A short program of psychoeducation may effectively prevent mania recurrence in patients with type 1 bipolar disorder (BD) in remission from a recent manic episode, according to a study published in Bipolar Disorders.
Conducted by the Capital Medical University research team based at the Beijing Anding Hospital, this controlled trial was rater-blind and randomized, with follow-up at 12 months. Study participants were admitted for inpatient treatment between September 2015 and April 2016 and were invited to take part based on the following eligibility criteria: current manic episode and diagnosis of BD type 1, at least 9 years education, aged 16 to 60 years, and in remission after 1 to 2 weeks of acute inpatient treatment. Participants were excluded for comorbidity with other psychotic disorders or neurological conditions, current substance abuse or dependence, pregnancy or lactation, intellectual disability, or serious medical disease.
The study was randomized by a code drawn up by an unaffiliated statistician, the number table was kept by an unaffiliated nurse, and outcome measures were assessed by psychiatrists who were both unaffiliated and blind to the protocol and treatment assignment.
All 140 study participants continued standard pharmacotherapy during the trial. The 71 subjects in the active treatment group participated in a group-based psychoeducation program during the remission phase of BD in the 2 weeks before discharge from inpatient treatment; groups of 8 to 12 patients met for 8 sessions of 40 to 60 minutes each. The 69 subjects in the control group met with research nurses for free discussions at equivalent times.
Fifteen participants experienced recurrence and rehospitalization. Only 4 of these were in the treatment group, which showed a significantly lower rate of rehospitalization compared with the control group (χ2 =3.887, P =.049). The treatment group also showed improvements in disability, mood symptoms, and global functioning.
Study limitations include a sample of primarily young women (88.73% in the treatment group with a mean age of 33.3 years, and 91.3% in the control group with a mean age of 34.5.), who experienced few previous bipolar episodes. In addition, the 12-month follow-up may not have been enough to assess the full impact on depressive symptoms.
Investigators conclude, “this intervention could be a positive addition to routine psychiatric inpatient care. Therefore, it is suggested that policy makers consider placing greater emphasis on and funding of the provision of more accessible psychoeducation interventions to inpatients with BD in China, and across the world.”
Chen R, Zhu X, Capitão LP, et al. Psychoeducation for psychiatric inpatients following remission of a manic episode in bipolar I disorder: A randomized controlled trial [published online March 26, 2018]. Bipolar Disord. doi: 10.1111/bdi.12642