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Group Psychoeducation as Adjunctive Maintenance Therapy in Bipolar Disorder

More data support the benefit of adding effective psychosocial therapies to somatic treatments for bipolar patients.

Researchers have recently demonstrated the additive effects of psychotherapy and mood stabilizers in treating patients with bipolar disorder (Journal Watch Psychiatry Apr 9 2003). This prospective Spanish study of 120 patients with bipolar I or II disorder who had been in remission for at least 6 months illustrates another helpful psychotherapeutic approach.

While continuing maintenance pharmacotherapy, patients were randomly assigned to 20 weekly nondirective group meetings (control group) or 21 weekly, 90-minute, group psychoeducation sessions that were aimed at increasing illness awareness, enhancing medication adherence, rapidly detecting symptoms of recurrence, and emphasizing the value of a regular schedule. Treating psychiatrists were blinded to the group assignments.

Significantly fewer psychoeducation patients than control patients had affective recurrences during group therapy (38% vs. 60%) and after a 2-year follow-up (67% vs. 92%). Times to recurrence were also significantly longer among psychoeducation patients. Maintenance medications did not differ significantly between the groups.

Comment: Although the authors bill the intervention as psychoeducation, it involves more than reading assignments and discussion of issues; as the authors briefly acknowledge, the intervention appears to combine social-rhythms therapy (see Journal Watch Psychiatry Aug 1 1997) and relapse-prevention therapy with an educational component. These results contribute to the body of data indicating that adding effective psychosocial therapies to somatic treatments should be standard for the care of bipolar patients.

— Steven Dubovsky, MD

Published in Journal Watch Psychiatry June 4, 2003

Citation(s):

Colom F et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Arch Gen Psychiatry 2003 Apr; 60:402-7.

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