
Research view
Title: | Relapse rate and outcome correlates in Egyptian patients with bipolar disorder treated with behavioural family psychoeducation |
Author: | Nahla Nagy, Walaa Sabry, Doaa Khalifa, Reem Hashem, Nasser Zahran and Afaf H. Khalil |
Abstract: |
Background
Despite the extensive use of mood stabilizers, a high percentage of patients with
bipolar affective disorder continue to experience frequent relapses. There is only a
small and heterogeneous body of evidence on the effectiveness of behavioural familyoriented
approaches for relapse prevention in patients with bipolar disorder.
Aim
The aim of the study was to compare the relapse and hospitalization/rehospitalization
rates in a group of patients with bipolar disorder who received behavioural family
psychoeducation therapy and pharmacotherapy with the rates in a second group of
bipolar patients who received supportive psychotherapy and pharmacotherapy. In
addition, the study aimed to investigate the various sociodemographic correlates and
clinical variables that affect the outcome of these patients.
Patients and methods
Bipolar patients (N = 111) and their relatives were recruited immediately after an acute
illness episode. They were randomly divided into two groups: group I and group II.
Group I received 21 sessions of behavioural family therapy (BFT), and group II
received a comparison treatment involving supportive psychotherapy sessions.
Patients were simultaneously maintained on mood-stabilizing medications. We used
the following parameters for assessment: Structured Clinical Interview for DSM-IV Axis
I Disorders (SCID-I); Young Mania Rating Scale (YMRS), Hamilton Depression Rating
Scale (HAM-D); Wisconsin Quality of Life Index Client Questionnaire (W-QLI); and the
Social Functioning Questionnaire (SFQ). The main outcome measures included
response rates, relapse rates and rate of rehospitalization.
Results
Patients assigned to BFT had fewer relapses (25.3%) and hospitalizations/
rehospitalizations (1.49%) during the study year compared with patients who received
supportive psychotherapy (34.3 and 50%, respectively). None of the
sociodemographic or clinical profile variables correlated with change in the outcome
measures.
Conclusion
BFT in combination with pharmacotherapy improves the outcome of bipolar illness by
reducing relapse and hospitalization/rehospitalization rates. The study also
demonstrated that BFT is effective for all patients across different sociodemographic
and clinical backgrounds.
Keywords:
behavioural family therapy, bipolar disorder, correlates, outcome, psychoeducation,
psychosocial intervention, relapse rate
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Journal: | Middle East Current Psychiatry 2015, 22:121–131 |
Text: | |
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