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Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: A 5-year controlled clinical trial

Published online by Cambridge University Press:  15 April 2020

A. González Isasi ,
E. Echeburúa ,
J.M. Limiñana  and
A. González-Pinto
A. González Isasi*
Affiliation:
Psychiatry Department, Hospital Universitario Insular, Las Palmas de Gran Canaria, Spain
E. Echeburúa
Affiliation:
Faculty of Psychology, University of the Basque Country, CIBERSAM, San Sebastián, Spain
J.M. Limiñana
Affiliation:
Unidad de Investigación, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
A. González-Pinto
Affiliation:
CIBERSAM, Department of Psychiatry, Santiago Apóstol Hospital, EHU/UPV, Vitoria, Spain
*
*Corresponding author. Hospital Universitario Insular de Gran Canaria, Servicio de Psiquiatría, Avenida Marítima s/n, 35016 Las Palmas, Las Palmas de Gran Canaria, Spain. Tel.: +34 92 84 41 50 2; fax: +34 92 84 41 55 5. E-mail address: anagonis@hotmail.com (A. González Isasi).
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Abstract

Objective:

The aim of this research, which represents an additional and longer follow-up to a previous trial, was to evaluate a 5-year follow-up study of a combined treatment (pharmacological + psychoeducational and cognitive-behavioral therapy) as compared with a standard pharmacological treatment in patients with refractory bipolar disorder.

Method:

Forty patients were randomly assigned to either an Experimental group–under combined treatment — or a Control group — under pharmacological treatment. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation time points.

Results:

Between-group differences were significant at all evaluation time points after treatment. Experimental group had less hospitalization events than Control group in the 12-month evaluation (P = 0.015). The Experimental group showed lower depression and anxiety in the 6-month (P = 0.006; P = 0.019), 12-month (P = 0.001; P < 0.001) and 5-year (P < 0.001, P < 0.001) evaluation time points. Significant differences emerged in mania and misadjustment already in the post-treatment evaluation (P = 0.009; P < 0.001) and were sustained throughout the study (6-month: P = 0.006, P < 0.001; 12-month: P < 0.001, P < 0.001; 5-year: P = 0.004, P < 0.001). After 5-year follow-up, 88.9% of patients in the Control group and 20% of patients in the Experimental group showed persistent affective symptoms and/or difficulties in social-occupational functioning.

Conclusions:

A combined therapy is long-term effective for patients with refractory bipolar disorder. Suggestions for future research are commented.

Keywords

Refractory bipolar disorderCombined therapyPharmacological treatmentPsychoeducationCognitive-behavioral modelLong-term follow-up
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 3 , March 2014 , pp. 134 - 141
Copyright
Copyright © European Psychiatric Association 2014

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