Kognitiv-psychoedukative Gruppenintervention bei stationären Patienten mit depressiven Erkrankungen – Ergebnisse einer prospektiven Pilotstudie

Abstract

Psychoeducational interventions that provide disorder-related information in a goal-oriented and structured manner have been integrated in psychiatric and psychotherapeutic approaches. The present cognitive psychoeducational group programme for inpatients with affective disorders is based on a multidimensional functional illness concept which covers aspects of vulnerability, stressors and coping strategies. It covers information about the disorder and its treatment options, building up rewarding activities, cognitive restructuring and relapse prevention. Materials und Methods: This programme was developed and modified at the University of Munich, Department of Psychiatry (LMU). A feasibility study was set up in a follow-up single group design and analyses of variance (ANOVAs) were performed. A total of 231 patients participated in 46 groups. Results: 125 patients evaluated the effectiveness of the programme and its treatment strategies. The group programme was widely accepted among patients that were pharmacologically and psychotherapeutically treated: more than three quarters of the patients rated its contents to be informative, helpful and applicable to everyday living. Conclusions: Inpatients with affective disorders may already benefit from a structured group programme if it takes into account their cognitive and motivational deficits. The group leaders’ didactic and psychotherapeutic strategies as well as the patients’ exchanging ideas with each other play a central role. In the course of further investigations the programme was differentiated for patients with major depression or bipolar disorders.

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.…”

“…The program was then differentiated for patients with major depression or bipolar disorders. 76 We investigated the effects of group intervention for 62 bipolar patients who attended cognitive-psychoeducational group therapy and their 49 relatives. 77 Psychoeducational interventions in bipolar patients and their relatives improved patients' and their relatives' knowledge of the illness and the burden of the illness as well as high expressed emotion were reduced in relatives at 1-year follow-up.…”

A Cognitive Behavioural Illness Management Program for Severe Depression: Predictors of Treatment Response

“…The absence of a control group limits the conclusions that can be drawn from this study. [30,[32][33][34] or outpatients with severe acute, partially remitted or chronic forms of depression (e.g., Keller et al and Teasdale et al [3,6] indicating that the combination of pharmacotherapy with psycho therapeutically interventions has a beneficial effect. It is associated with higher improvement, satisfaction with treatment and treatment adherence with pharmacotherapy than drug treatment alone [21,22,56].…”

“…Participating in interpersonal Schramm et al [30], cognitive Stuart and Bowers [31] or cognitive-psycho educational programs Schaub et al [12,32] led to high satisfaction with treatment and knowledge of depression as well as symptom reductions which were even maintained at six-month follow-up Backenstrass et al [33]. Only two controlled studies showed no or only little short-term benefits of combining pharmacotherapy with cognitive therapy compared to each condition only Hautzinger et al [34] or to the combination with supportive therapy De Jong-Meyer et al [35], however, there was some evidence for long-term effects.…”