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Psychoeducation: improving outcomes in bipolar disorder

Published online by Cambridge University Press:  16 April 2020

Francesc Colom  and
Dominic Lam
Francesc Colom*
Affiliation:
Bipolar Disorders Program, IDIBAPS, Barcelona Stanley Medical Research Center, Barcelona, Spain
Dominic Lam*
Affiliation:
Henry Wellcome Building (PO77), Psychology Department, Institute of Psychiatry, De Crespigny Park, LondonSE5 8AF, UK
*
*Corresponding authors. Tel.: +34 93 227 5401; fax: +34 93 207 5678(F. Colomb); tel.: +44 20 7848 0885; fax: +44 20 7848 5006 (D. Lam).E-mail address: fcolom@clinic.ub.es (F. Colom)
*Corresponding authors. Tel.: +34 93 227 5401; fax: +34 93 207 5678(F. Colomb); tel.: +44 20 7848 0885; fax: +44 20 7848 5006 (D. Lam).E-mail address: fcolom@clinic.ub.es (F. Colom)
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Abstract

Background

A relevant paradigm shift in the treatment of bipolar disorder started a few years ago; crucial findings on the usefulness of psychological interventions clearly support switching from an exclusively pharmacological therapeutic approach to a combined yet hierarchical model in which pharmacotherapy plays a central role, but psychological interventions may help cover the gap that exists between theoretical efficacy and “real world” effectiveness. Hereby we review the efficacy of several adjunctive psychotherapies in the maintenance treatment of bipolar patients.

Methods

A systematic review of the literature on the issue was performed, using MEDLINE and CURRENT CONTENTS databases. “Bipolar”, “Psychotherapy”, “Psychoeducation”, “Cognitive-behavioral” and “Relapse prevention” were entered as keywords.

Results

Psychological treatments specifically designed for relapse prevention in bipolar affective disorder are useful tools in conjunction with mood stabilizers. Most of the psychotherapy studies recently published report positive results on maintenance as an add-on treatment, and efficacy on the treatment of depressive episodes. Interestingly, several groups from all over the world reported similar positive results and reached very similar conclusions; almost every intervention tested contains important psychoeducative elements including both compliance enhancement and early identification of prodromal signs — stressing the importance of life-style regularity — and exploring patients' health beliefs and illness-awareness.

Conclusions

The usefulness of psychotherapy for improving treatment adherence and clinical outcome of bipolar patients is nowadays unquestionable, and future treatment guidelines should promote its regular use amongst clinicians. As clinicians, it is our major duty, to offer the best treatment available to our patients and this includes both evidence-based psychoeducation programs and newer pharmacological agents.

Keywords

Bipolar disorderPsychoeducationCognitionPsychotherapy
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 5-6 , August 2005 , pp. 359 - 364
Copyright
Copyright ©Elsevier SAS 2005

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