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The impact of a CBT-based bipolar disorder psychoeducation group on views about diagnosis, perceived recovery, self-esteem and stigma

Published online by Cambridge University Press:  09 September 2019

Thomas Richardson Open the ORCID record for Thomas Richardson [Opens in a new window]  and
Lucy White
Thomas Richardson*
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth POE 6AD, UK
Lucy White
Affiliation:
Mental Health Recovery Teams, Solent NHS Trust, St Mary’s Community Health Campus, Milton Road, Portsmouth POE 6AD, UK
*
*Corresponding author. Email: Thomas.Richardson@solent.nhs.uk
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Abstract

Previous research has shown that psychoeducation for bipolar disorder (BD) improves symptoms and reduces relapse risk, but there is little research on how this impacts stigma, perceived recovery and views about diagnosis. The aim of this study was to explore whether a cognitive behaviour therapy (CBT)-based 12-week BD psychoeducation group conducted in a community mental health team for adults impacted perceived stigma, diagnosis-related self-esteem, recovery and views about diagnosis. The case series pre- and post-group had 23 participants across three groups. The Brief Illness Perception Questionnaire, views on Manic Depression Questionnaire, Bipolar Recovery Questionnaire and author-constructed questions were completed pre and post. Twenty participants completed the group. An intent-to-treat repeated measures multiple analysis of variance showed significantly improved perceived recovery and improvements in sense of control and understanding around their diagnosis. Other specific questions such as understanding of triggers and impact of thinking patterns also improved. However, there was no change in the perceived stigma or self-esteem associated with living with BD. CBT-based psychoeducation groups may help improve perceived recovery and factors such as sense of control in BD. However, there appears to be no impact on stigma and self-esteem, and the role of non-specific factors needs to be examined further.

Key learning aims

  1. (1) To raise awareness of the impact of stigma and self-esteem in bipolar disorder.

  2. (2) To understand the content and structure of CBT-based psychoeducation groups.

  3. (3) To consider the potential benefits of CBT-based psychoeducation groups beyond symptoms and relapse reduction on factors such as perceived recovery.

Keywords

bipolar disorderCBTgrouppsychoeducationrecoveryself-esteemstigma
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e43
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Further reading

Jones, S. H., Smith, G., Mulligan, L., Lobban, F., Law, H., & Morrison, A. P. (2015). Recovery-focused cognitive-behavioural therapy for recent-onset bipolar disorder: randomised controlled pilot trial. British Journal of Psychiatry, 206, 58–66.CrossRefGoogle ScholarPubMed
Lam, D. H., Jones, S. H., & Hayward, P. (2010). Cognitive Therapy for BD: A Therapist’s Guide to Concepts, Methods and Practice, 2nd edition, pp. 71–122. Chichester, UK: Wiley.CrossRefGoogle Scholar
Oud, M., Mayo-Wilson, E., Braidwood, R., Schulte, P., Jones, S. H., Morriss, R., … & Kendall, T. (2016). Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis. British Journal of Psychiatry, 208, 213–222. doi: 10.1192/bjp.bp.114.157123 CrossRefGoogle ScholarPubMed

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA, USA: American Psychiatric Publishing.Google Scholar
Blairy, S., Linotte, S., Souery, D., Papadimitriou, G., Dikeos, D., Lerer, B., … & Macciardi, F. (2004). Social adjustment and self-esteem of bipolar patients: a multicentric study. Journal of Affective Disorders, 79, 97–103.CrossRefGoogle ScholarPubMed
Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research, 60, 631–637.CrossRefGoogle ScholarPubMed
Brohan, E., Gauci, D., Sartorius, N., Thornicroft, G., & the GAMIAN Europe Study Group (2011). Self-stigma, empowerment and perceived discrimination among people with BD or depression in 13 European countries: the GAMIAN–Europe study. Journal of Affective Disorders, 129, 56–63.CrossRefGoogle ScholarPubMed
Castle, D., Berk, M., Berk, L., Lauder, S., Chamberlain, J., & Gilbert, M. (2007). Pilot of group intervention for bipolar disorder. International Journal of Psychiatry in Clinical Practice, 11, 279–284 CrossRefGoogle ScholarPubMed
Colom, F., & Vieta, E. (2006). Psychoeducation Manual for Bipolar Disorder. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Camardese, G., Vasale, M., D’Alessandris, L., Mazza, M., Serrani, R., Travagliati, F., … & Janiri, L. (2018). A mixed program of psychoeducational and psychological rehabilitation for patients with bipolar disorder in a day hospital setting. Journal of Nervous and Mental Disease, 206, 290–295.Google Scholar
Crowe, M., & Inder, M. (2018). Staying well with bipolar disorder: a qualitative analysis of five‐year follow‐up interviews with young people. Journal of Psychiatric and Mental Health Nursing, 25, 236–244.CrossRefGoogle ScholarPubMed
de Andrés, R. D., Aillon, N., Bardiot, M.-C., Bourgeois, P., Mertel, S., Nerfin, F., … & Aubry, J.-M. (2006). Impact of the life goals group therapy program for bipolar patients: an open study. Journal of Affective Disorders, 93, 253–257.CrossRefGoogle Scholar
Etain, B., Scott, J., Cochet, B., Bellivier, F., Boudebesse, C., Drancourt, N., … & Fouques, D. (2018). A study of the real-world effectiveness of group psychoeducation for bipolar disorders: is change in illness perception a key mediator of benefit? Journal of Affective Disorders, 227, 713–720.CrossRefGoogle Scholar
Evans-Lacko, S., Henderson, C., & Thornicroft, G. (2013). Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. British Journal of Psychiatry, 202, 51–57.CrossRefGoogle Scholar
Gilkes, M., Perich, T., & Meade, T. (2018). Predictors of self-stigma in bipolar disorder: depression, mania, and perceived cognitive function. Stigma and Health, Epub ahead of print.Google Scholar
Hayward, P. (2010) ‘The Views on Manic Depression Questionnaire’, cited in Lam, D. H., Jones, S. H., & Hayward, P. (2010), Pre‐therapy assessment, in Cognitive Therapy for Bipolar Disorder: A Therapist’s Guide to Concepts, Methods and Practice, 2nd edition, pp. 71–122. Chichester, UK: Wiley.Google Scholar
Hayward, P., Wong, G., Bright, J. A., & Lam, D. (2002). Stigma and self-esteem in manic depression: an exploratory study. Journal of Affective Disorders, 69, 61–67.CrossRefGoogle Scholar
Howland, M., Levin, J., Blixen, C., Tatsuoka, C., & Sajatovic, M. (2016). Mixed-methods analysis of internalized stigma correlates in poorly adherent individuals with bipolar disorder. Comprehensive Psychiatry, 70, 174–180.CrossRefGoogle ScholarPubMed
Jones, S. H., Smith, G., Mulligan, L., Lobban, F., Law, H., & Morrison, A. P. (2015). Recovery-focused cognitive-behavioural therapy for recent-onset bipolar disorder: randomised controlled pilot trial. British Journal of Psychiatry, 206, 58–66.CrossRefGoogle ScholarPubMed
Jones, S., Mulligan, L. D., Higginson, S., Dunn, G., & Morrison, A. P. (2013). The bipolar recovery questionnaire: psychometric properties of a quantitative measure of recovery experiences in BD. Journal of Affective Disorders, 147, 34–43.CrossRefGoogle Scholar
Karidi, M. V., Vassilopoulou, D., Savvidou, E., Vitoratou, S., Maillis, A., Rabavilas, A., & Stefanis, C. N. (2015). Bipolar disorder and self-stigma: a comparison with schizophrenia. Journal of Affective Disorders, 184, 209–215.CrossRefGoogle ScholarPubMed
Knowles, R., Tai, S., Jones, S. H., Highfield, J., Morriss, R., & Bentall, R. P. (2007). Stability of self‐esteem in bipolar disorder: comparisons among remitted bipolar patients, remitted unipolar patients and healthy controls. Bipolar Disorders, 9, 490–495.CrossRefGoogle ScholarPubMed
Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. British Journal of Psychiatry, 199, 445–452.CrossRefGoogle ScholarPubMed
Madigan, K., Egan, P., Brennan, D., Hill, S., Maguire, B., Horgan, F., Flood, C., Kinsella, A., & O’Callaghan, E. (2012). A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. European Psychiatry, 27, 281–284.CrossRefGoogle ScholarPubMed
Merikangas, K. R., Jin, R., He, J.-P., Kessler, R. C., Lee, S., Sampson, N. A., … & Karam, E. G. (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of General Psychiatry, 68, 241–251.CrossRefGoogle ScholarPubMed
Nilsson, K. K., Kugathasan, P., & Straarup, K. N. (2016). Characteristics, correlates and outcomes of perceived stigmatization in bipolar disorder patients. Journal of Affective Disorders, 194, 196–201.CrossRefGoogle ScholarPubMed
Nilsson, K. K., Jøorgensen, C. R., Craig, T. K. J., Staarup, K. N., & Licht, R.M. (2010). Self‐esteem in remitted bipolar disorder patients: a meta‐analysis. Bipolar Disorders, 12, 585–592.CrossRefGoogle ScholarPubMed
Oud, M., Mayo-Wilson, E., Braidwood, R., Schulte, P., Jones, S. H., Morriss, R., … & Kendall, T. (2016). Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis. British Journal of Psychiatry, 208, 213–222. doi: 10.1192/bjp.bp.114.157123 CrossRefGoogle ScholarPubMed
Patelis-Siotis, I., Young, L. T., Robb, J. C., Marriott, M., Bieling, P. J., Cox, L. C., & Joffe, R. T. (2001). Group cognitive behavioral therapy for bipolar disorder: a feasibility and effectiveness study. Journal of Affective Disorders, 65, 145–153.CrossRefGoogle ScholarPubMed
Pavlova, B., Uher, R., Dennington, L., Wright, K., & Donaldson, C. (2011). Reactivity of affect and self-esteem during remission in bipolar affective disorder: an experimental investigation. Journal of Affective Disorders, 134, 102–111.CrossRefGoogle Scholar
Perlick, D. A., Rosenheck, R. A., Clarkin, J. F., Sirey, J. A., Salahi, J., Struening, E. L., & Link, B. G. (2001). Stigma as a barrier to recovery: adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatric Services, 52, 1627–1632.CrossRefGoogle ScholarPubMed
Post, F., Pardeller, S., Frajo-Apor, B., Kemmler, G., Sondermann, C., Hausmann, A., … & Hofer, A. (2018). Quality of life in stabilized outpatients with bipolar I disorder: associations with resilience, internalized stigma, and residual symptoms. Journal of Affective Disorders, 238, 399–404.CrossRefGoogle ScholarPubMed
Sanchez-Moreno, J., Martinez-Aran, A., Tabares-Seisdedos, R., Torrent, C., Vieta, E., & Ayuso-Mateos, J. (2009). Functioning and disability in bipolar disorder: an extensive review. Psychotherapy and Psychosomatics, 78, 285–297.CrossRefGoogle Scholar
Todd, N. J., Jones, S. H., Hart, A., & Lobban, F. A. (2014). A web-based self-management intervention for bipolar disorder ‘living with bipolar’: a feasibility randomised controlled trial. Journal of Affective Disorders, 169, 21–29.CrossRefGoogle ScholarPubMed
Warwick, H., Mansell, W., Porter, C. & Tai, S. (2019). ‘What people diagnosed with bipolar disorder experience as distressing’: a meta-synthesis of qualitative research. Journal of Affective Disorders, 248, 108–130.CrossRefGoogle ScholarPubMed
World Health Organisation (2018). World Health Organisation. Classification of Diseases Eleven (ICD-11). Geneva, Switzerland: World Health Organisation.Google Scholar
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