This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .
A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder.
BACKGROUND Bipolar patients are at risk for relapses of their illness even when undergoing optimal pharmacotherapy . This study was performed to determine whether combining family-focused therapy ( FFT ) with pharmacotherapy during a postepisode interval enhances patients ' mood stability during maintenance treatment . METHODS In a r and omized controlled trial , 101 bipolar patients were assigned to FFT and pharmacotherapy or a less intensive crisis management ( CM ) intervention and pharmacotherapy . Outcome assessment s were conducted every 3 to 6 months for 2 years . Participants ( mean + /- SD age , 35.6 + /- 10.2 years ) were referred from inpatient or outpatient clinics after onset of a manic , mixed , or depressed episode .  FFT consisted of 21 sessions of psychoeducation , communication training , and problem-solving skills training . Crisis management consisted of 2 sessions of family education plus crisis intervention sessions as needed . Both protocol s lasted 9 months . Patients received pharmacotherapy for 2 study years . Main outcome measures included time to relapse , depressive and manic symptoms , and medication adherence . RESULTS Rates of study completion did not differ across the FFT ( 22/31 , 71 % ) and CM groups ( 43/70 , 61 % ) . Patients undergoing FFT had fewer relapses ( 11/31 , 35 % ) and longer survival intervals ( mean + /- SD , 73.5 + /- 28.8 weeks ) than patients undergoing CM ( 38/70 , 54 % ; mean + /- SD , 53.2 + /- 39.6 weeks ; hazard ratio , 0.38 ; 95 % confidence interval , 0.20 - 0.75 ; P = .003 ; intent to treat ) . Patients undergoing FFT showed greater reductions in mood disorder symptoms and better medication adherence during the 2 years than patients undergoing CM . CONCLUSION Combining family psychoeducation with pharmacotherapy enhances the postepisode symptomatic adjustment and drug adherence of bipolar patients
This review shows a beneficial effect of EWS in time to recurrence , percentage of people hospitalised and functioning in people with bipolar disorder .
BACKGROUND Recurrence rates for bipolar disorder are high despite effective treatments with mood stabiliser drugs .
Self-help treatments and psychological treatments that teach patients to recognise and manage early warning symptoms and signs ( EWS ) of impending manic or depressive episodes are popular with patients .
The main aim of such interventions is to intervene early and prevent bipolar episodes , thereby increasing the time to the next recurrence and preventing hospitalisation .
OBJECTIVES To compare the effectiveness of an EWS intervention plus treatment as usual ( TAU ) versus TAU ( involving and not involving a psychological therapy ) on time to manic , depressive and all bipolar episodes ( the primary outcome ) , hospitalisation , functioning , depressive and manic symptoms .