Two-year evaluation of a multifamily psychoeducational program (PROTEC) in the family burden and prognosis of bipolar patients.

Autor: Barbeito S; Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja (UNIR), Logroño, La Rioja, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) G10, Vitoria-Gasteiz, Álava, España. Electronic address: sara.barbeito@unir.net., Vega P; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) G10, Vitoria-Gasteiz, Álava, España; Universidad del País Vasco, Leioa, Bizkaia, España; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Álava, España., Ruiz de Azúa S; Universidad del País Vasco, Leioa, Bizkaia, España., González-Ortega I; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) G10, Vitoria-Gasteiz, Álava, España; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Álava, España., Alberich S; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) G10, Vitoria-Gasteiz, Álava, España; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Álava, España., González-Pinto A; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) G10, Vitoria-Gasteiz, Álava, España; Universidad del País Vasco, Leioa, Bizkaia, España; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Álava, España.
Jazyk: angličtina
Zdroj: Spanish journal of psychiatry and mental health [Span J Psychiatry Ment Health] 2023 Oct-Dec; Vol. 16 (4), pp. 225-234. Date of Electronic Publication: 2021 Jul 17.
DOI: 10.1016/j.rpsm.2021.07.002
Abstrakt: Introduction: Bipolar disorder causes a significant burden on the lives of patients and their families. The family is one of the targets for therapeutic intervention, related to the prognosis in patients with bipolar disorder.
Aim: To assess the effectiveness of a multifamily psychoeducational program for people with bipolar disorder, in the family burden: objective and subjective and in the variables related to the course of the patients with bipolar disorder (symptoms, adherence, functionality, hospitalizations), comparing it with a control group (CG).
Materials and Methods: A total of 148 relatives of bipolar patients and 148 bipolar patients were recruited. The sample was randomized (experimental group [EG] and CG) and with single-blind evaluations (baseline, at 5 months and one year). Clinical and sociodemographic variables were collected from families and patients (family burden self-report scale, Strauss-Carpenter Scale, Global Assessment of Functioning, Morisky Green adherence Scale). Both, EG and CG received 8 multifamily sessions, applied exclusively on the relatives of patients with bipolar disorder, but in the EG a psychoeducational treatment was carried out and in the CG only playful and current topics were discussed. Bivariate and logistic regression models were used, among others.
Results: The caregivers and patients of the EG and CG did not differ in any of the baseline variables (sociodemographic and clinical) (P>.001). In the total sample, the baseline objective burden was light (mean 0.6±0.4) and the subjective ones was medium-moderate (mean 1.1±0.3). During the follow-up, in relation to the variables of the caregivers, there was a greater reduction in the objective burden in the EG compared to the CG (5 months P=.006; one year P=.002). It was found that the objective burden (P=.006) and the subjective burden (P=.003) were significantly reduced over a year in EG but not in the CG. During the follow-up, the patients whose caregivers belonged to the EG showed a greater increase in the frequency of social activity (P=.008), in the work activity (P=.002), and global functioning (P=.002), and reduced their symptoms (P≤.001). Longitudinal analyses, over a year, showed that patients in the EG had a greater improvement in functionality compared to patients in the CG (P=.001). After the intervention, adherence to pharmacological treatment improved more in EG than in the CG (P≤.001). Regarding hospitalizations, any patients in the CG were hospitalized during the 5 months after the intervention, while 27.8% of the patients in the CG were hospitalized (P≤.001); the difference between groups remained significant in the long term (one year: P≤.001; 2 years: P≤.001). There were no significant differences between groups in the pharmacological treatment of the patients in any of the evaluations.
Conclusions: The multifamily psychoeducational intervention group improved the family burden after the intervention. Likewise, bipolar patients, whose families attended the EG, improved significantly, over a year, the functionality, the frequency of social contacts, the work status, the adherence to treatment, and reduced their symptoms. In addition, in the EG, the percentage of hospitalizations during the 2 years of follow-up was significantly reduced.
(Copyright © 2021 Sociedad Española de Psiquiatría y Salud Mental (SEPSM). Published by Elsevier España S.L.U. All rights reserved.)
Databáze: MEDLINE
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