MedWire News: Psychoeducation aimed at caregivers of bipolar patients helps, alongside usual treatment, to reduce the risk for recurrences, particularly of mania and hypomania episodes, in bipolar disorder patients, Spanish study findings indicate.
Randomized controlled trials have demonstrated that family-focused treatment in addition to bipolar disorder pharmacotherapy has a positive effect. But there have been no trials that have used contemporary techniques to examine the specific effect of working with caregiver-only groups, explain Eduard Vieta, from the University of Barcelona, and colleagues.
The team randomly assigned 113 medicated euthymic bipolar outpatients who lived with their caregivers to an experimental group in which the caregivers received 12 90-minute psychoeducation sessions on bipolar disorder and coping skills or a control group in which the caregivers received no specific intervention.
The patients did not attend the groups, and they were assessed monthly for any mood recurrence during the intervention and for 12 months of follow-up, the researchers note in the journal Bipolar Disorders.
The average age of the patients in the experimental group was 33 years, compared with 35 years in the control group, at respective average ages of bipolar disorder onset of 23.51 years and 23.05 years. The average ages of the caregivers were 50 years and 48 years, respectively. In all, seven caregivers were lost to follow-up, with the remainder attending at least eight of the sessions.
Sixty-one patients were found to have a mood episode recurrence during follow-up, of whom 42% were from the intervention group and 66% from the control group. The difference between the two groups was significant, and the estimated number needed to treat was 4.1 patients.
Further analysis revealed that there were no significant differences in the number of mood episodes among patients with either depressive or mixed episode relapses. However, among those with a hypomanic/manic episode, the intervention was associated with a significantly longer time to relapse and a significantly lower number of patients experiencing relapse, at 17.5% versus 37.5% for controls.
"Overall, this randomized controlled trial supports that the use of psychoeducation group interventions for caregivers of euthymic bipolar patients who are receiving pharmacological treatment and outpatient follow-up is associated with improved outcomes of the patients," the team says.
They add: "The next step is to test whether caregiver and patient psychoeducation groups can have synergic effects."
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