CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

Group psychoeducation for relations of people with SMI and a diagnosis of bipolar disorder
RCT (1+)
RCT (1-)
Patients whose family members followed a group psychoeducational programme
presented a significantly longer period of time until any recurrence,
than those of the control group (p=0.044). When the analysis described the
type of relapse, only the time until hypomaniac or maniac relapse was significant
(P=0.015) but not for depressive relapses 104 .
Furthermore, 42% of the patients whose family members followed
a group psychoeducational programme presented relapses compared with
66% in the control group after 12 months’ follow-up (p=0.011). In a detailed
analysis, this difference was exclusively due to the lower percentage
of hypomaniac and maniac relapses in the experimental group (37.5%
p=0.017) 104 .
Family intervention vs. multi-family intervention
In a study performed when the patient was in an acute phase, individual
family intervention has not been found to be more effective than multifamily
intervention with respect to the improvement in symptoms at the
end of the treatment (28 months) (n = 92; RR = 0.67; 95% CI: between
0.34 and 1.32) 95 .
Family intervention vs. non-intervention
RCT (1-)
RCT (1-)
RCT (1-)
RCT (1-)
No differences are found in the clinical improvement between the two
groups (at the end of treatment) (n = 26; RR = 0.49; 95% CI: between 0.10
and 2.4), nor after 6 months’ follow-up (n = 26; RR = 0.73; 95% CI: between
0.05 and 10.49) 101 .
People from the family intervention group presented an increase in
anxiety levels, compared with the group that did not receive any intervention
(n = 39; WMD = 0.69; 95% CI between 0.05 and 1.34) 102 .
No differences are found between the family psychoeducation intervention
groups for carers caregivers and non-intervention in the relationships
in the family environment (expressiveness, cohesion and conflict).
Expressiveness (n = 45; WMD = -0.03; 95% CI: between -0.65 and 0.59);
cohesion (n = 45; WMD = 0.10; 95% CI; between -0.52 and 0.72), and
conflict (n = 45; WMD = -0.33; 95% CI: between -0.95 and 0.29) 103 .
Van Gent & Zwart 102 indicate that there are no differences between
the marital psychoeducation family intervention groups for couples vs. no
intervention (n = 45; WMD = -0.33; 95% CI: between -0.95 and 0.29).
There are no differences, either, between either of the two groups with respect
to treatment adherence at the end of the study (12 months) (n = 36;
RR = 1.06, 95% CI: between 0.73 and 1.54).
RCT (1-) With respect to the recovery of the person at the end of the study (28
months), no differences have been found between multi-family group psychoeducation
intervention and no intervention (n = 59; RR = 1.49, 95% CI:
between 0.76 and 2.95) or in people with mania (n = 45; RR = 1.57, 95%
CI: between 0.67 and 3.68) 100 .
62 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS