The British Journal of Psychiatry (2009) 194: 260-265. doi: 10.1192/bjp.bp.107.040485
© 2009 The Royal College of Psychiatrists
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Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial

F. Colom, PsyD, MSc, PhD

Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBER-SAM, University of Barcelona, Spain, and Psychological Medicine Division, Institute of Psychiatry, London, UK

E. Vieta, MD, PhD and J. Sánchez-Moreno, PsyD

Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBER-SAM, University of Barcelona, Spain

R. Palomino-Otiniano, PsyD

Department of Psychiatry, Oxford University, Oxford, UK

M. Reinares, PsyD, J. M. Goikolea, MD, A. Benabarre, MD, PhD and A. Martínez-Arán, PsyD, MSc, PhD

Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.

Correspondence: E. Vieta, Bipolar Disorders Program, Hospital Clinic of Barcelona, Villarroel 170, 08036 Barcelona, Spain. Email: EVIETA{at}clinic.ub.es

Declaration of interest

E.V. has served as consultant, advisor or speaker for the following companies: AstraZeneca, Bial, Bristol-Myers, Eli Lilly, Glaxo-Smith-Kline, Jannssen-Cilag, Lundbeck, Merck-Sharp and Dohme, Novartis, Organon, Otsuka, Pfizer Inc, Sanofi-Aventis, Servier and UCB Pharmaceuticals. F.C. has served as advisory or speaker for the following companies: Astra Zeneca, Eli-Lilly, Sanof-Aventis, Tecnifar and Shire. Funding detailed in Acknowledgements.

Background

The long-term efficacy of psychological interventions for bipolar disorders has not been tested.

Aims

This study assessed the efficacy of group psychoeducation to prevent recurrences and to reduce time spent ill for people with bipolar disorders.

Method

A randomised controlled trial with masked outcome assessment comparing group psychoeducation and non-structured group intervention during 5-year follow-up. One hundred and twenty people with bipolar disorders were included in the study and 99 completed 5-year follow-up. Time to any recurrence, number of recurrences, total number of days spent ill, frequency and length of hospitalisations were the main outcome measures.

Results

At the 5-year follow-up, time to any recurrence was longer for the psychoeducation group (log rank=9.953, P<0.002). The psychoeducation group had fewer recurrences (3.86 v. 8.37, F=23.6, P<0.0001) of any type and they spent less time acutely ill (154 v. 586 days, F=31.66, P=0.0001). The median number of days of hospitalisation per hospitalised participant was also lower for the psychoeducation group (45 v. 30, F=4.26, P=0.047).

Conclusions

Six-month group psychoeducation has long-lasting prophylactic effects in individuals with bipolar disorders. Group psychoeducation is the first psychological intervention showing such a long-term maintained efficacy in people with bipolar disorders.


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