Kognitiv-psychoedukative Gruppenintervention bei bipolar erkrankten Patienten: Pilotstudie mit Zwei-Jahres-Katamnese

Abstract

52 patients with bipolar disorder were treated with psychopharmacotherapy and a cognitive psychoeducational group programme that was established at the Department of Psychiatry and Psychotherapy of the Ludwig Maximilian University, Munich, Germany. The programme covers psychoeducation, identifying and coping with depressive and manic symptoms, relapse prevention and establishing a stable life style. 96 % rated the group to be helpful and felt well informed about their illness. There were significant gains in knowledge (F = 25,714, p < 0.001) and improvements in the severity of the illness (CGI; F = 68,255, p < 0.001) post-treatment. With regard to sociodemographic and clinical variables, only the level of work qualification showed a differential treatment response: patients with higher qualifications had a more favourable course of the illness (F = 4,125, p = 0.048). At one and two year follow-up 25 % and, respectively, 30 % of the sample had to be readmitted. A higher number of previous hospitalisations (p = 0.010) and male sex (p = 0.031) turned out to be significant predictors of relapse (R² = 0.358, p = 0.004) at two year follow-up. This disorder-specific group programme represents a key component of treatment offering emotional support for patients and their relatives. Patients are to be involved in the treatment process and need information about the illness, its psychosocial and pharmacological treatment as well as help in learning practical skills to improve their living with the disease. Being integrated and committed to a supporting network may increase their quality of life.

Psychoeducational and Cognitive Behavioral Treatment Programs: Implementation and Evaluation From 1995 to 2015 in Kraepelin’s Former Hospital

“…This has yielded hope that meaningful recovery from schizophrenia [79][80][81] is possible and that patients can learn to improve the course of their illness. Education about schizophrenia, bipolar disorder, and depression and teaching effective self-help strategies [75][76][77][78][79][80][81] is now widely accepted as a treatment standard. Illness management programs also include cognitive behavioral interventions, such as teaching coping strategies, instilling hope by reframing challenging experiences and setting goals, supporting treatment adherence, and providing groups for relatives that enhance social networks and reduce relapse rates.…”

“…42 Studies conducted in this hospital have demonstrated the feasibility, effectiveness, and efficacy of illness management group programs in patients with psychiatric illness. [75][76][77][78][79][80][81] Therapeutic interventions are also important for children (under the age of 18) who have parents with a psychiatric illness. 51 The interventions inform the children about the illness in a manner consistent with their developmental age, and seek to enhance their self-confidence and self-efficacy, both of which are important protective factors.…”

“…77 52 patients with bipolar disorder studied in a naturalistic setting showed improvements in the severity of illness and differential treatment response. 78 At the postassessment, patients with a higher education level performed better than those with less education. A higher number of previous hospitalizations and being male best predicted the readmission rate (30%) at the 2-year follow-up; however, the study lacked a control group, which limits the interpretation of the results.…”

“…A higher number of previous hospitalizations and being male best predicted the readmission rate (30%) at the 2-year follow-up; however, the study lacked a control group, which limits the interpretation of the results. 78…”

Eficacia de la Terapia Psicoeducativa Motivacional Breve Dual (TPMB-D) en pacientes hospitalizados con trastorno por uso de sustancias y patología dual

“…Ninguna de las variables sociodemográficas ni clínicas influyen en el aumento en el nivel de conocimientos, en la línea de estudios que encuentran que ninguna variable de este tipo influye en la adquisición de conocimientos en grupos psicoeducativos para familiares de enfermos mentales (Belloso, García y de Prado, 2000), pacientes con trastorno bipolar (Schaub et al, 2013) y pacientes con esquizofrenia (Prasko et al, 2011). Sin embargo, otros estudios encuentran que el grado de psicopatología influye en la la adquisición de conocimientos sobre la psicosis, aunque incluso los pacientes más graves se benefician de la psicoeducación (Kreiner, Baranyi, Stepan y Rothenhäusler, 2012).…”