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The long-term outcomes of an effectiveness trial of group versus individual psychoeducation for bipolar disorders

Lookup NU author(s): Emeritus Professor Jan Scott

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Abstract

Background: In this effectiveness trial we compared the long-term effects on hospitalizations of group psychoeducation (GP) versus individual psychoeducation (IP) for a heterogeneous sample of patients with BD recruited from general clinical settings.Methods: Eighty-five patients with BD were randomized to receive 10 weekly sessions of GP followed by 8 booster-sessions over the next two years, or three sessions of IP. Time to first admission over the course of GP was the primary outcome measure, with additional outcomes examining the use of psychiatric services over about 8 years.Results: Patients allocated to GP had longer survival time compared to IP over 27 months (p < 0.05). There were also group differences in survival time over 8 years, but treatment allocation alone was no longer a significant predictor of survival time (p = 0.07). There was an interaction between group (GP/IP) and harmful substance use (HSU), such that GP cases with comorbid HSU had the shortest survival time, whilst GP cases without HSU survived the longest (p=0.02). Also, GP cases had a small but significant reduction in hospital use compared with IP (p=0.04).Limitations: We did not have a 'pure' treatment as usual group. Wide confidence intervals for some of the odds ratios suggest that the findings need to be treated with some caution. Insufficient sample size for more detailed subgroup analyses.Conclusions: GP is superior to IP in delaying hospitalizations in a clinically representative population. However, GP did not prevent or delay admissions in BD patients with HSU. (C) 2016 Elsevier B.V. All rights reserved.

Publication metadata

Author(s): Kallestad H, Wullum E, Scott J, Stiles TC, Morken G

Publication type: Article

Publication status: Published

Journal: Journal of Affective Disorders

Year: 2016

Volume: 202

Pages: 32-38

Print publication date: 15/09/2016

Online publication date: 24/05/2016

Acceptance date: 21/05/2016

ISSN (print): 0165-0327

ISSN (electronic): 1573-2517

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.jad.2016.05.043

DOI: 10.1016/j.jad.2016.05.043

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