A Fiorillo1, V Del Vecchio2, M Luciano2, G Sampogna2, D Sbordone2, F Catapano2, C De Rosa2, C Malangone3, A Tortorella2, F Veltro4, G Nicolò5, M Piselli6, F Bardicchia7, G Ciampini8, D Lampis9, A Moroni10, M Bassi10, S Iapichino11, S Biondi11, A Graziani12, E Orlandi13, F Starace13, C Baronessa14, G Carrà15, M Maj2. 1. Department of Psychiatry, University of Naples SUN, Naples, Italy. Electronic address: anfioril@tin.it. 2. Department of Psychiatry, University of Naples SUN, Naples, Italy. 3. Department of Psychiatry, University of Naples SUN, Naples, Italy; Mental Health Centre of Ravello, Italy. 4. Mental Health Department of Campobasso, Italy. 5. Mental Health Centre of Rome, Italy. 6. Mental Health Centre of Foligno, Italy. 7. Mental Health Centre of Grosseto, Italy. 8. Mental Health Centre of Lanciano, Italy. 9. Mental Health Centre of Lanusei, Italy. 10. Niguarda Hospital, Milan, Italy. 11. Mental Health Centre of Montecatini, Italy. 12. Mental Health Centre of Ravello, Italy. 13. Mental Health Centre of Sassuolo, Italy. 14. Mental Health centre of Monza, Italy. 15. Mental Health centre of Monza, Italy; University College of London, UK.
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. LIMITATIONS: 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.
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. LIMITATIONS: 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: Muhammad Ishrat Husain; Imran B Chaudhry; Raza R Rahman; Munir M Hamirani; Nasir Mehmood; Peter M Haddad; John Hodsoll; Allan H Young; Farooq Naeem; Nusrat Husain Journal: Int J Bipolar Disord Date: 2017-02-11
Authors: Mario Luciano; Gaia Sampogna; Mario Amore; Ileana Andriola; Pietro Calcagno; Claudia Carmassi; Valeria Del Vecchio; Liliana Dell'Osso; Giorgio Di Lorenzo; Barbara Gelao; Vincenzo Giallonardo; Alessandro Rossi; Rodolfo Rossi; Alberto Siracusano; Andrea Fiorillo Journal: Eur Psychiatry Date: 2021-11-23 Impact factor: 5.361
Authors: Gaia Sampogna; Andrea Fiorillo; Mario Luciano; Valeria Del Vecchio; Luca Steardo; Benedetta Pocai; Marina Barone; Mario Amore; Francesca Pacitti; Liliana Dell'Osso; Giorgio Di Lorenzo; Mario Maj Journal: Front Psychiatry Date: 2018-06-07 Impact factor: 4.157