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Group psychoeducation comparable to peer support for remitted bipolar disorder
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Structured group psychoeducation was no more effective than unstructured peer support for remitted bipolar disorder, though was more beneficial to individuals with fewer past bipolar episodes.
“Group psychoeducation is a low-cost National Institute for Health and Care Excellence-recommended treatment for bipolar disorder. However, the clinical effectiveness and acceptability of this intervention are unclear compared with unstructured peer support matched for delivery and aim of treatment, and for previous bipolar history,” Richard Morriss, MD, of University of Nottingham, United Kingdom, and colleagues wrote.
To evaluate clinical efficacy and acceptability of structure group psychoeducation compared with optimized unstructured peer support for remitted bipolar disorder, researchers randomly assigned 304 individuals to receive psychoeducation (n = 153) or peer support (n = 151). Study participants were aged 18 years and older with bipolar disorder and no episode in the preceding 4 weeks. They attended 21 two-hour weekly sessions of structured group psychoeducation or optimized unstructured peer support.
Attendance was higher for psychoeducation groups vs. peer-support groups, with a median of 14 sessions vs. nine sessions (P = .026).
At 96 weeks, 58% of the psychoeducation group had experienced a next bipolar episode, compared with 65% of the peer-support group.
Time to next bipolar episode did not differ between groups (HR = 0.83; 95% CI, 0.62-1.11).
Planned moderator analysis indicated psychoeducation was most beneficial for participants with few (one to seven) previous bipolar episodes (HR = 0.28; 95% CI, 0.12-0.68; P = .034).
“Group psychoeducation may work well in bipolar patients with few episodes and perhaps with no substantial comorbidity. Because of its low cost, it should be implemented and delivered as part of a community-centered early intervention approach,” Eduard Vieta, MD, PhD, and Ivette Morilla, BsC, of the University of Barcelona Hospital Clinic, Spain, wrote in an accompanying editorial. “Ideally, one would like to see a new trial assessing this particular indication, and one would like to see the potential of interned-based, smartphone mediated supplementary packages that might help treatment delivery and access to the younger population. The earlier the better.” – by Amanda Oldt
Disclosure: The researchers report no relevant financial disclosures.