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Rennick-Egglestone S, Newby C, Robinson C, Yeo C, Ng F, Elliott R, Ali Y, Llewellyn-Beardsley J, Pomberth S, Harrison J, Gavan SP, Cuijpers P, Priebe S, Hall C, Slade M. Differences between online trial participants who have used statutory mental health services and who have not: analysis of baseline data from two pragmatic trials of a digital health intervention (Preprint). J Med Internet Res 2022. [DOI: 10.2196/44687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
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Hofmann AB, Schmid HM, Jabat M, Brackmann N, Noboa V, Bobes J, Garcia-Portilla MP, Seifritz E, Vetter S, Egger ST. Utility and validity of the Brief Psychiatric Rating Scale (BPRS) as a transdiagnostic scale. Psychiatry Res 2022; 314:114659. [PMID: 35709637 DOI: 10.1016/j.psychres.2022.114659] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/15/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
The Brief Psychiatric Rating Scale (BPRS) was originally conceived to assess psychopathology in several psychiatric disorders, making it an appropriate candidate to be used as a transdiagnostic instrument. We analyzed the utility and validity of the BPRS in a diagnostically heterogeneous sample of 600 psychiatric inpatients. As a comparator, we chose the mini-ICF-APP, a scale used to measure functioning and impairment across the diagnostic spectrum. Both scales had good internal consistency. The BPRS and the mini-ICF-APP showed a moderate correlation, with good levels of agreement. We were able to identify general symptoms present across the diagnostic spectrum, influencing severity and a cluster of symptoms specific for each diagnosis. Our results show the utility and validity of the BPRS as a transdiagnostic assessment tool that could easily be introduced in routine clinical work.
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Affiliation(s)
- Andreas B Hofmann
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Hanna M Schmid
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Mounira Jabat
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Nathalie Brackmann
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Forensic Psychiatry, Zurich, Switzerland
| | - Vanessa Noboa
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland; University San Francisco de Quito, Faculty of Medicine, Quito, Ecuador
| | - Julio Bobes
- University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Maria Paz Garcia-Portilla
- University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Erich Seifritz
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Stefan Vetter
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| | - Stephan T Egger
- University of Zurich, Faculty of Medicine, Psychiatric University Hospital of Zurich, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland; University of Oviedo, Faculty of Medicine, Department of Psychiatry, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain.
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Psychoeducational groups for close relatives of patients with borderline personality disorder. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01395-8. [PMID: 35294615 DOI: 10.1007/s00406-022-01395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
Psychoeducational groups for family members of patients with schizophrenia have proven to be effective. Borderline personality disorder (BPD) implies serious impairment in interpersonal relationships. Close relatives of individuals with BPD also show high levels of burden and need support. Psychoeducational groups could help to cope with the interactional problems in a relationship with a person with BPD. A manualised psychoeducational programme of 10 group sessions for close relatives of patients with BPD was tested. Measures administered at pretest and after 10 sessions were: perceived burden (IEQ-EU), knowledge about the disorder (WFBBPS-A) and quality of life (WHOQOL-BREF). For formative evaluation, a "Group Therapy Session Questionnaire" (participant and therapist version; GTS-A, GTS-T) was used. A total of 33 persons in three groups took part. Pre-post evaluations revealed a significantly lower level of burden and a significantly better knowledge about the disorder after participating in the psychoeducational group. Reduction of burden correlated significantly with the assessment of patients' symptom severity and carers' level of burden at study entry. There was no change in the quality of life. The participants and therapists generally rated the psychoeducational sessions very positively. The highest ratings were found in the sessions about communication skills and coping with crises. Findings indicate that the psychoeducational programme is well accepted and supportive for persons with close relationships to patients with BPD.
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Díaz Zuluaga AM, Duica K, Ruiz Galeano C, Vargas C, Agudelo Berruecos Y, Ospina S, López-Jaramillo C. Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA. ACTA ACUST UNITED AC 2018; 47:4-12. [PMID: 29428121 DOI: 10.1016/j.rcp.2017.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 01/11/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme. OBJECTIVE To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. METHODS A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks. RESULTS After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. CONCLUSIONS Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions.
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Affiliation(s)
- Ana M Díaz Zuluaga
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Kelly Duica
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Ruiz Galeano
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Yuli Agudelo Berruecos
- Grupo de Epidemiología Hospitalaria, Hospital Universitario de San Vicente Fundación, Medellín, Colombia
| | - Sigifredo Ospina
- Grupo de Epidemiología Hospitalaria, Hospital Universitario de San Vicente Fundación, Medellín, Colombia
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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A study of the real-world effectiveness of group psychoeducation for bipolar disorders: Is change in illness perception a key mediator of benefit? J Affect Disord 2018; 227:713-720. [PMID: 29179141 DOI: 10.1016/j.jad.2017.11.072] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/25/2017] [Accepted: 11/12/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Findings from efficacy trials of group psychoeducation (PE) for bipolar disorders (BD) led to its inclusion in evidence-based guidelines as a first-line mandatory treatment. However, pragmatic trials and observational studies are needed to determine its real-world effectiveness, impact on outcomes deemed important to patients and to clarify potential mediators of any benefits. METHODS Individuals with BD were offered the opportunity to participate in 20h of PE and asked to complete pre- and post-intervention ratings of symptoms, knowledge about BD, medication adherence, and illness perception. A priori, two key patient outcomes were identified (social functioning and self-esteem); sample attrition due to dropout or relapse was recorded. RESULTS Of 156 individuals who completed the pre-PE assessments, 103 completed the program and post-PE assessments. Only 4 of 53 dropouts were associated with BD relapse. Post-intervention, the PE completers demonstrated a statistically significant improvement in social functioning (p = 0.003, Effect Size (ES) = 0.26) and a trend towards improved self-esteem (ES = 0.14). Whilst there were significant changes in medication adherence (p = 0.002, ES = 0.28), knowledge of BD (p < 0.001, ES = 1.20), and illness perception (p < 0.001, ES = -0.37), mediational analysis demonstrated that only change in illness perception was associated to change in functioning (p=0.03) with no contribution from changes in knowledge of BD or medication adherence. CONCLUSIONS In real-world settings, over 60% individuals completed 10-session course of PE. After controlling for demography and baseline clinical state, change in illness perception, rather than change in knowledge or medication adherence, emerged as a potential mediator of some benefits of PE.
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Kumar D. Psychosocial interventions in schizophrenia: a survey of clinical training and clinicians’ opinions in India. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2018. [DOI: 10.1080/17522439.2018.1430845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Devvarta Kumar
- Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Motlova LB, Balon R, Beresin EV, Brenner AM, Coverdale JH, Guerrero APS, Louie AK, Roberts LW. Psychoeducation as an Opportunity for Patients, Psychiatrists, and Psychiatric Educators: Why Do We Ignore It? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:447-451. [PMID: 28536990 DOI: 10.1007/s40596-017-0728-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Impulsive lifestyle counseling to prevent dropout from treatment for substance use disorders in people with antisocial personality disorder: A randomized study. Addict Behav 2016; 57:48-54. [PMID: 26882500 DOI: 10.1016/j.addbeh.2016.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 01/22/2016] [Accepted: 02/03/2016] [Indexed: 12/31/2022]
Abstract
Patients with antisocial personality disorder in outpatient treatment for substance use disorders are at high risk of drop-out. Using a randomized design, this study tested the impact of adding a brief psycho-educational program, the Impulsive Lifestyle Counseling program, to outpatient substance abuse treatment in order to prevent treatment dropout. Patients (N=175) were recruited from 13 municipal treatment centers in Denmark, and assigned to treatment as usual or to the experimental condition. In all, 172 patients could be included in the analyses. In the intent-to-treat analysis, the risk of treatment dropout was reduced among patients randomized to the experimental program (hazard ratio=0.63, p=.031), after controlling for age, gender, and substitution treatment status. The study supported the efficacy of the Impulsive Lifestyle Counseling program as a method for preventing treatment dropout for patients with comorbid antisocial personality disorder in substance abuse treatment. Trial registration #ISRCTN67266318.
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Thylstrup B, Schrøder S, Hesse M. Psycho-education for substance use and antisocial personality disorder: a randomized trial. BMC Psychiatry 2015; 15:283. [PMID: 26573140 PMCID: PMC4647713 DOI: 10.1186/s12888-015-0661-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/26/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Antisocial personality disorder often co-exists with drug and alcohol use disorders. METHODS This trial examined the effectiveness of offering psycho-education for antisocial personality disorder in community substance use disorder treatment centers in Denmark. A total of 176 patients were randomly allocated to treatment as usual (TAU, n = 80) or TAU plus a psycho-educative program, Impulsive Lifestyle Counselling (ILC, n = 96) delivered by site clinicians (n = 39). Using follow-up interviews 3 and 9 months after randomization, we examined changes in drug and alcohol use (Addiction Severity Index Composite Scores), percent days abstinent (PDA) within last month, and aggression as measured with the Buss-Perry Aggression Questionnaire-Short Form and the Self-Report of Aggression and Social Behavior Measure. RESULTS Overall engagement in psychological interventions was modest: 71 (76 %) of participants randomized to psycho-education attended at least one counselling session, and 21 (23 %) attended all six sessions. The Median number of sessions was 2. All patients reduced drug and alcohol problems at 9 months with small within-group effect sizes. Intention-to-treat analyses indicated significant differences between ILC and TAU in mean drugs composite score (p = .018) and in PDA (p = .041) at 3 months. Aggression declined in both groups, but no differences between ILC and TAU were observed in terms of alcohol problems or aggression at any follow-up. CONCLUSIONS Moderate short-term improvements in substance use were associated with randomization to Impulsive Lifestyle Counselling. The findings support the usefulness of providing psycho-education to outpatients with antisocial personality disorder. TRIAL REGISTRATION ISRCTN registry, ISRCTN67266318 , 17/7/2012.
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Affiliation(s)
- Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Artillerivej 90, 2nd, 2300, Copenhagen S, Denmark.
| | - Sidsel Schrøder
- Centre for Alcohol and Drug Research, Aarhus University, Artillerivej 90, 2nd, 2300, Copenhagen S, Denmark.
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Artillerivej 90, 2nd, 2300, Copenhagen S, Denmark.
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von Maffei C, Görges F, Kissling W, Schreiber W, Rummel-Kluge C. Using films as a psychoeducation tool for patients with schizophrenia: a pilot study using a quasi-experimental pre-post design. BMC Psychiatry 2015; 15:93. [PMID: 25924784 PMCID: PMC4422602 DOI: 10.1186/s12888-015-0481-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/23/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Relapses and, subsequently, readmissions are common in patients with schizophrenia. Psychoeducation has been shown to reduce the number and duration of readmissions. Yet, only little more than 20% of psychiatric patients in German speaking countries receive psychoeducation. Among other reasons, costs may be considered too high by hospitals. The objective of the present study was to test the feasibility of a new cost-efficient approach in the psychoeducation of patients with schizophrenia. In this study, films were used to impart knowledge about the illness to inpatients. METHODS A total of 113 participants were initially included in the study, eleven of which were not included in the final analyses. Six films about the symptoms, diagnosis, causes, warning signs, treatment of schizophrenia and about the influence of family members and friends were shown in a group setting in the presence of nursing staff. All films combined facts, expert opinions, and personal experiences of peers. As the main outcome criterion of this feasibility pilot study, we measured the effects on knowledge. Secondary outcome measures included compliance, insight into illness, side effects, and quality of life. Data were collected directly after the intervention and about half a year afterwards. The number and the duration of readmissions to the hospital were recorded and compared to the number and duration of prior admissions. Patients were also asked to state their subjective opinion about the films. Main data analyses were done using paired t-tests and Wilcoxon signed-rank tests. Secondary analyses also involved ANOVAs and ANCOVAs. RESULTS One hundred and two inpatients were included in the data analyses. Showing the films in the tested setting was shown to be feasible. Knowledge about schizophrenia (p < .001), compliance (ps < .01), insight into illness (p < .01), and quality of life (p < .001) all increased significantly after patients had watched the films and remained stable for at least half a year. A vast majority (84.9%) of the patients found the films to be interesting and informative. CONCLUSIONS Using films to educate inpatients about schizophrenia is a feasible method that is cost- and time-efficient and well received by the patients.
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Affiliation(s)
- Christian von Maffei
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
| | - Frauke Görges
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
| | - Werner Kissling
- Department of Psychiatry and Psychotherapy, Technische Universität München, Möhlstr. 26, 81675, München, Germany.
| | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany. .,Forschungszentrum Depression der Stiftung Deutsche Depressionshilfe, Semmelweisstr. 10, 04103, Leipzig, Germany.
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Bankovská Motlová L, Dragomirecká E, Blabolová A, Španiel F, Slováková A. Psychoeducation for schizophrenia in the Czech Republic: curriculum modification based on opinions of service users and providers. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2015; 39:186-190. [PMID: 25416609 DOI: 10.1007/s40596-014-0234-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 10/01/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The authors examined current knowledge about psychoeducation for schizophrenia in Czech Republic. METHODS The authors sent a screening survey to 550 mental health-care facilities and administered a detailed questionnaire to 113 providers of mental health and social services and to 200 service users. The authors also carried out 14 focus groups and 16 individual interviews. RESULTS Forty-six departments provided some type of psychoeducation for schizophrenia; of these, 16 provided family psychoeducation for patients and relatives and 1 provided psychoeducation only for relatives. Service users who received psychoeducation performed significantly better in the test of knowledge than did service users who did not receive psychoeducation. CONCLUSION The authors propose a service user-driven curriculum based on information delivery followed by skills training. Psychiatrists should learn to explain schizophrenia relapse neurobiology to laypeople and to address relatives' frustrations.
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Kalckreuth S, Trefflich F, Rummel-Kluge C. Mental health related Internet use among psychiatric patients: a cross-sectional analysis. BMC Psychiatry 2014; 14:368. [PMID: 25599722 PMCID: PMC4299476 DOI: 10.1186/s12888-014-0368-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/17/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The Internet is of great importance in today's health sector, as most Internet users utilize online functions for health related purposes. Concerning the mental health care sector, little data exist about the Internet use of psychiatric patients. It is the scope of this current study to analyze the quantity and pattern of Internet usage among mental health patients. METHODS Patients from all services of the Department of Psychiatry at a university hospital were surveyed by completing a 29-item questionnaire. The data analysis included evaluation of frequencies, as well as group comparisons. RESULTS 337 patients participated in the survey, of whom 79.5% were Internet users. Social media was utilized by less than half of the users: social networks (47.8%), forums (19.4%), chats (18.7%), blogs (12.3%). 70.9% used the Internet for mental health related reasons. The contents accessed by the patients included: information on mental disorders (57.8%), information on medication (43.7%), search for mental health services (38.8%), platforms with other patients (19.8%) and platforms with mental health professionals (17.2%). Differences in the pattern of use between users with low, medium and high frequency of Internet use were statistically significant for all entities of social media (p < 0.01), search for mental health services (p = 0.017) and usage of platforms with mental health professionals (p = 0. 048). The analysis of differences in Internet use depending on the participants' type of mental disorder revealed no statistically significant differences, with one exception. Regarding the Internet's role in mental health care, the participants showed differing opinions: 36.2% believe that the Internet has or may have helped them in coping with their mental disorder, while 38.4% stated the contrary. CONCLUSIONS Most psychiatric patients are Internet users. Mental health related Internet use is common among patients, mainly for information seeking. The use of social media is generally less frequent. It varies significantly between different user types and was shown to be associated with high frequency of Internet use. The results illustrate the importance of the Internet in mental health related contexts and may contribute to the further development of mental health related online offers.
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Affiliation(s)
- Sophie Kalckreuth
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Leipzig University, Semmelweißstraße 10, 04103 Leipzig, Germany
| | - Friederike Trefflich
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Leipzig University, Semmelweißstraße 10, 04103 Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Leipzig University, Semmelweißstraße 10, Leipzig, 04103, Germany.
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Frank F, Rummel-Kluge C, Berger M, Bitzer EM, Hölzel LP. Provision of group psychoeducation for relatives of persons in inpatient depression treatment--a cross-sectional survey of acute care hospitals in Germany. BMC Psychiatry 2014; 14:143. [PMID: 24885727 PMCID: PMC4030273 DOI: 10.1186/1471-244x-14-143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depressive disorders are often recurrent and place a high burden on patients and their relatives. Psychoeducational groups for relatives may reduce relatives' burden, help prevent relapses in patients, and are recommended by the German "National Disease Management Guideline Unipolar Depression". Since there is limited knowledge on the provision of psychoeducational groups for relatives of persons in inpatient depression treatment, we conducted a survey among acute care hospitals in Germany. METHODS We conducted a two-step cross-sectional survey. Step I consisted of a questionnaire asking the heads of all psychiatric/psychosomatic acute care hospitals in Germany (N = 512) whether psychoeducational groups for relatives were provided within depression treatment, and if not, the reasons for not implementing them. In group offering hospitals the person responsible for conducting psychoeducational groups received a detailed questionnaire on intervention characteristics (step II). We performed descriptive data analysis. RESULTS The response rate was 50.2% (N = 257) in step I and 58.4% in step II (N = 45). 35.4% of the responding hospitals offered psychoeducational groups for relatives of patients with depressive disorders. According to the estimates of the respondents, relatives of about one in five patients took part in psychoeducational groups in 2011. Groups were mostly provided by two moderators (62.2%) as continuous groups (77.8%), without patients' participation (77.8%), with up to ten participants (65.9%), consisting of four or fewer sessions (51.5%) which lasted between one and one and a half hours each (77.8%). The moderators in charge were mostly psychologists (43.9%) or physicians (26.8%). Approximately one third used published manuals. Reasons for not conducting such psychoeducational groups were lack of manpower (60.1%), time (44.9%) and financial constraints (24.1%). 25.3% mentioned adequate concepts of intervention as a required condition for initiating such groups. CONCLUSIONS Only a small proportion of relatives of patients with depressive disorders participated in psychoeducational groups in 2011 in Germany. Mostly short interventions were favoured and main implementation barriers were scarce resources. Brief interventions that fit with healthcare routine should be developed and tested within randomised controlled trials. This could promote the provision of psychoeducational groups for relatives as evidence-based practice in inpatient depression treatment in Germany.
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Affiliation(s)
- Fabian Frank
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
- Department of Public Health and Health Education, University of Education Freiburg, Kunzenweg 21, D-79117 Freiburg, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University Medical Center Leipzig, Semmelweisstraße 10, D-04103 Leipzig, Germany
| | - Mathias Berger
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
| | - Eva M Bitzer
- Department of Public Health and Health Education, University of Education Freiburg, Kunzenweg 21, D-79117 Freiburg, Germany
| | - Lars P Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany
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Montoya A, Hervás A, Fuentes J, Cardo E, Polavieja P, Quintero J, Tannock R. Cluster-randomized, controlled 12-month trial to evaluate the effect of a parental psychoeducation program on medication persistence in children with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat 2014; 10:1081-92. [PMID: 24966679 PMCID: PMC4063801 DOI: 10.2147/ndt.s62487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This multicenter, cluster-randomized, nonblinded study evaluated the effect of parental psychoeducation on medication persistence among children and adolescents with newly diagnosed attention-deficit/hyperactivity disorder (ADHD). METHODS Patients received standard medication alone or medication plus a parental psychoeducation program, and were followed for 12 months. The primary endpoint was time to withdrawal or termination of medication due to any cause. Secondary endpoints included change in ADHD symptom severity, functional outcome, program satisfaction, and safety. RESULTS A total of 208 patients completed the study, which was terminated early because recruitment had ceased. At 12 months, there was no significant difference between the psychoeducation and control groups in the proportion of patients who discontinued pharmacologic treatment (13.2% versus 14.3%, respectively; size effect -0.3, P=0.34; hazard ratio 0.72, 95% confidence interval 0.36-1.43). Psychoeducation was associated with a significantly greater improvement in ADHD symptoms but not in functional outcome. Parental satisfaction with psychoeducation was high, and satisfaction with pharmacologic treatment was significantly greater in the psychoeducation group. There were no safety concerns. CONCLUSION No significant advantage for parental psychoeducation plus medication over medication alone in terms of time to medication withdrawal was observed. Psychoeducation had inconsistent but interesting effects on other outcomes.
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Affiliation(s)
- Alonso Montoya
- Medical Neurosciences, Lilly Research Laboratories Canada, Toronto, ON, Canada
| | - Amaia Hervás
- Child and Adolescent Mental Health Unit, Hospital Universitari Mutua de Terrassa, and Developmental Disorders Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joaquín Fuentes
- Child and Adolescent Psychiatry Unit, Policlinica Gipuzkoa, San Sebastian, Spain
| | - Esther Cardo
- Neuropediatric Unit, Hospital Son Llatzer, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pepa Polavieja
- Department of Clinical Research, Lilly Research Laboratories Spain, Alcobendas, Spain
| | - Javier Quintero
- Department of Psychiatry, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Rosemary Tannock
- Applied Psychology and Human Development, and Neurosciences and Mental Health Research Program, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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