title: Feasibility of a psychoeducational family intervention for people with bipolar I disorder and their relatives: Results from an Italian real-world multicentre study.
abstract: BACKGROUND
  Despite several guidelines recommend the use of psychoeducational family interventions (PFIs) as add-on in the treatment of patients with bipolar I disorder, their implementation on a large scale remains limited. The aim of the present study is to identify obstacles for the feasibility of PFIs in routine care.
  
  
  METHODS
  This was a multicentre, real-world, controlled, outpatient trial, carried out in 11 randomly recruited Italian mental health centres. Two mental health professionals from each center attended a modular training course on PFI and provided the intervention. Difficulties and benefits experienced by mental health professionals in implementing the intervention were assessed through the Family Intervention Schedule (FIS-R), which was administered six times.
  
  
  RESULTS
  Sixteen out of the 22 recruited professionals completed the training and administered the PFI to 70 patients with bipolar I disorder and their relatives. The retention rate of families receiving the intervention was 93%. Mental health professionals reported high levels of organizational difficulties, several benefits in their daily clinical work and low levels of intervention-related difficulties. The most important organizational obstacles were related to the need to integrate the intervention with other work responsibilities and to the lack of time to carry out the intervention. These difficulties did not decrease over time. Intervention-related difficulties were rated as less problematic since the first time assessment and tended to improve over time.
  
  
  CONCLUSIONS
  Low number of recruited professionals; use of a not previously validated assessment instrument.
  
  
  CONCLUSIONS
  PFIs are feasible in routine care for the treatment of patients with bipolar I disorder and their relatives, and main obstacles are related to the organization/structure of mental health centres, and not to the characteristics of the intervention itself.
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy. Electronic address: anfioril@tin.it.
authors.forename: A
authors.initials: A
authors.lastname: Fiorillo
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Del Vecchio
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Luciano
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sampogna
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Sbordone
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catapano
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Rosa
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy; Mental Health Centre of Ravello, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Malangone
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tortorella
authors.affiliation: Mental Health Department of Campobasso, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Veltro
authors.affiliation: Mental Health Centre of Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nicolò
authors.affiliation: Mental Health Centre of Foligno, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Piselli
authors.affiliation: Mental Health Centre of Grosseto, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bardicchia
authors.affiliation: Mental Health Centre of Lanciano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ciampini
authors.affiliation: Mental Health Centre of Lanusei, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Lampis
authors.affiliation: Niguarda Hospital, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Moroni
authors.affiliation: Niguarda Hospital, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bassi
authors.affiliation: Mental Health Centre of Montecatini, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Iapichino
authors.affiliation: Mental Health Centre of Montecatini, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Biondi
authors.affiliation: Mental Health Centre of Ravello, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Graziani
authors.affiliation: Mental Health Centre of Sassuolo, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Orlandi
authors.affiliation: Mental Health Centre of Sassuolo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Starace
authors.affiliation: Mental Health centre of Monza, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Baronessa
authors.affiliation: Mental Health centre of Monza, Italy; University College of London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Carrà
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Maj
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D017028:Caregivers / Q000193:education* / Q000523:psychology; D005196:Family Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D007558:Italy; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011368:Professional-Family Relations; D011369:Professional-Patient Relations
keywords: Bipolar I disorder; Feasibility; Implementation; Psychoeducational family intervention; Routine care