title: Pragmatic randomised controlled trial of group psychoeducation versus group support in the maintenance of bipolar disorder.
abstract: BACKGROUND
  Non-didactically delivered curriculum based group psychoeducation has been shown to be more effective than both group support in a specialist mood disorder centre in Spain (with effects lasting up to five years), and treatment as usual in Australia. It is unclear whether the specific content and form of group psychoeducation is effective or the chance to meet and work collaboratively with other peers. The main objective of this trial is to determine whether curriculum based group psychoeducation is more clinically and cost effective than unstructured peer group support.
  
  
  METHODS
  Single blind two centre cluster randomised controlled trial of 21 sessions group psychoeducation versus 21 sessions group peer support in adults with bipolar 1 or 2 disorder, not in current episode but relapsed in the previous two years. Individual randomisation is to either group at each site. The groups are carefully matched for the number and type of therapists, length and frequency of the interventions and overall aim of the groups but differ in content and style of delivery. The primary outcome is time to next bipolar episode with measures of the therapeutic process, barriers and drivers to the effective delivery of the interventions and economic analysis. Follow up is for 96 weeks after randomisation.
  
  
  CONCLUSIONS
  The trial has features of both an efficacy and an effectiveness trial design. For generalisability in England it is set in routine public mental health practice with a high degree of expert patient involvement.
authors.affiliation: Psychiatry and Community Mental Health, Institute of Mental Health, University of Nottingham & Nottinghamshire Healthcare NHS Trust. richard.morriss@nottingham.ac.uk
authors.forename: Richard K
authors.initials: RK
authors.lastname: Morriss
authors.forename: Fiona
authors.initials: F
authors.lastname: Lobban
authors.forename: Steven
authors.initials: S
authors.lastname: Jones
authors.forename: Lisa
authors.initials: L
authors.lastname: Riste
authors.forename: Sarah
authors.initials: S
authors.lastname: Peters
authors.forename: Christopher
authors.initials: C
authors.lastname: Roberts
authors.forename: Linda
authors.initials: L
authors.lastname: Davies
authors.forename: Debbie
authors.initials: D
authors.lastname: Mayes
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D002985:Clinical Protocols; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data*; D011615:Psychotherapy, Group / Q000379:methods / Q000706:statistics & numerical data*; D012657:Self-Help Groups / Q000706:statistics & numerical data*