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

Authors

  • Francesc Colom,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • María Reinares,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Isabella Pacchiarotti,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Dina Popovic,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
    2. Unit of Psychiatry, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Pisa, Italy
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  • Lorenzo Mazzarini,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
    2. Unit of Psychiatry, Department of Neurosciences, Sant’Andrea Hospital, Sapienza University, Rome, Italy
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  • Anabel Martínez-Arán,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Carla Torrent,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Adriane Rosa,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Rosario Palomino-Otiniano,

    1. Highfield Unit, Department of Psychiatry, Oxford, UK
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  • Carolina Franco,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Caterina M. Bonnin,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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  • Eduard Vieta

    Corresponding author
    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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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: EVIETA@clinic.ub.es

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.

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