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Park Y, Cho S, Lee YS, Roh S. Depression Literacy and Depressive Symptoms: The Mediating Role of Self-Rated Mental Health Among Korean Americans. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:561-575. [PMID: 38721748 DOI: 10.1080/26408066.2024.2349529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Depression literacy (DL) is increasingly recognized as an important predictor of mental health outcomes, but there remains a noticeable lack of scientific inquiry focusing on Korean Americans in this area. In addition, women are known to be more susceptible to depression, potentially affecting their DL and depressive symptoms differently than men. This study aimed to explore two primary objectives: (1) the potential role of self-rated mental health (SRMH) in mediating the association between DL and depressive symptoms in this population, and (2) whether gender differences exist in the presence and magnitudes of these mediation effects. METHOD Data were drawn from a survey with 693 Korean Americans aged 18 and older residing in New York and New Jersey. The PROCESS macro was used to test the mediation effect of self-rated mental health on the relationship between depression literacy and depressive symptoms in men and women. RESULTS Self-rated mental health was found to mediate the relation between depression literacy and depressive symptoms in women but not in men. CONCLUSIONS Providing evidence-informed, culturally tailored and gender specific depression literacy education and programs for the KA communities may be an important strategy to reduce depressive symptoms in this group.
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Affiliation(s)
- Yeddi Park
- School of Education and Human Development, Fairfield University, Fairfield, Connecticut, USA
| | - Soyeon Cho
- Department of Human Services, New York City College of Technology/CUNY, Brooklyn, New York, USA
| | - Yeon-Shim Lee
- College of Health & Social Sciences, School of Social Work, San Francisco State University, San Francisco, California, USA
| | - Soonhee Roh
- Department of Social Work, University of South Dakota-Sioux Falls, Sioux Falls, South Dakota, USA
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Levrat V, Favre S, Richard-Lepouriel H. Current practices of psychoeducation interventions with persons with bipolar disorders: a literature review. Front Psychiatry 2024; 14:1320654. [PMID: 38250257 PMCID: PMC10797008 DOI: 10.3389/fpsyt.2023.1320654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
This review sought to summarize the literature on current practices and forms of psychoeducation in the management of patients with bipolar disorder (BD), including only randomized controlled trials to ensure the best level of evidence. An extensive review of the available literature was conducted using PubMed/MEDLINE, Embase, and PsychInfo databases from inception to April 28th, 2022. The search yielded 381 studies. Seventy articles were included after removing duplicates and applying the inclusion/exclusion criteria. A best-evidence synthesis was used to identify the key results of each study and summarize the outcomes. Eleven descriptive categories were made. They encompass different forms of psychoeducation compared or combined with other psychosocial interventions, varying in setting (individual or group), with or without family members, structured or unstructured, mediated or not by digital tools (smartphone, internet). Globally, these studies show that psychoeducation is important in the treatment of BD, as it leads to a decrease in relapses, mood episodes, hospitalizations, and improved functioning or quality of life. Some studies also showed the benefits of psychoeducation on the patient's level of knowledge of pharmacological treatment and the disorder or compliance with medication, as well as reduced self-stigma. The limitations of this review are linked to the selection of only RCTs and the reliance on their post-hoc analyses. This review confirms the benefit of psychoeducation and psychosocial interventions on the evolution of BD (in different outcomes, including quality of life, relapse, and rehospitalization rates, for example). More recent interventions, such as mindfulness or online psychoeducation, represent an interesting option but more evidence is needed.
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Affiliation(s)
- Vanessa Levrat
- Mood Disorder and Anxiety Unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland
| | - Sophie Favre
- Mood Disorder and Anxiety Unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland
| | - Hélène Richard-Lepouriel
- Mood Disorder and Anxiety Unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Yilmaz S, Huguet A, Kisely S, Rao S, Wang J, Baur K, Price M, O'Mahen H, Wright K. Do psychological interventions reduce symptoms of depression for patients with bipolar I or II disorder? A meta-analysis. J Affect Disord 2022; 301:193-204. [PMID: 35007645 DOI: 10.1016/j.jad.2021.12.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/18/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Psychological therapies may play an important role in the treatment of bipolar disorders. Several meta-analyses that examine the effectiveness of psychotherapies for patients with bipolar disorder include conclusions about the impact upon bipolar depression. However, these tend not to consider differences in depression outcome depending upon whether the therapy primarily targets acute depression, nor severity of baseline depression. This may affect the conclusions drawn about the effectiveness of these therapies for acute bipolar depression treatment. OBJECTIVES This meta-analysis explored the effectiveness of psychological therapies in reducing bipolar depression, in particular examining whether: (1) the effect of therapy is greater when baseline depressive symptoms are more severe, and (2) the effect of therapy is greater when the primary focus of the therapy is the treatment of acute bipolar depression? DATA SOURCES A systematic search was conducted using the following electronic databases; Cochrane Controlled Register of Trials (1996), MEDLINE (1966 onwards), EMBASE (1980 onwards), PsycINFO (1974 onwards), Scopus, Web of Science and Clinical Trials Registries (listed at:https://www.hhs.gov/ohrp/international/clinical-trial-registries/index.html). ELIGIBILITY CRITERIA Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. The comparators were usual care, wait-list, placebo, active treatment control. Post-treatment depression status was required to be measured continuously using a validated self- or observer- report measure, or categorically by a validated diagnostic instrument or clinical diagnosis by a suitably qualified person. DATA EXTRACTION AND SYNTHESIS Titles and abstracts were screened, followed by full texts. Two reviewers conducted each stage until agreement was reached, and both independently extracted study information. Means, standard deviations (SDs) and number of participants were retrieved from articles and used to perform a meta-analysis. The primary outcome was depressive symptom score. RESULTS The database search identified 6388 studies. After removing the duplicates, 3298 studies remained, of which, 28 studies were included in the qualitative review and 22 in the meta-analysis. Effect sizes range from -1.99 [-2.50, -1.49] to 0.89 [-0.12, 1.90]. There was low quality evidence of a significant effect on symptoms of depression for cognitive behavioral therapy and dialectical behavior therapy. Trials of psychoeducation, mindfulness-based therapy, family therapy and interpersonal and social rhythm therapy showed no evidence of any effect on depression. We found no significant relationship between baseline depression score and depression outcome post-treatment when we controlled for therapy type and comparator. The result also showed that the effect sizes for studies targeting acute depression to be tightly clustered around a small overall effect size. CONCLUSIONS Some psychological therapies may reduce acute bipolar depression although this conclusion should be viewed with caution given the low quality of evidence. More research using similar therapy types and comparators is needed to better understand the relationship between depression status at baseline and outcome.
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Affiliation(s)
- Sakir Yilmaz
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Perry road, Exeter EX4 4QG, UK.
| | - Anna Huguet
- Department of Community Health and Epidemiology, Dalhousie University, Canada; Departament de Psicologia, Universitat Rovira I Virgili, Spain; IWK Health Center, Canada
| | - Steve Kisely
- Department of Community Health and Epidemiology, Dalhousie University, Canada; University of Queensland, Psychiatry, Australia; Metro South Addiction and Mental Health Epidemiology Service, Australia
| | - Sanjay Rao
- Faculty of Medicine, Psychiatry, University of Ottawa, Canada
| | - JianLi Wang
- Department of Psychiatry, University of Ottawa, School of Epidemiology, Public Health and Preventive Medicine, Canada
| | | | | | - Heather O'Mahen
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Perry road, Exeter EX4 4QG, UK
| | - Kim Wright
- Department of Psychology, Washington Singer Laboratories, University of Exeter, Perry road, Exeter EX4 4QG, UK
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Rabelo JL, Cruz BF, Ferreira JDR, Viana BDM, Barbosa IG. Psychoeducation in bipolar disorder: A systematic review. World J Psychiatry 2021; 11:1407-1424. [PMID: 35070785 PMCID: PMC8717031 DOI: 10.5498/wjp.v11.i12.1407] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/11/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder characterized by mood swings. Psychosocial interventions, such as psychoeducation, play an essential role in promoting social rehabilitation and improving pharmacological treatment.
AIM To investigate the role of psychoeducation in BD.
METHODS A systematic review of original studies regarding psychoeducation interventions in patients with BD and their relatives was developed. A systematic literature search was performed using the Medline, Scopus, and Lilacs databases. No review articles or qualitative studies were included in the analysis. There were no date restriction criteria, and studies published up to April 2021 were included.
RESULTS A total of forty-seven studies were selected for this review. Thirty-eight studies included patients, and nine included family members. Psychoeducation of patients and family members was associated with a lower number of new mood episodes and a reduction in number and length of stay of hospitalizations. Psychoeducational interventions with patients are associated with improved adherence to drug treatment. The strategies studied in patients and family members do not interfere with the severity of symptoms of mania or depression or with the patient's quality of life or functionality. Psychoeducational interventions with family members do not alter patients' adherence to pharmacotherapy.
CONCLUSION Psychoeducation as an adjunct strategy to pharmacotherapy in the treatment of BD leads to a reduction in the frequency of new mood episodes, length of hospital stay and adherence to drug therapy.
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Affiliation(s)
- Juliana Lemos Rabelo
- Interdisciplinary Laboratory of Medical Investigation–School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Programa de Extensão em Psiquiatria e Psicologia de Idosos, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Breno Fiuza Cruz
- Interdisciplinary Laboratory of Medical Investigation–School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Programa de Extensão em Psiquiatria e Psicologia de Idosos, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Department of Mental Health, School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | | | - Bernardo de Mattos Viana
- Programa de Extensão em Psiquiatria e Psicologia de Idosos, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Department of Mental Health, School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Izabela Guimarães Barbosa
- Interdisciplinary Laboratory of Medical Investigation–School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Programa de Extensão em Psiquiatria e Psicologia de Idosos, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Department of Mental Health, School of Medicine, UFMG, Belo Horizonte 30130-100, Minas Gerais, Brazil
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So SH, Mak ADP, Chan PS, Lo CCW, Na S, Leung MHT, Ng IHC, Chau AKC, Lee S. Efficacy of Phase 1 of Life Goals Programme on symptom reduction and mood stability for bipolar disorder. J Affect Disord 2021; 281:949-957. [PMID: 33229019 DOI: 10.1016/j.jad.2020.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/21/2020] [Accepted: 11/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Life Goals Programme (LGP) was developed as a psychological intervention for bipolar disorder, with its structured 6-session psychoeducation phase (Phase 1) targeting understanding of the disorder, medication adherence, early warning signs, and coping with symptoms and triggers. The present study tested the efficacy of Phase 1 of the LGP on symptom recovery and moment-by-moment mood stability, as well as medication adherence and quality of life. METHODS Adults with bipolar disorder were randomly allocated to the LGP condition (six weekly group sessions) or the waitlist condition (six weeks of standard care, followed by the same LGP intervention). Participants were assessed before and after treatment, and at 6-month follow up. Waitlist participants were additionally assessed at baseline. Assessment included a clinical interview (SCID, MADRS, YMRS, and HAM-A), self-reported questionnaires, and 6-day experience sampling assessment on a mobile device. RESULTS 64 out-patients with bipolar disorder (44 Bipolar I and 20 Bipolar II subtypes) participated in this study. LGP was well received and attended. Following LGP, there were significant improvements in knowledge about illness and level of anxiety, which were of large effect sizes and sustained at 6-month follow-up. Experience sampling assessment revealed small but significant improvements in moment-by-moment mood stability. Improvement in medication adherence was significant at 6 months and was of a moderate-to-large effect size. Changes in anxiety and mood stability were significantly greater following LGP than standard care. LIMITATIONS Our results warrant further testing against active control. CONCLUSIONS There was a robust improvement in emotional regulation following the 6-week LGP.
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Affiliation(s)
- Suzanne H So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR.
| | - Arthur Dun-Ping Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | - Pui-Shuen Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Chloe Chor-Wing Lo
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Shirley Na
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Iris Hoi-Ching Ng
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
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Keshavarzpir Z, Seyedfatemi N, Mardani-Hamooleh M, Esmaeeli N, Boyd JE. The Effect of Psychoeducation on Internalized Stigma of the Hospitalized Patients with Bipolar Disorder: A Quasi-Experimental Study. Issues Ment Health Nurs 2021; 42:79-86. [PMID: 32881602 DOI: 10.1080/01612840.2020.1779881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Stigma is one of the common problems of patients with bipolar disorders, which impedes their recovery. This is a quasi-experimental study on 76 hospitalized patients with bipolar disorder (38 in each group) in Iran. The intervention group received six sessions of psychoeducation in a period of 2 weeks. Internalized stigma was measured by the Internalized Stigma of Mental Illness scale. The education significantly reduced the scores of alienation, discrimination experience, stigma resistance and total score of stigma in the intervention group. Hence, this education can be used as an accessible technique in hospitals to reduce the internalized stigma.
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Affiliation(s)
- Zinat Keshavarzpir
- Psychiatric Nurse Practitioner, Tehran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nazanin Esmaeeli
- Iran Psychiatric Center, Iran University of Medical Sciences, Tehran Iran
| | - Jennifer E Boyd
- Mental Health for Psychosocial Recovery Services, San Francisco VA Medical Center, San Francisco, California, USA
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Novick DM, Swartz HA. Evidence-Based Psychotherapies for Bipolar Disorder. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2019; 17:238-248. [PMID: 32047369 DOI: 10.1176/appi.focus.20190004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Bipolar disorder is a recurrent psychiatric disorder marked by waxing and waning affective symptoms and impairment in functioning. Some of the morbidity and mortality associated with the illness may be reduced with evidence-based psychotherapies (EBPs) along with pharmacotherapy. To enhance clinicians' understanding of which therapy modalities have evidence supporting their use, the authors conducted a systematic literature review to identify randomized controlled trials (RCTs) of psychotherapy for adults with bipolar disorder. A strong evidence base exists for psychoeducation, cognitive-behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy, and peer-support programs. Promising modalities include functional remediation, mindfulness-based cognitive therapy, illness management and recovery, and technology-assisted strategies. RCTs demonstrate a consistent advantage of these psychotherapies plus pharmacotherapy, compared with the use of pharmacotherapy alone. Adjunctive EBPs hasten time to remission, delay time to recurrence, and improve functional outcomes. EBPs play an important role in helping individuals develop skills needed to manage the persistent and lifelong psychosocial, neurocognitive, vocational, and interpersonal consequences of bipolar disorder. Continued efforts to improve the effectiveness of EBPs for adults with bipolar disorder are warranted.
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Affiliation(s)
- Danielle M Novick
- Outpatient Mood Disorders Clinic and Clinical Training Committee, VA Pittsburgh Healthcare System, Pittsburgh (Novick); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Swartz)
| | - Holly A Swartz
- Outpatient Mood Disorders Clinic and Clinical Training Committee, VA Pittsburgh Healthcare System, Pittsburgh (Novick); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Swartz)
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Stenberg U, Haaland-Øverby M, Koricho AT, Trollvik A, Kristoffersen LGR, Dybvig S, Vågan A. How can we support children, adolescents and young adults in managing chronic health challenges? A scoping review on the effects of patient education interventions. Health Expect 2019; 22:849-862. [PMID: 31131527 PMCID: PMC6803408 DOI: 10.1111/hex.12906] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/20/2019] [Accepted: 04/18/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This scoping review aims to give a comprehensive and systematic overview of published evaluations and the potential impact of patient education interventions for children, adolescents and young adults who are living with chronic illness and/or impairment loss. Methods Relevant literature published between 2008 and 2018 has been comprehensively reviewed, with attention paid to variations in study, intervention and patient characteristics. Arksey and O'Malley's framework for scoping studies guided the review process, and thematic analysis was undertaken to synthesize extracted data. Results Of the 7214 titles identified, 69 studies were included in this scoping review. Participant‐reported benefits of the interventions included less distress from symptoms, improved medical adherence and/or less use of medication, and improved knowledge. The majority of studies measuring physical activity and/or physiologic outcomes found beneficial effects. Interventions were also beneficial in terms of decreased use of urgent health care, hospitalization, visits to general practitioner and absence from school. By sharing experiences, participants had learned from each other and attained new insight on how they could manage illness‐related challenges. Discussion Study results corroborate previous research suggesting that different types of patient education interventions have a positive impact on children, adolescents and young adults, but research on this field is still in a starting phase. The results summed up in the current review supports the utility of patient education interventions that employ behavioural strategies tailored to the developmental needs of children, adolescents and young adults with different cultural backgrounds.
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Affiliation(s)
- Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | | | - Anne Trollvik
- Institute of Nursing, Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
| | | | | | - André Vågan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
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Tatay-Manteiga A, Cauli O, Tabarés-Seisdedos R, Michalak EE, Kapczinski F, Balanzá-Martínez V. Subjective neurocognition and quality of life in patients with bipolar disorder and siblings. J Affect Disord 2019; 245:283-288. [PMID: 30419528 DOI: 10.1016/j.jad.2018.11.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/20/2018] [Accepted: 11/03/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with significant neurocognitive and functional impairment, which may progress across stages. However, the potential progression of subjective cognitive complaints and quality of life (QoL) has not been addressed. Our main objective was to assess subjective cognitive complaints and QoL on euthymic patients with BD and their healthy siblings. METHODS Four groups were compared: euthymic patients with type I BD in the early (n = 25) and late (n = 23) stages, their healthy siblings (latent stage; n = 23) and healthy controls (n = 21). Cognitive complaints and QoL were assessed using the COBRA and WHO-QoLBREF questionnaires, respectively. RESULTS Late-stage patients had greater number of subjective cognitive complaints and reported a worse QoL compared to the other groups. Early-stage patients also had more cognitive complaints than controls and siblings, although differences were not significant. Siblings and controls reported similar QoL. LIMITATIONS the most important limitation of this study is the criterion used to define the early and late stages of BD, as currently there is no consensus and previous studies have used different criteria. CONCLUSIONS This is the first study to examine subjective cognition and QoL in patients with BD and siblings. Our results raise the possibility that burden of cognitive complaints increase with disorder progression, in tandem with deterioration in subjective QoL. That would support a clinical staging model of BD. This hypothesis remains to be confirmed by a longitudinal analysis.
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Affiliation(s)
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Flavio Kapczinski
- McMaster's Department of Psychiatry and Behavioral Neurosciences, Hamilton, ON, Canada; Department of Psychiatry of the Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
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Tomita T, Kudo S, Sugawara N, Fujii A, Tsuruga K, Sato Y, Ishioka M, Nakamura K, Yasui-Furukori N. Sex Differences In Psychoeducation For Patients With Depression: A Comparison Of Frequency And Efficacy Of Psychoeducation. Neuropsychiatr Dis Treat 2019; 15:3069-3078. [PMID: 31806976 PMCID: PMC6842745 DOI: 10.2147/ndt.s207544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/08/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We aimed to reveal sex differences in depression comprehension by reanalyzing data from a previous study of patients who were administered antidepressants. METHODS A total of 424 outpatients were enrolled in the study. Participants were provided an original self-administered questionnaire that comprised eight items: depressive symptoms, course of depression, cause of depression, treatment plan, duration of antidepressant use, how to discontinue antidepressants, side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?" The level of patients' comprehension of these questions was rated on a scale of 0-10 (11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version, and other scales. Patients were divided on the basis of sex, regardless of whether they were in remission. RESULTS Compared with male patients, female patients with depression exhibited lower levels of depression and did not receive adequate psychoeducation from their physicians. While depression comprehension of female patients might not necessarily be associated with remission, male patients in remission received more explanations about depression and understood more compared with female patients. CONCLUSION Depression comprehension of male patients might be associated with remission, and psychoeducation should be sex-oriented to improve treatment responses.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Shuhei Kudo
- Department of Psychiatry, Tsugaru General Hospital, Goshogawara, Japan
| | - Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Akira Fujii
- Department of Mental Health, Mutsu General Hospital, Mutsu, Japan
| | - Koji Tsuruga
- Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, Japan
| | - Yasushi Sato
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | | | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
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11
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The Association Between the Severity and Level of Understanding of Depression Among Patients Treated With Antidepressants: A Survey of 424 Outpatients in Japan. Clin Neuropharmacol 2018; 41:1-5. [PMID: 29300204 DOI: 10.1097/wnf.0000000000000257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The present study investigated the association between the severity and knowledge of depression and attempted to reveal the specific aspects of understanding associated with severity. METHODS A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire: (a) the symptoms of depression, (b) the course of depression, (c) the cause of depression, (d) the treatment plan, (e) the duration of antidepressant use, (f) how to discontinue antidepressant use, (g) the adverse effects of antidepressants, and (h) psychotherapy. Each category consisted of the following questions: "How much do you understand about your treatment?" The level of understanding was rated on an 11-point scale ranging from 0 to 10. The following scales were administered: the Quick Inventory of Depressive Symptomatology, Japanese version (QIDS-J); the Global Assessment of Functioning; and the Clinical Global Impression, Severity scale. Subjects were divided in 5 groups according to severity of QIDS-J. Clinical characteristics were also investigated. RESULTS Based on an analysis of variance, significant differences were found among the 5 groups with regard to age at onset, duration of disease, and duration of antidepressant use. A multiple regression analysis revealed that item B significantly and negatively predicted the QIDS-J scores, whereas item C significantly and positively predicted these scores. Some multiple logistic regression models seeking to distinguish severity found that all but items E to H were significantly associated with severity. CONCLUSIONS Items B and C were significantly negatively and positively associated with depression severity, respectively. Sufficient and suitable psychoeducation in and knowledge of depression might improve the treatment responses in patients with depression.
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12
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Demissie M, Hanlon C, Birhane R, Ng L, Medhin G, Fekadu A. Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review. BJPsych Open 2018; 4:375-384. [PMID: 30202599 PMCID: PMC6127962 DOI: 10.1192/bjo.2018.46] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Adjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone. AIMS To evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries. METHOD A systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis. RESULTS A total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive-behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation. CONCLUSIONS Adjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings. DECLARATION OF INTEREST None.
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Affiliation(s)
- Mekdes Demissie
- Lecturer, College of Health Sciences, Department of Psychiatry, Addis Ababa University, Ethiopia
| | - Charlotte Hanlon
- Associate Professor, College of Health Sciences, Department of Psychiatry, Addis Ababa University, Ethiopia and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Services and Population Research, King's College London, UK
| | - Rahel Birhane
- Research Assistant, College of Health Sciences, Department of Psychiatry, Addis Ababa University, Ethiopia
| | - Lauren Ng
- Assistant Professor, School of Medicine, Boston University, USA
| | - Girmay Medhin
- Associate Professor, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | - Abebaw Fekadu
- Associate Professor, College of Health Sciences, Department of Psychiatry and Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), Collage of Health Science, Addis Ababa University, Ethiopia and Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex and Center for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, UK
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Tomita T, Kudo S, Sugawara N, Fujii A, Tsuruga K, Sato Y, Ishioka M, Nakamura K, Yasui-Furukori N. The characteristics of understanding of depression among older patients treated with antidepressants: a comparison between older and younger patients. Neuropsychiatr Dis Treat 2018; 14:1319-1327. [PMID: 29872299 PMCID: PMC5973405 DOI: 10.2147/ndt.s158254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To reveal characteristics of understanding of depression among older patients, we reanalyzed the data from a previous study of patients who were administered antidepressants. METHODS A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight items: depressive symptoms, the course of depression, the cause of depression, the treatment plan, the duration of antidepressant use, how to discontinue antidepressants, the side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?". The level of understanding was rated on a scale of 0-10 (11 anchor points). Subjects were divided into two groups: younger patients who were <65 years of age and older patients who were ≥65 years of age. RESULTS Older patients with depression showed lower levels of understanding of depression and did not receive sufficient psychoeducation from their physicians, but their understanding of depression might not be associated with their remission. In the younger group, the scores of understanding of the course of depression, the treatment plan, how to discontinue antidepressants, and psychotherapy items, and the total understanding score of remitters, were significantly higher than those of non-remitters. In contrast, there were no significant differences in the items score or total score between remitters and non-remitters in the older group. CONCLUSION Older patients showed lower levels of understanding of depression and did not appear to receive sufficient psychoeducation, but their understanding of depression might not be associated with their remission.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Shuhei Kudo
- Department of Psychiatry, Tsugaru General Hospital, Goshogawara, Japan
| | - Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Akira Fujii
- Department of Mental Health, Mutsu General Hospital, Mutsu, Japan
| | - Koji Tsuruga
- Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, Japan
| | - Yasushi Sato
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | | | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
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Tomita T, Kudo S, Sugawara N, Fujii A, Tsuruga K, Sato Y, Ishioka M, Nakamura K, Yasui-Furukori N. Timing of psychoeducation for patients with depression who were treated with antidepressants: when should patients receive psychoeducation. Neuropsychiatr Dis Treat 2018; 14:505-510. [PMID: 29483775 PMCID: PMC5813768 DOI: 10.2147/ndt.s156797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We analyzed data on the understanding of depression among patients who were prescribed antidepressants to determine when psychoeducation should be provided. PATIENTS AND METHODS A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire consisting of eight categories: (A) depressive symptoms, (B) the course of depression, (C) causes of depression, (D) the treatment plan, (E) the duration of antidepressant use, (F) discontinuation of antidepressants, (G) the side effects of antidepressants, and (H) psychotherapy. Each category was assessed with the following two questions: "Have you received an explanation of this topic from the doctor in charge?" and "How much do you understand about your treatment?" The level of understanding of patients was rated on a scale from 0 to 10 (no understanding to full understanding; 11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version (QIDS-J) and other scales. Participants were divided into two groups: patients receiving psychoeducation at their first visit vs patients receiving psychoeducation after their first visit. RESULTS Of the patients who had received an explanation of each psychoeducation item, a greater proportion were in the first visit group than in the after first visit group for nearly all items. Compared with the after first visit group, the first visit group showed a better understanding of each psychoeducation item and significantly lower QIDS scores for those receiving explanations of Items A and C. There was no significant difference between the two groups in remittance rates. CONCLUSION Psychoeducation on depression, especially regarding the symptoms and causes of depression, should be provided at patients' first visit.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki
| | - Shuhei Kudo
- Department of Psychiatry, Tsugaru General Hospital, Goshogawara
| | - Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira
| | - Akira Fujii
- Department of Mental Health, Mutsu General Hospital, Mutsu
| | - Koji Tsuruga
- Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori
| | - Yasushi Sato
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki
| | | | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki
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Hidalgo-Mazzei D, Reinares M, Mateu A, Juruena MF, Young AH, Pérez-Sola V, Vieta E, Colom F. Is a SIMPLe smartphone application capable of improving biological rhythms in bipolar disorder? J Affect Disord 2017; 223:10-16. [PMID: 28711743 DOI: 10.1016/j.jad.2017.07.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/02/2017] [Accepted: 07/08/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Biological rhythms (BR) disturbance has been suggested as a potential mediator of mood episodes in Bipolar Disorder (BD). The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was designed as an assessment tool to evaluate BR domains comprehensively. In the context of a trial evaluating a smartphone application delivering personalized psychoeducational contents for BD (SIMPLe 1.0), the main aim of this study is to evaluate the potential impact of SIMPLe 1.0 in BR regulation using the BRIAN scale. METHODS 51 remitted BD patients were asked to use the application for 3 months. Paired t-test analyses were employed to compare baseline and follow-up BRIAN´s total and domains scores. The sample was divided into completers and non-completers of the study to evaluate differences between groups regarding BRIAN scores using ANCOVA analyses. RESULTS The BRIAN's mean total score of the whole sample significantly decreased from baseline to post-intervention (35.89 (SD 6.64) vs. 31.18 (SD 6.33), t = 4.29, p = 0.001). At post-intervention, there was a significant difference between groups regarding the total BRIAN mean score (29.47 (SD 6.21) completers vs. 35.92 (SD 3.90) non-completers, t = 2.50, p = 0.02). This difference was maintained after conducting a one-way ANCOVA controlling for pre-intervention BRIAN scores, F (1, 46) = 10.545, p=0.002. LIMITATIONS A limited sample, pre-post measures, and a short study timeframe could have affected the results. Additional factors affecting BR, such as medication, could not be ruled out. CONCLUSION Our results suggest that there are potential positive effects of a psychoeducational smartphone application as an adjunctive to treatment as usual on BD patients' BR.
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Affiliation(s)
- Diego Hidalgo-Mazzei
- Bipolar Disorder Program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, United Kingdom
| | - María Reinares
- Bipolar Disorder Program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ainoa Mateu
- Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, United Kingdom; Stress and Affective Disorder Programme, Department of Neuroscience and Behaviour, University of Sao Paulo, Brazil
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, United Kingdom
| | - Víctor Pérez-Sola
- Institute of Neurosciences and Addictions, Hospital del Mar, Barcelona, Catalonia, Spain; Mental Health Group, IMIM-Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar Disorder Program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Francesc Colom
- Mental Health Group, IMIM-Hospital del Mar, CIBERSAM, Barcelona, Catalonia, Spain
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16
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Morton E, Michalak EE, Murray G. What does quality of life refer to in bipolar disorders research? A systematic review of the construct's definition, usage and measurement. J Affect Disord 2017; 212:128-137. [PMID: 28160685 DOI: 10.1016/j.jad.2017.01.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/23/2016] [Accepted: 01/22/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Quality of life (QoL) is increasingly investigated in bipolar disorders (BD) research, yet little attention has been paid to its optimal definition and measurement. This is a significant limitation, as the broader QoL literature recognises a number of divergent meanings and measurement tensions. The aim here was to advance understanding of QoL in BD by clarifying use of the construct in the existing literature and considering measurement implications. METHODS Thematic analysis techniques were used to interrogate articles identified via systematic search for (a) explicit discussion of QoL definitional/measurement issues, and (b) usage of the term QoL. RESULTS A total of 275 articles were included in the analysis. A range of definitional and methodological issues confounding the study of QoL in BD were identified. While explicit definition of QoL proved rare, thematic analysis of usage of the construct revealed the concepts of functioning, health, subjective experience and wellbeing were thought to be relevant to QoL in BD. LIMITATIONS The review does not engage in top-down theory development. Our analysis was grounded in the empirical literature to support future theoretical work relevant to existing usage of QoL in BD. CONCLUSIONS There was no evidence of a consensus definition of QoL in BD. A plurality of QoL definitions is not necessarily a flaw in the literature, but points to empirical and conceptual issues demanding attention. Awareness of the diversity of constructs associated with QoL will enable clinicians to better select treatments on the basis of specific QoL outcomes. A research agenda and provisional considerations for empirical research are outlined based on the present analyses.
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Affiliation(s)
- Emma Morton
- Swinburne University of Technology, Psychological Sciences and Statistics, Australia
| | - Erin E Michalak
- University of British Columbia, Department of Psychiatry, Canada
| | - Greg Murray
- Swinburne University of Technology, Psychological Sciences and Statistics, Australia.
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Husain MI, Chaudhry IB, Rahman RR, Hamirani MM, Mehmood N, Haddad PM, Hodsoll J, Young AH, Naeem F, Husain N. Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan. Int J Bipolar Disord 2017; 5:3. [PMID: 28155203 PMCID: PMC5307423 DOI: 10.1186/s40345-017-0074-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/11/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Despite the use of maintenance medication, recurrence rates in bipolar affective disorder (BPAD) are high. To date, there are no clinical trials that have investigated the use of psychological interventions in bipolar disorder in Pakistan. AIM The purpose of the study was to assess the feasibility and acceptability of a culturally adapted bipolar psychoeducation programme (CaPE) in Pakistan. METHODS Thirty-four euthymic bipolar I and II outpatients were randomized to either 12 weekly sessions of individual psychoeducation plus Treatment As Usual (Intervention) or Treatment As Usual (TAU) (Control). Outcomes were assessed using the Young Mania Rating Scale (YMRS), Beck Depression Inventory (BDI), EuroQoL (EQ-5D), Bipolar Knowledge and Attitudes and Questionnaire (BKAQ), and a self-reported measure of medication adherence (Morisky Medication Adherence Scale-4 items, MMAS-4). Effect sizes were derived from baseline adjusted standardized regression coefficients. RESULTS Retention in the study was good, 80% of patients in the TAU follow-up assessment and 100% of patients in the CaPE group attended all 12 sessions. Patient satisfaction was higher in the CaPE group relative to control (ES = 1.41). Further, there were large effect sizes shown for CaPE versus TAU for medication adherence (MMAS-4: ES = 0.81), knowledge and attitudes towards bipolar (BKAQ: ES = 0.68), mania (YMRS: ES = 1.18), depression (BDI: ES = 1.17) and quality of life measures (EQ-5D: ES ⇒ 0.88). CONCLUSIONS Culturally adapted psychoeducation intervention is acceptable and feasible, and can be effective in improving mood symptoms and knowledge and attitudes to BPAD when compared with TAU. Larger scale studies are needed to confirm our findings. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT02210390.
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Affiliation(s)
- Muhammad Ishrat Husain
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
| | - Imran B Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Sindh, Pakistan
| | - Raza R Rahman
- Department of Psychiatry, Dow University of Health Sciences, Karachi, Pakistan
| | - Munir M Hamirani
- Department of Psychiatry, Abbasi Shaheed Hospital, Karachi, Pakistan
| | - Nasir Mehmood
- Pakistan Institute of Living and Learning, Karachi, Sindh, Pakistan
| | | | - John Hodsoll
- Centre for Affective Disorders, Institute of PsychiatryPsychology and Neuroscience, King's College London, London, UK
| | - Allan H Young
- Centre for Affective Disorders, Institute of PsychiatryPsychology and Neuroscience, King's College London, London, UK
| | - Farooq Naeem
- Department of Psychiatry, Queens' University, Kingston, ON, Canada
| | - Nusrat Husain
- University of Manchester, Oxford Road, Manchester, UK
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Salcedo S, Gold AK, Sheikh S, Marcus PH, Nierenberg AA, Deckersbach T, Sylvia LG. Empirically supported psychosocial interventions for bipolar disorder: Current state of the research. J Affect Disord 2016; 201:203-14. [PMID: 27243619 DOI: 10.1016/j.jad.2016.05.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/29/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Bipolar disorder requires psychiatric medications, but even guideline-concordant treatment fails to bring many patients to remission or keep them euthymic. To address this gap, researchers have developed adjunctive psychotherapies. The purpose of this paper is to critically review the evidence for the efficacy of manualized psychosocial interventions for bipolar disorder. METHODS We conducted a search of the literature to examine recent (2007-present), randomized controlled studies of the following psychotherapy interventions for bipolar disorder: psychoeducation (PE), cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and family therapies such as family focused therapy (FFT). RESULTS All of the psychotherapy interventions appear to be effective in reducing depressive symptoms. Psychoeducation and CBT are associated with increased time to mood episode relapse or recurrence. MBCT has demonstrated a particular effectiveness in improving depressive and anxiety symptoms. Online psychotherapy interventions, programs combining one or more psychotherapy interventions, and targeted interventions centering on particular symptoms have been the focus of recent, randomized controlled studies in bipolar disorder. CONCLUSIONS Psychotherapy interventions for the treatment of bipolar disorder have substantial evidence for efficacy. The next challenge will to disseminate these psychotherapies into the community.
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Affiliation(s)
- Stephanie Salcedo
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
| | - Alexandra K Gold
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sana Sheikh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychology, Suffolk University, Boston, MA, USA
| | - Peter H Marcus
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Hidalgo-Mazzei D, Mateu A, Reinares M, Murru A, Del Mar Bonnín C, Varo C, Valentí M, Undurraga J, Strejilevich S, Sánchez-Moreno J, Vieta E, Colom F. Psychoeducation in bipolar disorder with a SIMPLe smartphone application: Feasibility, acceptability and satisfaction. J Affect Disord 2016; 200:58-66. [PMID: 27128358 DOI: 10.1016/j.jad.2016.04.042] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/11/2016] [Accepted: 04/16/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND During the last fifteen years, the possibility of delivering psychoeducation programs through Internet-based platforms have been explored. Studies evaluating those programs have shown good to acceptable retention rates. In this context, we developed a smartphone application (SIMPLe) collecting information about mood symptoms and offering personalized psychoeducation messages. The main aims of this study were to evaluate the feasibility, acceptability and satisfaction of the smartphone application. METHODS The study was conducted from March to August 2015. Participation in the study was proposed to a consecutive sample of adult patients attending an outpatient mental health clinic. Sociodemographic data, clinical and functional assessments alongside smartphone ownership and uses were collected at baseline and at 3 months' follow-up. A 5 item Likert-scale satisfaction questionnaire was also employed. RESULTS 51 participants were initially enrolled in the study, 36 (74%) remained actively using the application after 3 months. The whole sample interacted with the application a mean of 77 days (SD=26.2). During these days they completed 88% of the daily tests. Over 86% of the participants agreed that the experience using the application was satisfactory. LIMITATIONS The diversity of smartphones operating systems led to a moderate, although representative, sample number. Additionally, the subjective data reporting, narrow time frame of use and stability of the patients could have affected the results. CONCLUSIONS The results confirm that this particular intervention is feasible and represent a satisfactory and acceptable instrument for the self-management of bipolar disorder as an add-on to the usual treatment but future clinical trials must still probe its efficacy.
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Affiliation(s)
- Diego Hidalgo-Mazzei
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ainoa Mateu
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Andrea Murru
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Del Mar Bonnín
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Cristina Varo
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Marc Valentí
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Juan Undurraga
- Department of Psychiatry, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile; Early Intervention Program, Instituto Psiquiátrico "Dr Horwitz Barak", Santiago, Chile
| | - Sergio Strejilevich
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina
| | - José Sánchez-Moreno
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar disorder program, Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Francesc Colom
- Mental Health Group, IMIM-Hospital del Mar, Barcelona, Catalonia, Spain
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Miziou S, Tsitsipa E, Moysidou S, Karavelas V, Dimelis D, Polyzoidou V, Fountoulakis KN. Psychosocial treatment and interventions for bipolar disorder: a systematic review. Ann Gen Psychiatry 2015; 14:19. [PMID: 26155299 PMCID: PMC4493813 DOI: 10.1186/s12991-015-0057-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/29/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic disorder with a high relapse rate, significant general disability and burden and with a psychosocial impairment that often persists despite pharmacotherapy. This indicates the need for effective and affordable adjunctive psychosocial interventions, tailored to the individual patient. Several psychotherapeutic techniques have tried to fill this gap, but which intervention is suitable for each patient remains unknown and it depends on the phase of the illness. METHODS The papers were located with searches in PubMed/MEDLINE through May 1st 2015 with a combination of key words. The review followed the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The search returned 7,332 papers; after the deletion of duplicates, 6,124 remained and eventually 78 were included for the analysis. The literature supports the usefulness only of psychoeducation for the relapse prevention of mood episodes and only in a selected subgroup of patients at an early stage of the disease who have very good, if not complete remission, of the acute episode. Cognitive-behavioural therapy and interpersonal and social rhythms therapy could have some beneficial effect during the acute phase, but more data are needed. Mindfulness interventions could only decrease anxiety, while interventions to improve neurocognition seem to be rather ineffective. Family intervention seems to have benefits mainly for caregivers, but it is uncertain whether they have an effect on patient outcomes. CONCLUSION The current review suggests that the literature supports the usefulness only of specific psychosocial interventions targeting specific aspects of BD in selected subgroups of patients.
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Affiliation(s)
- Stella Miziou
- Aristotle University of Thessaloniki, Thessaloníki, Greece
| | | | | | - Vangelis Karavelas
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | - Dimos Dimelis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | | | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
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21
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Kudo S, Tomita T, Sugawara N, Sato Y, Ishioka M, Tsuruga K, Nakagami T, Nakamura K, Yasui-Furukori N. The low level of understanding of depression among patients treated with antidepressants: a survey of 424 outpatients in Japan. Neuropsychiatr Dis Treat 2015; 11:2811-6. [PMID: 26604765 PMCID: PMC4630178 DOI: 10.2147/ndt.s93657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We used self-administered questionnaires to investigate the level of understanding of depression among outpatients who were administered antidepressants. METHODS A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire that consisted of eight categories: (A) depressive symptoms, (B) the course of depression, (C) the cause of depression, (D) the treatment plan, (E) the duration of taking antidepressants, (F) how to discontinue antidepressants, (G) the side effects of the antidepressants, and (H) psychotherapy. Each category consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about it?" The level of understanding was rated on a scale of 0-10 (11 anchor points). The Quick Inventory of Depressive Symptomatology Japanese version, Global Assessment of Functioning, and Clinical Global Impression - Severity scale were administered, and clinical characteristics were investigated. RESULTS The percentages of participants who received explanations were as follows: 61.8% for (A), 49.2% for (B), 50.8% for (C), 57.2% for (D), 46.3% for (E), 28.5% for (F), 50.6% for (G), and 36.1% for (H). The level of understanding in participants who received explanations from their physicians was significantly higher compared with patients who did not receive explanations for all evaluated categories. Patient age, age at disease onset, and Global Assessment of Functioning scores were significantly associated with more items compared with the other variables. CONCLUSION Psychoeducation is not sufficiently performed. According to the study results, it is possible for patients to receive better psychoeducation and improve their clinical outcomes.
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Affiliation(s)
- Shuhei Kudo
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan ; Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan
| | - Yasushi Sato
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Masamichi Ishioka
- Department of Psychiatry, Hirosaki Aiseikai Hospital, Hirosaki, Japan
| | - Koji Tsuruga
- Department of Psychiatry, Aomori Prefectural Tsukushigaoka Hospital, Aomori, Japan
| | - Taku Nakagami
- Department of Neuropsychiatry, Odate City General Hospital, Odate, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
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