Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: A 5-year controlled clinical trial - 28/02/14
, E. Echeburúa b, J.M. Limiñana c, A. González-Pinto dBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Objective |
The aim of this research, which represents an additional and longer follow-up to a previous trial, was to evaluate a 5-year follow-up study of a combined treatment (pharmacological+psychoeducational and cognitive-behavioral therapy) as compared with a standard pharmacological treatment in patients with refractory bipolar disorder.
Method |
Forty patients were randomly assigned to either an Experimental group–under combined treatment — or a Control group — under pharmacological treatment. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation time points.
Results |
Between-group differences were significant at all evaluation time points after treatment. Experimental group had less hospitalization events than Control group in the 12-month evaluation (P=0.015). The Experimental group showed lower depression and anxiety in the 6-month (P=0.006; P=0.019), 12-month (P=0.001; P<0.001) and 5-year (P<0.001, P<0.001) evaluation time points. Significant differences emerged in mania and misadjustment already in the post-treatment evaluation (P=0.009; P<0.001) and were sustained throughout the study (6-month: P=0.006, P<0.001; 12-month: P<0.001, P<0.001; 5-year: P=0.004, P<0.001). After 5-year follow-up, 88.9% of patients in the Control group and 20% of patients in the Experimental group showed persistent affective symptoms and/or difficulties in social-occupational functioning.
Conclusions |
A combined therapy is long-term effective for patients with refractory bipolar disorder. Suggestions for future research are commented.
Le texte complet de cet article est disponible en PDF.Keywords : Refractory bipolar disorder, Combined therapy, Pharmacological treatment, Psychoeducation, Cognitive-behavioral model, Long-term follow-up
Plan
Vol 29 - N° 3
P. 134-141 - mars 2014 Retour au numéro
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