A study of the real-world effectiveness of group psychoeducation for bipolar disorders: Is change in illness perception a key mediator of benefit?
| Autor: | Noémie Drancourt, Frank Bellivier, Barbara Cochet, Mohamed Lajnef, Jan Scott, Sophie Lauer, C. Boudebesse, Chantal Henry, Damien Fouques, Bruno Etain, L. Yon, Marion Leboyer, I. Dusser, Jean-Romain Richard |
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| Přispěvatelé: | Variabilité de réponse aux Psychotropes (VariaPsy - U1144), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fondation FondaMental [Créteil], Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7), Newcastle University [Newcastle], Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Clinique, Psychanalyse, Développement (CliPsyD), Université Paris Nanterre (UPN), HAL Nanterre, Administrateur, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Hôpital Saint-Louis, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Biomécanique cellulaire et respiratoire (BCR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Mandatory treatment medicine.medical_specialty Bipolar Disorder medicine.medical_treatment [SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior [SHS.PSY]Humanities and Social Sciences/Psychology Medication adherence Effectiveness Clinical state Sample attrition Medication Adherence [SHS.PSY] Humanities and Social Sciences/Psychology Illness perceptions 03 medical and health sciences 0302 clinical medicine Patient Education as Topic Recurrence Secondary Prevention Bipolar disorders Illness perception Psychoeducation medicine Humans Functioning 030212 general & internal medicine Psychiatry Mediators Social functioning Cognitive Behavioral Therapy [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior Middle Aged 030227 psychiatry 3. Good health Psychiatry and Mental health Clinical Psychology Treatment Outcome [SCCO.PSYC] Cognitive science/Psychology [SCCO.PSYC]Cognitive science/Psychology Patient Compliance Female Observational study [No keyword] sense organs Psychology Clinical psychology |
| Zdroj: | Journal of Affective Disorders Journal of Affective Disorders, Elsevier, 2018, 227, pp.713--720. ⟨10.1016/j.jad.2017.11.072⟩ Journal of Affective Disorders, 2018, 227, pp.713--720. ⟨10.1016/j.jad.2017.11.072⟩ |
| ISSN: | 0165-0327 1573-2517 |
| DOI: | 10.1016/j.jad.2017.11.072 |
| Popis: | International audience; BACKGROUND: Findings from efficacy trials of group psychoeducation (PE) for bipolar disorders (BD) led to its inclusion in evidence-based guidelines as a first-line mandatory treatment. However, pragmatic trials and observational studies are needed to determine its real-world effectiveness, impact on outcomes deemed important to patients and to clarify potential mediators of any benefits. METHODS: Individuals with BD were offered the opportunity to participate in 20h of PE and asked to complete pre- and post-intervention ratings of symptoms, knowledge about BD, medication adherence, and illness perception. A priori, two key patient outcomes were identified (social functioning and self-esteem); sample attrition due to dropout or relapse was recorded. RESULTS: Of 156 individuals who completed the pre-PE assessments, 103 completed the program and post-PE assessments. Only 4 of 53 dropouts were associated with BD relapse. Post-intervention, the PE completers demonstrated a statistically significant improvement in social functioning (p = 0.003, Effect Size (ES) = 0.26) and a trend towards improved self-esteem (ES = 0.14). Whilst there were significant changes in medication adherence (p = 0.002, ES = 0.28), knowledge of BD (p < 0.001, ES = 1.20), and illness perception (p < 0.001, ES = -0.37), mediational analysis demonstrated that only change in illness perception was associated to change in functioning (p=0.03) with no contribution from changes in knowledge of BD or medication adherence. CONCLUSIONS: In real-world settings, over 60% individuals completed 10-session course of PE. After controlling for demography and baseline clinical state, change in illness perception, rather than change in knowledge or medication adherence, emerged as a potential mediator of some benefits of PE. |
| Databáze: | OpenAIRE |
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