Psychoeducation in bipolar patients with comorbid personality disorders.
BACKGROUND
The co-occurrence of personality and bipolar disorders is quite common. Bipolar patients with personality disorders have been described as having poorer outcome than 'pure' bipolar patients. However, from a combined-approach point of view, a little has been done to improve the course of these patients. Psychoeducation has shown its efficacy in the prevention of relapses in the bipolar population but, to date, no data is available on its efficacy in the management of bipolar patients with personality disorders.


METHODS
The present study shows a subanalysis from a single-blind randomized prospective clinical trial on the efficacy of group psychoeducation in bipolar I patients. Bipolar patients fulfilling DSM-IV criteria for any personality disorder were randomized to either psychoeducational treatment or a non-structured intervention. There were 22 patients in the control group and 15 in the psychoeducation group. All patients received naturalistic pharmacological treatment as well. The follow-up phase comprised 2 years where all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly for several outcome measures.


RESULTS
At the end of the follow-up phase (2 years), a 100% of control group patients fulfilled criteria for recurrence versus a 67% in the psychoeducation group (p < 0.005). Patients included in the psychoeducation group had a higher time-to-relapse and a significantly lower mean number of total, manic and depressive relapses. No significant differences regarding the number of patients who required hospitalization were found but the mean duration of days spent in the hospitalization room was significantly higher for the patients included in the control group.


CONCLUSIONS
Psychoeducation may be a useful intervention for bipolar patients with comorbid personality disorders. Further studies should address the efficacy of specifically tailored interventions for this common type of patients.
Colom
Francesc
F
Bipolar Disorders Program, Hospital Clinic University of Barcelona, IDIBAPS, Spain.
Vieta
Eduard
E
Sánchez-Moreno
José
J
Martínez-Arán
Anabel
A
Torrent
Carla
C
Reinares
María
M
Goikolea
José Manuel
JM
Benabarre
Antonio
A
Comes
Mercè
M
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D010353:Patient Education as Topic; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods*; D055502:Secondary Prevention; D016037:Single-Blind Method