Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: A 5-year controlled clinical trial

European Psychiatry - Tập 29 - Trang 134-141 - 2014
A. González Isasi1, E. Echeburúa2, J.M. Limiñana3, A. González-Pinto4
1Psychiatry Department, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
2Faculty of Psychology, University of the Basque Country, CIBERSAM, San Sebastián, Spain
3Unidad de Investigación, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
4CIBERSAM, Department of Psychiatry, Santiago Apóstol Hospital, EHU/UPV, Vitoria, Spain

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AbstractObjective:The aim of this research, which represents an additional and longer follow-up to a previous trial, was to evaluate a 5-year follow-up study of a combined treatment (pharmacological + psychoeducational and cognitive-behavioral therapy) as compared with a standard pharmacological treatment in patients with refractory bipolar disorder.Method:Forty patients were randomly assigned to either an Experimental group–under combined treatment — or a Control group — under pharmacological treatment. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation time points.Results:Between-group differences were significant at all evaluation time points after treatment. Experimental group had less hospitalization events than Control group in the 12-month evaluation (P = 0.015). The Experimental group showed lower depression and anxiety in the 6-month (P = 0.006; P = 0.019), 12-month (P = 0.001; P < 0.001) and 5-year (P < 0.001, P < 0.001) evaluation time points. Significant differences emerged in mania and misadjustment already in the post-treatment evaluation (P = 0.009; P < 0.001) and were sustained throughout the study (6-month: P = 0.006, P < 0.001; 12-month: P < 0.001, P < 0.001; 5-year: P = 0.004, P < 0.001). After 5-year follow-up, 88.9% of patients in the Control group and 20% of patients in the Experimental group showed persistent affective symptoms and/or difficulties in social-occupational functioning.Conclusions:A combined therapy is long-term effective for patients with refractory bipolar disorder. Suggestions for future research are commented.

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European Psychiatry

Tập 29

134-141

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