Benefits of Psychoeducation in Bipolar Disorder Mediated by Perceived Improvement
Mediation analysis revealed that the change in social functioning was partially mediated by changes in illness perception but not medication adherence or changes in knowledge.
In a real-world analysis published in the Journal of Affective Disorders, perceived change in illness mediated the benefits of psychoeducation for patients with bipolar disorder, not change in knowledge or medication adherence.
Researchers recruited patients with bipolar disorder to participate in a 20-hour psychoeducation intervention spread into 10 sessions over 3 months. They assessed symptoms, knowledge about bipolar disorder, medication adherence, and illness perception before and after the intervention. The key effectiveness outcomes were self-esteem and social functioning, as measured by the Coopersmith self-esteem inventory and the Questionnaire de Fonctionnement Social.
Of the 156 participants recruited, a total of 103 (66%) completed the program. Of the 53 program dropouts, 4 were caused by relapse of bipolar disorder.
Social functioning was significantly improved in participants who completed the program compared with those who did not (P =.003; effect size =0.26). Although self-esteem was improved in those who completed the study, the effect was not significant (P =.2).
Compared with baseline, participants who completed the psychoeducation program had significantly improved medication adherence (P =.002), knowledge of bipolar disorder (P <.001), and illness perception (P <.001). Mediation analysis revealed that the change in social functioning was partially mediated by change in illness perception (P =.03) but not in medication adherence or changes in knowledge.
“'Real world data' illustrate that group [psychoeducation] is effective in improving social functioning and identifies the importance of further research on mediators,” the study authors concluded.
Etain B, Scott J, Cochet B, et al. A study of the real-world effectiveness of group psychoeducation for bipolar disorders: is change in illness perception a key mediator of benefit [published online November 22, 2017] J Affect Disord. doi:10.1016/j.jad.2017.11.072.