MedWire News: Study results suggest that providing psychoeducation to the caregivers of bipolar disorder (BD) patients improves long-term outcome in terms of time to recurrence in patients with early stage, but not advanced stage, illness.
“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 BD,” say Eduard Vieta (University of Barcelona, Spain) and colleagues.
The researchers performed a post-hoc analysis from a 15-month randomized controlled trial on the efficacy of caregiver psychoeducation for bipolar disorder in preventing recurrences. In total, 113 medicated euthymic BD outpatients who lived with their caregivers were divided according to whether they had early (stage I) or advanced (stages II, III, or IV) illness.
Stage I included individuals with well-established periods of euthymia who returned to their baseline level of functioning in the absence of overt psychiatric morbidity between episodes. Patients with advanced-stage illness ranged from those with rapid cycling or psychiatric symptoms during euthymia to those who were unable to live autonomously and required daily supervision.
Psychoeducation consisted of 12 90-minute group sessions delivered to caregivers focusing on structured information about the nature of BP and skills training for its management.
Stage I patients benefited from caregiver psychoeducation compared with patients whose caregivers did not receive any specific intervention (cumulative proportion of patients without an episode at 13 months=68% vs 37%) . By contrast, patients with advanced-stage BD did not show any benefit.
“This highlights that aspects such as functioning and illness severity may modulate response to psychological treatments, as remarked by the positive results on Stage I patients compared with the lack of prophylactic efficacy of caregiver psychoeducation amongst those patients on advanced stages,” write the authors in the Journal of Affective Disorders.
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