A multi-center naturalistic study of a newly designed 12-sessions group psychoeducation program for patients with bipolar disorder and their caregivers

Springer Science and Business Media LLC - Tập 8 - Trang 1-9 - 2020
Susan Zyto1,2, Nienke Jabben3, Peter F. J. Schulte4, Eline J. Regeer5, Peter J. J. Goossens6,7, Ralph W. Kupka5,2,8
1Mental Health Service Organisation North Holland North, Center for Psychosomatic Medicine, Hoorn, The Netherlands
2Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
3Department of Psychiatry, Zuyderland Medical Center, Sittard, The Netherlands
4Mental Health Service Organisation North Holland North, Alkmaar, The Netherlands
5Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
6Dimence Group Mental Health Care Center, Deventer, The Netherlands
7University Center for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
8GGZinGeest Center for Mental Health Care, Amsterdam, The Netherlands

Tóm tắt

Psychoeducation (PE) for bipolar disorder (BD) has a first-line recommendation for the maintenance treatment phase of BD. Formats vary greatly in the number of sessions, whether offered individually or in a group, and with or without caregivers attending. Due to a large variation in formats in the Netherlands, a new program was developed and implemented in 17 outpatient clinics throughout the country. The current study investigated the feasibility of a newly developed 12-sessions PE group program for patients with BD and their caregivers in routine outpatient practice and additionally explored its effectiveness. Participants in the study were 108 patients diagnosed with BD, 88 caregivers and 35 course leaders. Feasibility and acceptance of the program were investigated by measures of attendance, and evaluative questionnaires after session 12. Preliminary treatment effects were investigated by pre- and post-measures on mood symptoms, attitudes towards BD and its treatment, levels of self-management, and levels of expressed emotion. There was a high degree of satisfaction with the current program as reported by patients, caregivers, and course leaders. The average attendance was high and 83% of the patients and 75% of the caregivers completed the program. Analyses of treatment effects suggest positive effects on depressive symptoms and self-management in patients, and lower EE as experienced by caregivers. This compact 12-sessions psychoeducation group program showed good feasibility and was well accepted by patients, caregivers, and course leaders. Preliminary effects on measures of self-management, expressed emotions, and depressive symptoms were promising. After its introduction it has been widely implemented in mental health institutions throughout the Netherlands.

Tài liệu tham khảo

Altman EG, Hedeker D, Peterson JL, Davis JM. The altman self-rating mania scale. Biol Psychiatry. 1997;42(10):948–55.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

Arvilommi P, Suominen K, Mantere O, Leppamaki S, Valtonen H, Isometsa E. Predictors of adherence to psychopharmacological and psychosocial treatment in bipolar I or II disorders—an 18-month prospective study. J Affect Disord. 2014;155:110–7.

Berk M, Post R, Ratheesh A, Gliddon E, Singh A, Vieta E, et al. Staging in bipolar disorder: from theoretical framework to clinical utility. World Psychiatry. 2017;16(3):236–44.

Castle D, Berk M, Berk L, Lauder S, Chamberlain J, Gilbert M. Pilot of group intervention for bipolar disorder. Int J Psychiatry Clin Pract. 2007;11(4):279–84.

Castle D, White C, Chamberlain J, Berk M, Berk L, Lauder S, et al. Group-based psychosocial intervention for bipolar disorder: randomised controlled trial. Br J Psychiatry. 2010;196(5):383–8.

Chen R, Zhu X, Capitao LP, Zhang H, Luo J, Wang X, et al. Psychoeducation for psychiatric inpatients following remission of a manic episode in bipolar I disorder: a randomized controlled trial. Bipolar Disord. 2019;21(1):76–85.

Cole JD, Kazarian SS. The Level of Expressed Emotion Scale: a new measure of expressed emotion. J Clin Psychol. 1988;44(3):392–7.

Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry. 2003a;60(4):402–7.

Colom F, Vieta E, Reinares M, Martinez-Aran A, Torrent C, Goikolea JM, et al. Psychoeducation efficacy in bipolar disorders: beyond compliance enhancement. J Clin Psychiatry. 2003b;64(9):1101–5.

Colom F, Vieta E, Sanchez-Moreno J, Palomino-Otiniano R, Reinares M, Goikolea JM, et al. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. Br J Psychiatry. 2009;194(3):260–5.

Connolly KR, Thase ME. The clinical management of bipolar disorder: a review of evidence-based guidelines. Prim Care Companion CNS Disord. 2011. https://doi.org/10.4088/PCC.10r01097.

de Pellegrinelli BK, de Costa OLF, Silval KI, Dias VV, Roso MC, Bandeira M, et al. Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder. Acta Psychiatrica Scandinavica. 2013;127(2):153–8.

D’Souza R, Piskulic D, Sundram S. A brief dyadic group based psychoeducation program improves relapse rates in recently remitted bipolar disorder: a pilot randomised controlled trial. J Affect Disord. 2010;120(1–3):272–6.

Gitlin MJ, Swendsen J, Heller TL, Hammen C. Relapse and impairment in bipolar disorder. Am J Psychiatry. 1995;152(11):1635–40.

Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39(4 Pt 1):1005–26.

Hofman A, Honig A, Vossen M. Het manisch-depressief syndroom; psycho-educatie als onderdeel van behandeling. Tijdschr. Psychiatr. 1992;34:549–59.

Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med. 1983;13(1):177–83.

Honig A, Hofman A, Rozendaal N, Dingemans P. Psychoeducation in bipolar disorder: Effect on expressed emotion. Psychiatry Research. 1997;72:17–22.

Kallestad H, Wullum E, Scott J, Stiles TC, Morken G. The long-term outcomes of an effectiveness trial of group versus individual psychoeducation for bipolar disorders. J Affect Disord. 2016;15(202):32–8.

Kukla M, Salyers MP, Lysaker PH. Levels of patient activation among adults with schizophrenia: associations with hope, symptoms, medication adherence, and recovery attitudes. J Nerv Ment Dis. 2013;201(4):339–44.

Levitt AJ, Mueser KT, Degenova J, Lorenzo J, Bradford-Watt D, Barbosa A, et al. Randomized controlled trial of illness management and recovery in multiple-unit supportive housing. Psychiatr Serv. 2009;60(12):1629–36.

Madigan K, Egan P, Brennan D, Hill S, Maguire B, Horgan F, et al. A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. Eur Psychiatry. 2012;27(4):281–4.

Miklowitz DJ. The role of family systems in severe and recurrent psychiatric disorders: a developmental psychopathology view. Dev Psychopathol. 2004;16(3):667–88.

Miklowitz DJ. Psychosocial interventions for bipolar disorder: a critical review of evidence for efficacy. In: Yatham LN, Kusumakar V, editors. Bipolar disorder: a clinician’s guide to treatment management. 2nd ed. Oxford: Routledge; 2009. p. 575–90.

Moljord IE, Lara-Cabrera ML, Perestelo-Perez L, Rivero-Santana A, Eriksen L, Linaker OM. Psychometric properties of the Patient Activation Measure-13 among out-patients waiting for mental health treatment: a validation study in Norway. Patient Educ Couns. 2015;98(11):1410–7.

Morriss R, Lobban F, Riste L, Davies L, Holland F, Long R, et al. Clinical effectiveness and acceptability of structured group psychoeducation versus optimised unstructured peer support for patients with remitted bipolar disorder (PARADES): a pragmatic, multicentre, observer-blind, randomised controlled superiority trial. Lancet Psychiatry. 2016;3(11):1029–38.

Parikh SV, Hawke LD, Zaretsky A, Beaulieu S, Patelis-Siotis I, Macqueen G, et al. Psychosocial interventions for bipolar disorder and coping style modification: similar clinical outcomes, similar mechanisms? Can J Psychiatry Revue Canadienne de Psychiatrie. 2013;58(8):482–6.

Peris TS, Miklowitz DJ. Parental expressed emotion and youth psychopathology: new directions for an old construct. Child Psychiatry Hum Dev. 2015;46(6):863–73.

Reinares M, Colom F, Sanchez-Moreno J, Torrent C, Martinez-Aran A, Comes M, et al. Impact of caregiver group psychoeducation on the course and outcome of bipolar patients in remission: a randomized controlled trial. Bipolar Disord. 2008;10(4):511–9.

Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, et al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003;54(5):573–83.

Schulman-Green D, Jaser S, Martin F, Alonzo A, Grey M, McCorkle R, et al. Processes of self-management in chronic illness. J Nurs Scholarsh. 2012;44(2):136–44.

Soo SA, Zhang ZW, Khong SJ, Low JEW, Thambyrajah VS, Alhabsyi S, et al. Randomized controlled trials of psychoeducation modalities in the management of bipolar disorder: a systematic review. J Clin Psychiatry. 2018. https://doi.org/10.4088/JCP.17r11750.

van Gent EM, Zwart FM. Psychoeducation of partners of bipolar-manic patients. J Affect Disord. 1991;21(1):15–8.

Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97–170.

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