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Eduard Vieta - One of the best experts on this subject based on the ideXlab platform.
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the impact of staging bipolar disorder on treatment outcome of family Psychoeducation
Journal of Affective Disorders, 2010Co-Authors: Maria Reinares, Francesc Colom, Adriane R Rosa, Mar C Bonnin, Carolina Franco, Brisa Sole, Flavio Kapczinski, Eduard VietaAbstract:Abstract Background Psychological interventions on top of pharmacological treatment can improve the outcome of bipolar disorder. However, there is a paucity of data on the aspects that may influence the effectiveness of psychological approaches to bipolar disorders. The staging models suggest a progression from prodromal to more severe and treatment-resistant presentations. The aim of this study was to assess whether a staging model in bipolar disorder was related to patients' response to Psychoeducation delivered to caregivers. Methods Post-hoc analysis from a 15-month randomized controlled trial showing the efficacy of group Psychoeducation for caregivers in the prophylaxis of recurrences. The sample was composed of 113 medicated euthymic bipolar outpatients who lived with their caregivers. For the purpose of this study the patients were subdivided into two groups according to staging. The prophylactic efficacy of caregiver Psychoeducation was studied based on staging. Results Patients on Stage I benefited from caregiver Psychoeducation by having longer time to recurrence (Log-rank chi-square: 6.26; p = 0.012). No significant benefits from caregiver Psychoeducation were found in patients on advanced stages. Limitations The present post-hoc analysis was not properly powered to compare each one of the four stages with each other, instead staging was divided into Stage I and advanced stages (II, III or IV). Conclusions Psychoeducation for caregivers of bipolar patients on Stage I may improve long-term outcome in terms of time to recurrence. This study highlights the need to introduce psychological interventions early in the course of the illness as some treatments may be more useful in patients at earlier stages of bipolar disorder.
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long term mental health resource utilization and cost of care following group Psychoeducation or unstructured group support for bipolar disorders a cost benefit analysis
The Journal of Clinical Psychiatry, 2009Co-Authors: Jan Scott, Francesc Colom, J M Goikolea, A Benabarre, Jose Sanchezmoreno, Ekaterina Popova, Nuria Cruz, Marc Valenti, Miguel A Asenjo, Eduard VietaAbstract:Objective To explore the short- and long-term mental health resource utilization and cost of care in a sample of 120 individuals with bipolar disorders who participated in a randomized controlled efficacy trial of group Psychoeducation versus unstructured group support. Method Prospective, independent monitoring of DSM-IV bipolar disorder type I or II patients aged 18 to 65 years was conducted during the intervention phase (6 months) and follow-up phase (5-year postintervention) of a randomized controlled trial reporting clinical outcomes and inpatient and outpatient mental health service utilization, with estimation of cost of treatment per patient. The study was conducted from October 1997 through October 2006. Results Compared with individuals with bipolar disorder receiving the control intervention, psychoeducated patients had twice as many planned outpatient appointments, but the estimated mean cost of emergency consultation utilization was significantly less. There were trends for psychoeducated patients to opt for self-funded psychotherapy after completing group Psychoeducation and to utilize more medications. However, inpatient care accounted for 40% estimated total cost in the control group but only about 15% in the Psychoeducation group. Conclusions This study demonstrates the importance of taking a long-term overview of the cost versus benefits of adjunctive psychological therapy in bipolar disorders. If viewed only in the short-term, the Psychoeducation group used more mental health care resources without clear additional health gain. However, extended follow-up demonstrated a long-term advantage for psychoeducated individuals, such that, compared to an unstructured support group intervention, group Psychoeducation is less costly and more effective.
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group Psychoeducation for stabilised bipolar disorders 5 year outcome of a randomised clinical trial
British Journal of Psychiatry, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Maria Reinares, J M Goikolea, R Palominootiniano, A Benabarre, Anabel MartinezaranAbstract:Background The long-term efficacy of psychological interventions for bipolar disorders has not been tested. Aims This study assessed the efficacy of group Psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders. Method A randomised controlled trial with masked outcome assessment comparing group Psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures. Results At the 5-year follow-up, time to any recurrence was longer for the Psychoeducation group (log rank=9.953, P <0.002). The Psychoeducation group had fewer recurrences (3.86 v . 8.37, F =23.6, P <0.0001) of any type and they spent less time acutely ill (154 v . 586 days, F =31.66, P =0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the Psychoeducation group (45 v . 30, F =4.26, P =0.047). Conclusions Six-month group Psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group Psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.
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Psychoeducation for bipolar ii disorder an exploratory 5 year outcome subanalysis
Journal of Affective Disorders, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, J M Goikolea, Ekaterina Popova, C M Bonnin, Jan ScottAbstract:Abstract Background Bipolar II represents a significant subgroup of bipolar patients. However, there is limited evidence regarding the efficacy of pharmacological and/or psychosocial therapies. Method Post-hoc analyses were undertaken using data on 20 (out of 120) patients who fulfilled DSM-IV criteria for BP II who had participated in a single-blind randomized controlled treatment trial (RCT) exploring the acute and long-term efficacy of group Psychoeducation plus standard pharmacological treatment as compared with unstructured support groups plus standard pharmacological treatment. Eight BP II subjects had been randomized to a Psychoeducation group and 12 to an unstructured support group. Results Psychoeducated, as compared to control group bipolar II patients, had significantly better 5-year outcomes, with lower mean number of BP episodes (p Conclusions Although these findings should be treated with caution, it appears that Psychoeducation plus medication can benefit bipolar II subjects. Dedicated treatment trials will need to clarify whether these therapies require modifications in duration and/or content to meet the needs of bipolar II patients.
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Psychoeducation manual for bipolar disorder
2006Co-Authors: Francesc Colom, Eduard Vieta, Jan ScottAbstract:Although the mainstay of bipolar therapy is drug treatment, Psychoeducation is a technique that has proven to be very effective as an add-on to medication, helping to reduce the number of all types of bipolar recurrences and hospitalisation. The object is to improve patients' understanding of the disorder and therefore their adherence to pharmacotherapy. Based on the highly successful, evidence-based Barcelona program, this book is a pragmatic, therapists' guide for how to implement Psychoeducation for bipolar patients. It gives practical guidance for how to conduct a Psychoeducation group, using sessions and cases drawn from the Barcelona Psychoeducation Program. Moreover, it provides the reader with a great amount of practical tips and tricks and specific techniques to maximize the benefits of bipolar Psychoeducation. The authors formed the first group to show the efficacy of Psychoeducation as a maintenance treatment and have a long history of performing bipolar Psychoeducation.
Francesc Colom - One of the best experts on this subject based on the ideXlab platform.
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keeping therapies simple Psychoeducation in the prevention of relapse in affective disorders
British Journal of Psychiatry, 2011Co-Authors: Francesc ColomAbstract:Psychological interventions for mood disorders can be divided into ‘ skilled’ and ‘simple’. Psychoeducation belongs to the latter group: a simple and illness-focused therapy with prophylactic efficacy in all major mood disorders. Successful implementation of Psychoeducation requires a proper setting, including open-door policy, team effort and empowerment of the therapeutic alliance.
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the impact of staging bipolar disorder on treatment outcome of family Psychoeducation
Journal of Affective Disorders, 2010Co-Authors: Maria Reinares, Francesc Colom, Adriane R Rosa, Mar C Bonnin, Carolina Franco, Brisa Sole, Flavio Kapczinski, Eduard VietaAbstract:Abstract Background Psychological interventions on top of pharmacological treatment can improve the outcome of bipolar disorder. However, there is a paucity of data on the aspects that may influence the effectiveness of psychological approaches to bipolar disorders. The staging models suggest a progression from prodromal to more severe and treatment-resistant presentations. The aim of this study was to assess whether a staging model in bipolar disorder was related to patients' response to Psychoeducation delivered to caregivers. Methods Post-hoc analysis from a 15-month randomized controlled trial showing the efficacy of group Psychoeducation for caregivers in the prophylaxis of recurrences. The sample was composed of 113 medicated euthymic bipolar outpatients who lived with their caregivers. For the purpose of this study the patients were subdivided into two groups according to staging. The prophylactic efficacy of caregiver Psychoeducation was studied based on staging. Results Patients on Stage I benefited from caregiver Psychoeducation by having longer time to recurrence (Log-rank chi-square: 6.26; p = 0.012). No significant benefits from caregiver Psychoeducation were found in patients on advanced stages. Limitations The present post-hoc analysis was not properly powered to compare each one of the four stages with each other, instead staging was divided into Stage I and advanced stages (II, III or IV). Conclusions Psychoeducation for caregivers of bipolar patients on Stage I may improve long-term outcome in terms of time to recurrence. This study highlights the need to introduce psychological interventions early in the course of the illness as some treatments may be more useful in patients at earlier stages of bipolar disorder.
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has number of previous episodes any effect on response to group Psychoeducation in bipolar patients a 5 year follow up post hoc analysis
Acta Neuropsychiatrica, 2010Co-Authors: Francesc Colom, Anabel Martinezaran, Maria Reinares, Carla Torrent, Isabella Pacchiarotti, Dina Popovic, Lorenzo Mazzarini, Adriane R RosaAbstract:Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martinez-Aran A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group Psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Objective: One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group Psychoeducation for bipolar disorders according to the number of previous episodes. Methods: For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Results: Patients with more than seven episodes at study entry did not show any significant improvement with Psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from Psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9–14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. Conclusion: The number of previous episodes clearly worsens response to Psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention.
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long term mental health resource utilization and cost of care following group Psychoeducation or unstructured group support for bipolar disorders a cost benefit analysis
The Journal of Clinical Psychiatry, 2009Co-Authors: Jan Scott, Francesc Colom, J M Goikolea, A Benabarre, Jose Sanchezmoreno, Ekaterina Popova, Nuria Cruz, Marc Valenti, Miguel A Asenjo, Eduard VietaAbstract:Objective To explore the short- and long-term mental health resource utilization and cost of care in a sample of 120 individuals with bipolar disorders who participated in a randomized controlled efficacy trial of group Psychoeducation versus unstructured group support. Method Prospective, independent monitoring of DSM-IV bipolar disorder type I or II patients aged 18 to 65 years was conducted during the intervention phase (6 months) and follow-up phase (5-year postintervention) of a randomized controlled trial reporting clinical outcomes and inpatient and outpatient mental health service utilization, with estimation of cost of treatment per patient. The study was conducted from October 1997 through October 2006. Results Compared with individuals with bipolar disorder receiving the control intervention, psychoeducated patients had twice as many planned outpatient appointments, but the estimated mean cost of emergency consultation utilization was significantly less. There were trends for psychoeducated patients to opt for self-funded psychotherapy after completing group Psychoeducation and to utilize more medications. However, inpatient care accounted for 40% estimated total cost in the control group but only about 15% in the Psychoeducation group. Conclusions This study demonstrates the importance of taking a long-term overview of the cost versus benefits of adjunctive psychological therapy in bipolar disorders. If viewed only in the short-term, the Psychoeducation group used more mental health care resources without clear additional health gain. However, extended follow-up demonstrated a long-term advantage for psychoeducated individuals, such that, compared to an unstructured support group intervention, group Psychoeducation is less costly and more effective.
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group Psychoeducation for stabilised bipolar disorders 5 year outcome of a randomised clinical trial
British Journal of Psychiatry, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Maria Reinares, J M Goikolea, R Palominootiniano, A Benabarre, Anabel MartinezaranAbstract:Background The long-term efficacy of psychological interventions for bipolar disorders has not been tested. Aims This study assessed the efficacy of group Psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders. Method A randomised controlled trial with masked outcome assessment comparing group Psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures. Results At the 5-year follow-up, time to any recurrence was longer for the Psychoeducation group (log rank=9.953, P <0.002). The Psychoeducation group had fewer recurrences (3.86 v . 8.37, F =23.6, P <0.0001) of any type and they spent less time acutely ill (154 v . 586 days, F =31.66, P =0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the Psychoeducation group (45 v . 30, F =4.26, P =0.047). Conclusions Six-month group Psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group Psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.
J M Goikolea - One of the best experts on this subject based on the ideXlab platform.
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long term mental health resource utilization and cost of care following group Psychoeducation or unstructured group support for bipolar disorders a cost benefit analysis
The Journal of Clinical Psychiatry, 2009Co-Authors: Jan Scott, Francesc Colom, J M Goikolea, A Benabarre, Jose Sanchezmoreno, Ekaterina Popova, Nuria Cruz, Marc Valenti, Miguel A Asenjo, Eduard VietaAbstract:Objective To explore the short- and long-term mental health resource utilization and cost of care in a sample of 120 individuals with bipolar disorders who participated in a randomized controlled efficacy trial of group Psychoeducation versus unstructured group support. Method Prospective, independent monitoring of DSM-IV bipolar disorder type I or II patients aged 18 to 65 years was conducted during the intervention phase (6 months) and follow-up phase (5-year postintervention) of a randomized controlled trial reporting clinical outcomes and inpatient and outpatient mental health service utilization, with estimation of cost of treatment per patient. The study was conducted from October 1997 through October 2006. Results Compared with individuals with bipolar disorder receiving the control intervention, psychoeducated patients had twice as many planned outpatient appointments, but the estimated mean cost of emergency consultation utilization was significantly less. There were trends for psychoeducated patients to opt for self-funded psychotherapy after completing group Psychoeducation and to utilize more medications. However, inpatient care accounted for 40% estimated total cost in the control group but only about 15% in the Psychoeducation group. Conclusions This study demonstrates the importance of taking a long-term overview of the cost versus benefits of adjunctive psychological therapy in bipolar disorders. If viewed only in the short-term, the Psychoeducation group used more mental health care resources without clear additional health gain. However, extended follow-up demonstrated a long-term advantage for psychoeducated individuals, such that, compared to an unstructured support group intervention, group Psychoeducation is less costly and more effective.
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group Psychoeducation for stabilised bipolar disorders 5 year outcome of a randomised clinical trial
British Journal of Psychiatry, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Maria Reinares, J M Goikolea, R Palominootiniano, A Benabarre, Anabel MartinezaranAbstract:Background The long-term efficacy of psychological interventions for bipolar disorders has not been tested. Aims This study assessed the efficacy of group Psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders. Method A randomised controlled trial with masked outcome assessment comparing group Psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures. Results At the 5-year follow-up, time to any recurrence was longer for the Psychoeducation group (log rank=9.953, P <0.002). The Psychoeducation group had fewer recurrences (3.86 v . 8.37, F =23.6, P <0.0001) of any type and they spent less time acutely ill (154 v . 586 days, F =31.66, P =0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the Psychoeducation group (45 v . 30, F =4.26, P =0.047). Conclusions Six-month group Psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group Psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.
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Psychoeducation for bipolar ii disorder an exploratory 5 year outcome subanalysis
Journal of Affective Disorders, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, J M Goikolea, Ekaterina Popova, C M Bonnin, Jan ScottAbstract:Abstract Background Bipolar II represents a significant subgroup of bipolar patients. However, there is limited evidence regarding the efficacy of pharmacological and/or psychosocial therapies. Method Post-hoc analyses were undertaken using data on 20 (out of 120) patients who fulfilled DSM-IV criteria for BP II who had participated in a single-blind randomized controlled treatment trial (RCT) exploring the acute and long-term efficacy of group Psychoeducation plus standard pharmacological treatment as compared with unstructured support groups plus standard pharmacological treatment. Eight BP II subjects had been randomized to a Psychoeducation group and 12 to an unstructured support group. Results Psychoeducated, as compared to control group bipolar II patients, had significantly better 5-year outcomes, with lower mean number of BP episodes (p Conclusions Although these findings should be treated with caution, it appears that Psychoeducation plus medication can benefit bipolar II subjects. Dedicated treatment trials will need to clarify whether these therapies require modifications in duration and/or content to meet the needs of bipolar II patients.
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stabilizing the stabilizer group Psychoeducation enhances the stability of serum lithium levels
Bipolar Disorders, 2005Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Anabel Martinezaran, Maria Reinares, J M Goikolea, Jan ScottAbstract:Objective: To determine the effect on the serum lithium levels of a Psychoeducational program in patients with bipolar disorder. Method: This is a subanalysis of data obtained from a larger study on the efficacy of group Psychoeducation in the prophylaxis of recurrences in bipolar disorders. Data on plasma lithium levels were obtained at five time points: baseline, 6, 12, 18 and 24 months. Serum lithium levels of patients who had received psychoeduction (psychoeducated) (N = 49) and non-psychoeducated patients (N = 44) were compared. Results: Mean serum lithium levels were significantly higher and more stable for the Psychoeducation group. Conclusions: As changes in serum lithium level may be a powerful predictor of recurrence for bipolar patients, the addition of group Psychoeducation to standard pharmacological treatment may be beneficial to optimize serum lithium levels and, thereby improve outcome.
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Psychoeducation in bipolar patients with comorbid personality disorders
Bipolar Disorders, 2004Co-Authors: Francesc Colom, Eduard Vieta, Anabel Martinezaran, Maria Reinares, J M Goikolea, A Benabarre, Carla Torrent, Jose Sanchezmoreno, Merce ComesAbstract:Background: The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than ‘pure’ bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders. Method: The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group Psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either Psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the Psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures. Results: At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the Psychoeducation group (p < 0.005). Patients included in the Psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group. Conclusion: Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients.
Anabel Martinezaran - One of the best experts on this subject based on the ideXlab platform.
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has number of previous episodes any effect on response to group Psychoeducation in bipolar patients a 5 year follow up post hoc analysis
Acta Neuropsychiatrica, 2010Co-Authors: Francesc Colom, Anabel Martinezaran, Maria Reinares, Carla Torrent, Isabella Pacchiarotti, Dina Popovic, Lorenzo Mazzarini, Adriane R RosaAbstract:Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martinez-Aran A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group Psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Objective: One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group Psychoeducation for bipolar disorders according to the number of previous episodes. Methods: For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Results: Patients with more than seven episodes at study entry did not show any significant improvement with Psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from Psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9–14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. Conclusion: The number of previous episodes clearly worsens response to Psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention.
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group Psychoeducation for stabilised bipolar disorders 5 year outcome of a randomised clinical trial
British Journal of Psychiatry, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Maria Reinares, J M Goikolea, R Palominootiniano, A Benabarre, Anabel MartinezaranAbstract:Background The long-term efficacy of psychological interventions for bipolar disorders has not been tested. Aims This study assessed the efficacy of group Psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders. Method A randomised controlled trial with masked outcome assessment comparing group Psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures. Results At the 5-year follow-up, time to any recurrence was longer for the Psychoeducation group (log rank=9.953, P <0.002). The Psychoeducation group had fewer recurrences (3.86 v . 8.37, F =23.6, P <0.0001) of any type and they spent less time acutely ill (154 v . 586 days, F =31.66, P =0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the Psychoeducation group (45 v . 30, F =4.26, P =0.047). Conclusions Six-month group Psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group Psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.
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stabilizing the stabilizer group Psychoeducation enhances the stability of serum lithium levels
Bipolar Disorders, 2005Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Anabel Martinezaran, Maria Reinares, J M Goikolea, Jan ScottAbstract:Objective: To determine the effect on the serum lithium levels of a Psychoeducational program in patients with bipolar disorder. Method: This is a subanalysis of data obtained from a larger study on the efficacy of group Psychoeducation in the prophylaxis of recurrences in bipolar disorders. Data on plasma lithium levels were obtained at five time points: baseline, 6, 12, 18 and 24 months. Serum lithium levels of patients who had received psychoeduction (psychoeducated) (N = 49) and non-psychoeducated patients (N = 44) were compared. Results: Mean serum lithium levels were significantly higher and more stable for the Psychoeducation group. Conclusions: As changes in serum lithium level may be a powerful predictor of recurrence for bipolar patients, the addition of group Psychoeducation to standard pharmacological treatment may be beneficial to optimize serum lithium levels and, thereby improve outcome.
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Psychoeducation in bipolar patients with comorbid personality disorders
Bipolar Disorders, 2004Co-Authors: Francesc Colom, Eduard Vieta, Anabel Martinezaran, Maria Reinares, J M Goikolea, A Benabarre, Carla Torrent, Jose Sanchezmoreno, Merce ComesAbstract:Background: The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than ‘pure’ bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders. Method: The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group Psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either Psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the Psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures. Results: At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the Psychoeducation group (p < 0.005). Patients included in the Psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group. Conclusion: Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients.
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Psychoeducation efficacy in bipolar disorders beyond compliance enhancement
The Journal of Clinical Psychiatry, 2003Co-Authors: Francesc Colom, Eduard Vieta, Anabel Martinezaran, Maria Reinares, J M Goikolea, Carla Torrent, Cristobal GastoAbstract:Background: Several previous studies have established that low treatment adherence is common among bipolar patients and may explain high rates of recurrence. On the other hand, some patients keep relapsing even when they strictly follow their prescribed somatic treatments. Psychological interventions such as Psychoeducation may foster early recognition of prodromal symptoms and minimize the risk of relapse. To date, studies assessing the usefulness of Psychoeducation in fully compliant patients are lacking. Method: This was a single-blind, randomized, prospective clinical trial on the efficacy of group Psychoeducation in remitted fully compliant DSM-IV bipolar I patients (N = 25) who were compared with a group with similar characteristics (N = 25) who did not receive Psychoeducation. All patients received naturalistic pharmacologic treatment. Recruitment began in 1997 and follow-up was completed in January 2002. The follow-up phase comprised 2 years during which all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly on several outcome measures. Results: At the end of the 2-year follow-up, 23 subjects (92%) in the control group fulfilled criteria for recurrence versus 15 patients (60%) in the Psychoeducation group (p <.01). The number of total recurrences and the number of depressive episodes were significantly lower in psychoeducated patients. Conclusion: Although the present study has the limitation of small sample size, Psychoeducation showed its efficacy in preventing relapses in bipolar I patients who were adherent to drug treatment. The action of Psychoeducation seems to go beyond compliance enhancement and may support a tripod model composed by lifestyle regularity and healthy habits, early detection of prodromal signs followed by prompt drug intervention, and finally treatment compliance.
Maria Reinares - One of the best experts on this subject based on the ideXlab platform.
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the impact of staging bipolar disorder on treatment outcome of family Psychoeducation
Journal of Affective Disorders, 2010Co-Authors: Maria Reinares, Francesc Colom, Adriane R Rosa, Mar C Bonnin, Carolina Franco, Brisa Sole, Flavio Kapczinski, Eduard VietaAbstract:Abstract Background Psychological interventions on top of pharmacological treatment can improve the outcome of bipolar disorder. However, there is a paucity of data on the aspects that may influence the effectiveness of psychological approaches to bipolar disorders. The staging models suggest a progression from prodromal to more severe and treatment-resistant presentations. The aim of this study was to assess whether a staging model in bipolar disorder was related to patients' response to Psychoeducation delivered to caregivers. Methods Post-hoc analysis from a 15-month randomized controlled trial showing the efficacy of group Psychoeducation for caregivers in the prophylaxis of recurrences. The sample was composed of 113 medicated euthymic bipolar outpatients who lived with their caregivers. For the purpose of this study the patients were subdivided into two groups according to staging. The prophylactic efficacy of caregiver Psychoeducation was studied based on staging. Results Patients on Stage I benefited from caregiver Psychoeducation by having longer time to recurrence (Log-rank chi-square: 6.26; p = 0.012). No significant benefits from caregiver Psychoeducation were found in patients on advanced stages. Limitations The present post-hoc analysis was not properly powered to compare each one of the four stages with each other, instead staging was divided into Stage I and advanced stages (II, III or IV). Conclusions Psychoeducation for caregivers of bipolar patients on Stage I may improve long-term outcome in terms of time to recurrence. This study highlights the need to introduce psychological interventions early in the course of the illness as some treatments may be more useful in patients at earlier stages of bipolar disorder.
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has number of previous episodes any effect on response to group Psychoeducation in bipolar patients a 5 year follow up post hoc analysis
Acta Neuropsychiatrica, 2010Co-Authors: Francesc Colom, Anabel Martinezaran, Maria Reinares, Carla Torrent, Isabella Pacchiarotti, Dina Popovic, Lorenzo Mazzarini, Adriane R RosaAbstract:Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martinez-Aran A, Torrent C, Rosa A, Palomino-Otiniano R, Franco C, Bonnin CM, Vieta E. Has number of previous episodes any effect on response to group Psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis. Objective: One of the main utilities of staging in bipolar disorder is enhancing the formulation of pharmacological and non-pharmacological treatment strategies. Hence, it is essential to ascertain whether the number of previous episodes influences treatment response. Hereby, we present a 5-year post hoc study on the efficacy of group Psychoeducation for bipolar disorders according to the number of previous episodes. Methods: For this subanalysis, we have compared the 5-year outcome of 120 euthymic psychoeducated versus non-psychoeducated bipolar patients according to the number of previous episodes at study entry. Results: Patients with more than seven episodes at study entry did not show any significant improvement with Psychoeducation according to time to recurrence. Patients with more than 14 episodes did not benefit from Psychoeducation in terms of a reduction of time spent ill. Patients with 7 or 8 episodes showed a benefit in terms of fewer days spent in hypomania, depression, mixed episodes or any episodes but not mania, while patients with 9–14 episodes showed a benefit in terms of fewer days spent in hypomania and depression but not in mixed states or mania. Only patients who presented up to 6 episodes showed reduction in time spent in any episode polarity. Conclusion: The number of previous episodes clearly worsens response to Psychoeducation, perhaps in a more subtle way than that observed with other psychological therapies. Psychoeducation should be delivered as soon as possible in the illness course, supporting the idea of early intervention.
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group Psychoeducation for stabilised bipolar disorders 5 year outcome of a randomised clinical trial
British Journal of Psychiatry, 2009Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Maria Reinares, J M Goikolea, R Palominootiniano, A Benabarre, Anabel MartinezaranAbstract:Background The long-term efficacy of psychological interventions for bipolar disorders has not been tested. Aims This study assessed the efficacy of group Psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders. Method A randomised controlled trial with masked outcome assessment comparing group Psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures. Results At the 5-year follow-up, time to any recurrence was longer for the Psychoeducation group (log rank=9.953, P <0.002). The Psychoeducation group had fewer recurrences (3.86 v . 8.37, F =23.6, P <0.0001) of any type and they spent less time acutely ill (154 v . 586 days, F =31.66, P =0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the Psychoeducation group (45 v . 30, F =4.26, P =0.047). Conclusions Six-month group Psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group Psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.
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stabilizing the stabilizer group Psychoeducation enhances the stability of serum lithium levels
Bipolar Disorders, 2005Co-Authors: Francesc Colom, Eduard Vieta, J Sanchezmoreno, Anabel Martinezaran, Maria Reinares, J M Goikolea, Jan ScottAbstract:Objective: To determine the effect on the serum lithium levels of a Psychoeducational program in patients with bipolar disorder. Method: This is a subanalysis of data obtained from a larger study on the efficacy of group Psychoeducation in the prophylaxis of recurrences in bipolar disorders. Data on plasma lithium levels were obtained at five time points: baseline, 6, 12, 18 and 24 months. Serum lithium levels of patients who had received psychoeduction (psychoeducated) (N = 49) and non-psychoeducated patients (N = 44) were compared. Results: Mean serum lithium levels were significantly higher and more stable for the Psychoeducation group. Conclusions: As changes in serum lithium level may be a powerful predictor of recurrence for bipolar patients, the addition of group Psychoeducation to standard pharmacological treatment may be beneficial to optimize serum lithium levels and, thereby improve outcome.
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Psychoeducation in bipolar patients with comorbid personality disorders
Bipolar Disorders, 2004Co-Authors: Francesc Colom, Eduard Vieta, Anabel Martinezaran, Maria Reinares, J M Goikolea, A Benabarre, Carla Torrent, Jose Sanchezmoreno, Merce ComesAbstract:Background: The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than ‘pure’ bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders. Method: The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group Psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either Psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the Psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures. Results: At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the Psychoeducation group (p < 0.005). Patients included in the Psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group. Conclusion: Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients.
