María Reinares1, Isabella Pacchiarotti1, Brisa Solé1, Aitana García-Estela2, Adriane R Rosa3, Caterina M Bonnín1, Consuelo De Dios4, Immaculada Torres1, Cristina Varo1, Laura Montejo1, Èlia Valls1, Estanislao Mur-Mila2, Diego Hidalgo-Mazzei1, Esther Jiménez1, Carla Torrent1, José Manuel Goikolea1, Anabel Martínez-Arán1, Víctor Pérez-Sola2, Eduard Vieta5, Francesc Colom6. 1. Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, C/Villarroel, 170, 12-0 08036, Catalonia, Spain. 2. Mental Health Research Group, IMIM-Parc de Salut Mar, CIBERSAM, Auotonomous University of Barcelona (Department of Clinical and Health Psychology), Office 202, PRBB Building, Charles Darwin Sq. (SN) 08003, Barcelona, Catalonia, Spain. 3. Department of Pharmacology, Universidade Federal do Rio Grande do Sul, Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. 4. Servicio de Psiquiatría, Hospital Universitario La Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IDiPaz), CIBERSAM, Madrid, Spain. 5. Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, C/Villarroel, 170, 12-0 08036, Catalonia, Spain. Electronic address: evieta@clinic.cat. 6. Mental Health Research Group, IMIM-Parc de Salut Mar, CIBERSAM, Auotonomous University of Barcelona (Department of Clinical and Health Psychology), Office 202, PRBB Building, Charles Darwin Sq. (SN) 08003, Barcelona, Catalonia, Spain. Electronic address: fcolom@imim.es.
Abstract
BACKGROUND: The efficacy of adjunctive group psychoeducation in bipolar disorder has been proven although treatment response differ among individuals. The aim of this study was to characterize responders and non-responders to group psychoeducation in order to identify baseline variables that could predict treatment response. METHODS: The sample was composed of 103 medicated euthymic patients with bipolar disorder referred to 21 sessions of group psychoeducation (6 months). Sociodemographic and clinical variables, temperament, circadian rhythms, BDNF, cognitive and psychosocial functioning were collected. At the 18-month endpoint, the patients were split in two groups on the basis of having suffered any recurrence. Significant group differences were included in a logistic regression analysis. RESULTS: Ninety patients out of 103 engaged in group psychoeducation, 47 of whom (52.2%) responded to psychoeducation and 43 (47.8%) did not. Recurrences occurred more often in the follow-up, the most common being depression. Responders and non-responders differed in gender, age at diagnosis, latency of diagnosis, temperament, attention composite score and BDNF. Lower age at diagnosis of bipolar disorder, lower cyclothimic temperament scores and being male -which was associated with bipolar type I and a trend to more previous manic episodes- were significantly related to a better response to psychoeducation in the regression analysis. LIMITATIONS: No control group. CONCLUSIONS: This study identifies age at diagnosis as a significant modifiable risk factor of treatment response, highlighting the need for early identification of bipolar disorder. Existing programs should be adjusted to the characteristics of specific subpopulations in the framework of a personalized approach.
BACKGROUND: The efficacy of adjunctive group psychoeducation in bipolar disorder has been proven although treatment response differ among individuals. The aim of this study was to characterize responders and non-responders to group psychoeducation in order to identify baseline variables that could predict treatment response. METHODS: The sample was composed of 103 medicated euthymic patients with bipolar disorder referred to 21 sessions of group psychoeducation (6 months). Sociodemographic and clinical variables, temperament, circadian rhythms, BDNF, cognitive and psychosocial functioning were collected. At the 18-month endpoint, the patients were split in two groups on the basis of having suffered any recurrence. Significant group differences were included in a logistic regression analysis. RESULTS: Ninety patients out of 103 engaged in group psychoeducation, 47 of whom (52.2%) responded to psychoeducation and 43 (47.8%) did not. Recurrences occurred more often in the follow-up, the most common being depression. Responders and non-responders differed in gender, age at diagnosis, latency of diagnosis, temperament, attention composite score and BDNF. Lower age at diagnosis of bipolar disorder, lower cyclothimic temperament scores and being male -which was associated with bipolar type I and a trend to more previous manic episodes- were significantly related to a better response to psychoeducation in the regression analysis. LIMITATIONS: No control group. CONCLUSIONS: This study identifies age at diagnosis as a significant modifiable risk factor of treatment response, highlighting the need for early identification of bipolar disorder. Existing programs should be adjusted to the characteristics of specific subpopulations in the framework of a personalized approach.
Authors: Anna Wrobel; Samantha E Russell; Olivia M Dean; Sue Cotton; Michael Berk; Alyna Turner Journal: BMJ Open Date: 2021-04-29 Impact factor: 2.692