Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T16:18:34.727Z Has data issue: false hasContentIssue false
  • English
  • Français

Has number of previous episodes any effect on response to group psychoeducation in bipolar patients? A 5-year follow-up post hoc analysis

Published online by Cambridge University Press:  24 June 2014

Francesc Colom ,
María Reinares ,
Isabella Pacchiarotti ,
Dina Popovic ,
Lorenzo Mazzarini ,
Anabel Martínez-Arán ,
Carla Torrent ,
Adriane Rosa ,
Rosario Palomino-Otiniano  and
Carolina Franco
...Show all authors
Francesc Colom
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
María Reinares
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Isabella Pacchiarotti
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Dina Popovic
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain Unit of Psychiatry, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Pisa, Italy
Lorenzo Mazzarini
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain Unit of Psychiatry, Department of Neurosciences, Sant’Andrea Hospital, Sapienza University, Rome, Italy
Anabel Martínez-Arán
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Carla Torrent
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Adriane Rosa
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Rosario Palomino-Otiniano
Affiliation:
Highfield Unit, Department of Psychiatry, Oxford, UK
Carolina Franco
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Caterina M. Bonnin
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
Eduard Vieta*
Affiliation:
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
*
Dr Eduard Vieta, Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Villarroel 170, 08036 Barcelona, Catalonia, Spain. Tel: +34 932275401; Fax: +34 932279876; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Colom F, Reinares M, Pacchiarotti I, Popovic D, Mazzarini L, Martínez-Arán 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.

Keywords

bipolar disordermood stabiliserspsychotherapyresistancetreatment
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 22 , Issue 2 , April 2010 , pp. 50 - 53
Copyright
Copyright © 2010 John Wiley & Sons A/S

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fava, GA, Kellner, R.Staging: a neglected dimension in psychiatric classification. Acta Psychiatr Scand 1993;87:225–230. CrossRefGoogle ScholarPubMed
Scott, J, Paykel, E, Morriss, Ret al. Cognitive-behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial. Br J Psychiatry 2006;188:313–320CrossRefGoogle ScholarPubMed
Vieta, E.Improving treatment adherence in bipolar disorder through psychoeducation. J Clin Psychiatry 2005;66(Suppl. 1):24–29. Google ScholarPubMed
Colom, F, Vieta, E, Sanchez-Moreno, Jet al. Group psychoeducation for stabilised bipolar disorders: five-year outcome of a randomised clinical trial. Br J Psychiatry 2009;194:259–264CrossRefGoogle Scholar
Colom, F, Vieta, E.Psychoeducation manual for bipolar disorder. Cambridge: Cambridge University Press, 2006. CrossRefGoogle Scholar
Colom, F, Vieta, E, Martinez-Aran, Aet 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 2003;60:402–407. CrossRefGoogle Scholar
Colom, F, Vieta, E, Daban, C, Pacchiarotti, I, Sánchez-Moreno, J.Clinical and therapeutic implications of predominant polarity in bipolar disorder. J Affect Disord 2006;93:13–17. CrossRefGoogle ScholarPubMed
Rosa, AR, Andreazza, AC, Kunz, Met al. Predominant polarity in bipolar disorder: diagnostic implications. J Affect Disord 2008;107:45–51. CrossRefGoogle ScholarPubMed
Malhi, GS, Ivanovski, B, Hadzi-Pavlovic, D, Mitchell, PB, Vieta, E, Sachdev, P.Neuropsychological deficits and functional impairment in bipolar depression,hypomania and euthymia. Bipolar Disord 2007;9:114–125. CrossRefGoogle ScholarPubMed
Martinez-Aran, A, Vieta, E, Reinares, Met al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry 2004;161:262–270CrossRefGoogle ScholarPubMed
Berk, M, Conus, P, Lucas, Net al. Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disord 2007a;9:671–678. CrossRefGoogle ScholarPubMed
Berk, M, Hallam, KT, McGorry, PD.The potential utility of a staging model as a course specifier: a bipolar disorder perspective. J Affect Disord 2007b;100:279–281. CrossRefGoogle ScholarPubMed
Scott, J, Colom, F, Vieta, E.A meta-analysis of relapse rates with adjunctive psychological therapies compared to usual psychiatric treatment for bipolar disorders. Int J Neuropsychopharmacol 2007;10:123–129. CrossRefGoogle ScholarPubMed