Original Title: Estudio de casos y controles: la eficacia de la intervención psicoeducativa en la sobrecarga experimentada por familiares de pacientes bipolares

Authors' objectives: 1. Assess the overload level in family members of patients diagnosed with bipolar disorder. 2. Assess the efficiency of psychoeducation to reduce family overload: by comparing the overload before and after receiving psychoeducation treatment in the experimental group and by comparing the overload of the experimental group after receiving the psychoeducation treatment with the overload of the control group that did not receive any treatment. 3. Detect variables that have an influence on the level of overload (by increasing or reducing this). 4. Relate the level of overload of the main carer to the patient’s progress. 5. Prepare psychoeducational guidelines for the family members of patients with bipolar disorder.

Authors' results and conclusions: Sixty families were included; 49.2% were men and 50.8% women. No significant differences were found between either groups, nor in the overload level experienced. Subjective burden: t: -0.739; p: 0.464, Objective burden: t: 0.077; p: 0.939, Attribution: t: 0.724; p: 0.474, Zarit: t: -0.994; p: 0,327. No differences were found either with regard to the pre-test status of family members of persons with bipolar disorder in the year prior to the treatment, or in the number of relapses in patients due to this illness (F: 0.66; p: 0.42), or in the number of hospital admissions (F: 0.45; p: 0.50), or in the consumption of drugs (χ2 : 0.86; p: 0.35). Therefore, we can say that they are equivalent groups. We found that the subjective burden (GE: t: 2.69; p: 0.01) (GC: t: 0.16; p: 0.87) and the objective burden (GE: t: 2.08; p: 0.049) (GC: t: -1.07; p: 0.29) and the Zarit overload scale (GE: t: 2.43; p: 0.02) (GC: t: 0.67; p: 0.50) was reduced in the experimental group but not so in the control group. On analysing the intragroup change, we found that there are differences in the objective burden (GE: t: 2.13; p: 0.04), subjective burden (GE: t: 2.38; p: 0.027) and Zarit (GE: t: 2.10; p: 0.049). On making the baseline assessment of the status of patients, we did not find significant differences between the control and experimental groups, nor in the number of hospitalisations (p: 0.039), work (p: 0.68), social activity (p: 0.43), symptoms of patients during the last month (p: 0.38) and overall functioning (p: 0.64). In the control group we did not find significant differences in the areas between the baseline assessment and after five months. However, in the experimental group, we found a reduction in hospitalisations (p: 0.016), work (p: 0.003), social activity (p: 0.075), symptoms 1 month before (p: 0.037) and overall functioning (p: 0.061). CONCLUSIONS AND RECOMMENDATIONS The most relevant finding was the major decrease in family burden levels experienced by carers following application of the psychoeducation treatment. The quality of life of both family members and persons affected by bipolar disorder improves and the overload experienced by family members of the treatment group was reduced and their work, symptomatological, social and overall functional status improved. Therefore, the reduction in the symptomatology both of family members and patients and the improvement in patient functionality support and recommend the application of family group psychoeducational treatments.

Authors' methods: Sixty family members of patients were included in the study. Thirty were chosen randomly for the control group and another 30 for the experimental group. In both groups, a baseline assessment was made of the overload experienced by the family members of patients with bipolar disorder and a further assessment was made 5 months after being included in the study. The experimental group was subjected to a 12-session group psychoeducation programme. The psychoeducational guidelines have been drawn up based on a review of the PUBMED, MEDLINE, OVID databases up to the present day.

Project Status: Completed

Year Published: 2011

URL for published report: https://www.euskadi.eus/contenidos/informacion/2011_osteba_publicacion/es_def/adjuntos/D-11-02%20Estudios%20de%20Casos%20y%20Controles.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government