Jidong Dung Ezekiel, Husain M Ishrat, Ike Tarela Juliet, Khoso Ameer, Taru Maigari Yusufu, Nwoga Charles Nnaemeka, Francis Christopher, Mwankon Shadrack B, Jidong John Ezekiel, Pwajok Juliet Y, Shakoor Suleman, Asif Atta Muhammad, Xue Siqi, Husain Nusrat
Division of Psychology and Mental Health, University of Manchester, UK.
Global Centre for Research on Mental Health Inequalities, Mersey Care NHS Foundation Trust, Liverpool, UK.
BJPsych Open. 2025 Jun 27;11(4):e133. doi: 10.1192/bjo.2025.66.
Bipolar disorders are a major cause of disability worldwide, with most of the disease burden attributed to those in low- and middle-income countries, including Nigeria. There is limited evidence on culturally appropriate interventions for bipolar disorders in Nigeria.
The study aims to examine the feasibility, and acceptability of culturally adapted psychoeducation (CaPE) for treating bipolar disorders.
A randomised controlled trial (RCT) compared CaPE plus treatment as usual (TAU) with TAU alone among 34 persons with bipolar disorders in Jos, Nigeria. CaPE comprised 12 group sessions of in-person psychoeducation lasting approximately 90 min each, delivered on a weekly basis by clinical researchers supervised by clinical psychologists and consultant psychiatrists. The primary outcome was feasibility, measured by participants' recruitment and retention rates. Other outcomes included acceptability as measured by the Service Satisfaction Scale (SSS), Brief Bipolar Disorder Symptom Scale (BBDSS), Patient Health Questionnaire (PHQ-9) and Quality-of-Life scale (EQ5D). Outcomes were assessed at baseline and weeks 12 and 24. Focus group ( = 10) and individual interviews ( = 5) were conducted with the CaPE + TAU group, recorded, transcribed verbatim and analysed using interpretative phenomenological analysis.
The CaPE+TAU group ( = 17) recorded a high participant recruitment and retention rate of 86% across 12 sessions, and also recorded a higher level of satisfaction with SSS compared with the TAU alone group; 87.5% indicated very satisfied compared with 66.7% indicated not sure in the TAU group. In terms of clinical outcomes, for PHQ-9 scores the intervention group showed a reduction from baseline to end of intervention (EOI) and follow-up, with differences of -12.01 and -7.39, respectively (both < 0.001). The EQ5D index showed a notable improvement in the intervention group at both EOI and follow-up ( < 0.001). Lastly, BBDS scores decreased significantly in the CaPE+TAU group at both EOI and follow-up, with differences of -21.45 and -15.76 (both < 0.001).
The RCT of CaPE is a feasible, acceptable and culturally appropriate treatment option for bipolar disorders in Nigeria. Further adequately powered RCTs evaluating the intervention's clinical and cost-effectiveness are warranted.
双相情感障碍是全球致残的主要原因，疾病负担大多归因于低收入和中等收入国家的人群，包括尼日利亚。关于尼日利亚针对双相情感障碍的文化适宜性干预措施的证据有限。
本研究旨在探讨文化适应心理教育（CaPE）治疗双相情感障碍的可行性和可接受性。
在尼日利亚乔斯，一项随机对照试验（RCT）将CaPE联合常规治疗（TAU）与单纯TAU进行了比较，研究对象为34例双相情感障碍患者。CaPE包括12次面对面的小组心理教育课程，每次课程约90分钟，由临床心理学家和顾问精神科医生监督的临床研究人员每周进行一次。主要结局是可行性，通过参与者的招募率和留存率来衡量。其他结局包括通过服务满意度量表（SSS）、双相情感障碍简易症状量表（BBDSS）（中文版为《简明双相障碍症状量表》）、患者健康问卷（PHQ-9）和生活质量量表（EQ5D）来衡量的可接受性。在基线、第12周和第24周对结局进行评估。对CaPE+TAU组进行了焦点小组访谈（n = 10）和个人访谈（n = 5），进行录音并逐字转录，采用解释现象学分析进行分析。
CaPE+TAU组（n = 17）在12次课程中的参与者招募和留存率较高，为86%，并且与单纯TAU组相比，在SSS上的满意度更高；87.5%表示非常满意，而TAU组中66.7%表示不确定。在临床结局方面，对于PHQ-9评分，干预组从基线到干预结束（EOI）和随访时均有所降低，差异分别为-12.01和-7.39（均P < 0.001）。EQ5D指数在干预组的EOI和随访时均有显著改善（P < 0.
