Inoue Atsuko, Kobayashi Sayaka, Oshibuchi Hidehiro, Tsuji Kaoru, Inada Ken, Nishimura Katsuji
Department of Psychiatry, Tokyo Women's Medical University, Tokyo, JPN.
Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Tokyo, JPN.
Cureus. 2024 Dec 26;16(12):e76441. doi: 10.7759/cureus.76441. eCollection 2024 Dec.
Introduction Psychoeducation is a form of psychosocial treatment with proven efficacy in preventing the relapse of bipolar disorder (BD). However, the effectiveness of psychoeducation has not been verified in Japan. We aimed to examine the effect of a brief group psychoeducation course (eight-session long) on relapse prevention in Japanese patients with BD and associated factors. Methods This single-arm, mirror-image study included 55 patients with BD. To verify the effectiveness of relapse prevention, the numbers of hospitalizations during the two years before and two years after participation were compared. Manic and depressive symptoms, treatment satisfaction, and self-efficacy (SE) in coping with illness were also assessed. Results The number of hospitalizations for the 47 participants who completed the program decreased significantly after psychoeducation. Overall, SE improved significantly after participation, but not among the participants who were hospitalized during the observation period. The hospitalized participants were significantly older, had more hospitalizations during the two years before participation, and had lower SE after participation than the non-hospitalized participants. They also exhibited higher depression levels after participation than before participation. Limitations The results of this single-arm, single-center study should be confirmed in future randomized controlled trials or other studies with a larger number of patients to demonstrate their generalizability. Conclusions Brief group psychoeducation courses may decrease relapse among Japanese patients with BD. A high number of hospitalizations prior to the psychoeducation program, older age, more severe depressive symptoms after participation than before participation, and low SE after participation could be associated with relapse.
引言
心理教育是一种心理社会治疗形式，在预防双相情感障碍（BD）复发方面具有已证实的疗效。然而，心理教育在日本的有效性尚未得到验证。我们旨在研究一个简短的团体心理教育课程（为期八节）对日本BD患者预防复发的效果及相关因素。
方法
这项单臂、镜像研究纳入了55例BD患者。为验证预防复发的有效性，比较了参与前两年和参与后两年的住院次数。还评估了躁狂和抑郁症状、治疗满意度以及应对疾病的自我效能感（SE）。
结果
完成该项目的47名参与者在接受心理教育后住院次数显著减少。总体而言，参与后SE显著提高，但在观察期内住院的参与者中未提高。与未住院的参与者相比，住院参与者年龄显著更大，参与前两年住院次数更多，参与后SE更低。他们参与后抑郁水平也比参与前更高。
局限性
这项单臂、单中心研究的结果应在未来的随机对照试验或其他有更多患者的研究中得到证实，以证明其可推广性。
结论
简短的团体心理教育课程可能会减少日本BD患者的复发。心理教育项目前住院次数多、年龄大、参与后抑郁症状比参与前更严重以及参与后SE低可能与复发有关。
