Efficacy of psychoeducational approaches on bipolar disorders: a review of the literature.

BACKGROUND

To evaluate the efficacy of psychoeducation in the treatment of bipolar disorder according to specific therapeutic targets such as treatment compliance, patients' and families' knowledge of the illness and its treatments, relapse prevention, symptomatic (depressive or (hypo)manic) phases of the illness or social and occupational functioning.

METHODS

A systematic review of the literature published on psychoeducation up to July 2006 was carried out using the main electronic data bases (Medline, PubMed). The key words employed included bipolar disorder, psychoeducation, depression, mania, relapse prevention and treatment compliance.

RESULTS

Although the methodological shortcomings of the early studies must be taken into account, most data accumulated to date suggest that psychoeducation, used alone or as a component of more complex interventions, makes it possible to improve the course of the illness, notably by increasing the patients' and their families' knowledge of the disorder and of treatment options, by decreasing the risk of (hypo)manic or depressive relapse and of hospitalization and by improving treatment compliance.

LIMITATIONS

More studies based solely on psychoeducation, rather than psychoeducation as part of a multicomponent approach, are needed to confirm the efficacy of PE reported to date.

CONCLUSIONS

Given the results published to date, psychoeducation should be part of the integrated treatment of bipolar disorder. As a complement to pharmacotherapy, psychoeducation delivered individually or in a group setting constitutes a first-line psychological intervention. Applicable to a majority of patients and their families, it can be delivered by a wide range of health professionals trained in this approach.