinik für Psychiatrie und Psychotherapie (Autor:in)
  • Udo Dannlowski - , Westfälische Wilhelms-Universität Münster (Autor:in)
  • Thomas Ethofer - , Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen (Autor:in)
  • Irina Falkenberg - , Philipps-Universität Marburg (Autor:in)
  • Andreas Jansen - , Philipps-Universität Marburg (Autor:in)
  • Georg Juckel - , Ruhr-Universität Bochum (Autor:in)
  • Tilo Kircher - , Philipps-Universität Marburg (Autor:in)
  • Christoph Mulert - , Universität Hamburg, Justus Liebig University Giessen (Autor:in)
  • Gregor Leicht - , Universität Hamburg (Autor:in)
  • Anne Rau - , Universitätsklinikum Tübingen (Autor:in)
  • Jonas Rauh - , Universität Hamburg (Autor:in)
  • Dirk Ritter - , Klinik und Poliklinik für Psychiatrie und Psychotherapie (Autor:in)
  • Philipp Ritter - , Klinik und Poliklinik für Psychiatrie und Psychotherapie (Autor:in)
  • Sarah Trost - , Georg-August-Universität Göttingen, Universitäre Altersmedizin FELIX PLATTER (Autor:in)
  • Christoph Vogelbacher - , Philipps-Universität Marburg (Autor:in)
  • Henrik Walter - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Sarah Wolter - , Georg-August-Universität Göttingen, Otto von Guericke University Magdeburg (Autor:in)
  • Martin Hautzinger - , Eberhard Karls Universität Tübingen (Autor:in)
  • Felix Bermpohl - , Charité – Universitätsmedizin Berlin (Autor:in)


Background: In bipolar disorder (BD), the alternation of extreme mood states indicates deficits in emotion processing, accompanied by aberrant neural function of the emotion network. The present study investigated the effects of an emotion-centered psychotherapeutic intervention on amygdala responsivity and connectivity during emotional face processing in BD. Methods: In a randomized controlled trial within the multicentric BipoLife project, euthymic patients with BD received one of two interventions over 6 months: an unstructured, emotion-focused intervention (FEST), where patients were guided to adequately perceive and label their emotions (n = 28), or a specific, structured, cognitive behavioral intervention (SEKT) (n = 31). Before and after interventions, functional magnetic resonance imaging was conducted while patients completed an emotional face-matching paradigm (final functional magnetic resonance imaging sample of patients completing both measurements: SEKT, n = 17; FEST, n = 17). Healthy control subjects (n = 32) were scanned twice after the same interval without receiving any intervention. Given the focus of FEST on emotion processing, we expected FEST to strengthen amygdala activation and connectivity. Results: Clinically, both interventions stabilized patients’ euthymic states in terms of affective symptoms. At the neural level, FEST versus SEKT increased amygdala activation and amygdala-insula connectivity at postintervention relative to preintervention time point. In FEST, the increase in amygdala activation was associated with fewer depressive symptoms (r = 0.72) 6 months after intervention. Conclusions: Enhanced activation and functional connectivity of the amygdala after FEST versus SEKT may represent a neural marker of improved emotion processing, supporting the FEST intervention as an effective tool in relapse prevention in patients with BD.


Seiten (von - bis)750-759
FachzeitschriftBiological Psychiatry: Cognitive Neuroscience and Neuroimaging
PublikationsstatusVeröffentlicht - Juli 2023

Externe IDs

PubMed 36898634
ORCID /0000-0003-4286-5830/work/149796286
ORCID /0000-0002-2666-859X/work/149797559



  • Amygdala, Bipolar disorder, Emotion processing, Euthymia, Psychotherapy, fMRI, Bipolar Disorder, Humans, Brain Mapping, Emotions/physiology, Neural Pathways