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      A Real-World Study of the Association between a Brief Group Psychoeducation and the Course of Bipolar Disorder

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          Abstract

          Although pharmacotherapy is considered the first-line treatment for bipolar disorders (BD), adjunctive psychoeducation has proven its effectiveness in improving self-management of the disease and reducing relapse rates. Few studies have evaluated the effect of brief group psychoeducation on pragmatic variables, such as the number of hospitalizations. The aim of the present study was to assess the mid-term effect of a four-session group psychoeducation on course-related variables in BD. Thirty-two individuals with BD were included in the study. Sixteen were exposed to psychoeducation and were matched to sixteen nonexposed individuals who received their usual treatment. Both groups were compared on insight, treatment adherence, change in the number of hospitalizations and visits to the emergency services, occurrence rate after intervention, and time to the first psychiatric hospitalization and the first urgent attendance. There was a significant reduction in the mean number of hospitalizations and urgent attendances in the exposed group in comparison to the nonexposed group. The first urgent attendance was significantly sooner in the nonexposed cohort. There were no differences between groups in any of the other variables. This intervention has shown benefits for pragmatic variables of the disease course and may be a feasible and cost-effective intervention to routinely implement in the management of BD.

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          Most cited references34

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          Cox's Regression Model for Counting Processes: A Large Sample Study

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            The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013.

            We present the global burden of bipolar disorder based on findings from the Global Burden of Disease Study 2013 (GBD 2013).
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              The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder.

              These guidelines are based on a first edition that was published in 2004, and have been edited and updated with the available scientific evidence up to October 2012. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the long-term treatment of bipolar disorder in adults. Material used for these guidelines are based on a systematic literature search using various data bases. Their scientific rigor was categorised into six levels of evidence (A-F) and different grades of recommendation to ensure practicability were assigned. Maintenance trial designs are complex and changed fundamentally over time; thus, it is not possible to give an overall recommendation for long-term treatment. Different scenarios have to be examined separately: Prevention of mania, depression, or an episode of any polarity, both in acute responders and in patients treated de novo. Treatment might differ in Bipolar II patients or Rapid cyclers, as well as in special subpopulations. We identified several medications preventive against new manic episodes, whereas the current state of research into the prevention of new depressive episodes is less satisfactory. Lithium continues to be the substance with the broadest base of evidence across treatment scenarios. Although major advances have been made since the first edition of this guideline in 2004, there are still areas of uncertainty, especially the prevention of depressive episodes and optimal long-term treatment of Bipolar II patients.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                10 May 2021
                May 2021
                : 18
                : 9
                : 5019
                Affiliations
                [1 ]Sant Pau Biomedical Research Institute (IIB-Sant Pau), Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; ecasellas@ 123456santpau.cat (E.C.); mportella@ 123456santpau.cat (M.J.P.)
                [2 ]Centre de Salut Mental D’adults (CSMA) de Sarria-Sant Gervasi, Associació Centre D’higiene Mental Les Corts, Grup CHM Salut Mental, 08029 Barcelona, Spain; beatriz.raventos@ 123456chmcorts.com
                [3 ]Department of Psychiatry, Hospital Universitari Mútua de Terrassa, 08221 Barcelona, Spain; mpineiro@ 123456mutuaterrassa.cat
                [4 ]Institut de Neuropsiquiatria I Addiccions (INAD), Parc de Salut Mar, 08003 Barcelona, Spain; Helena.nama@ 123456gmail.com
                [5 ]Department of Psychiatry, Consorci Sanitari de Mataró, 08304 Mataró, Spain; mcastillon@ 123456santpau.cat
                [6 ]Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
                Author notes
                [* ]Correspondence: amartinbl@ 123456santpau.cat
                Author information
                https://orcid.org/0000-0002-2007-9516
                https://orcid.org/0000-0002-3917-0854
                Article
                ijerph-18-05019
                10.3390/ijerph18095019
                8126006
                34068535
                6e5fa152-6141-442b-bb5b-e2ddb9bf5c3d
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 26 March 2021
                : 03 May 2021
                Categories
                Article

                Public health
                bipolar disorder,group psychoeducation,disease progression,recurrence,treatment adherence,insight

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