A prospective longitudinal study searching for predictors of response to group psychoeducation in bipolar disorder

• Published in: Journal of affective disorders 2020-09, Vol.274, p.1113-1121
• Main Authors: Reinares, María, Pacchiarotti, Isabella, Solé, Brisa, García-Estela, Aitana, Rosa, Adriane R., Bonnín, Caterina M., De Dios, Consuelo, Torres, Immaculada, Varo, Cristina, Montejo, Laura, Valls, Èlia, Mur-Mila, Estanislao, Hidalgo-Mazzei, Diego, Jiménez, Esther, Torrent, Carla, Goikolea, José Manuel, Martínez-Arán, Anabel, Pérez-Sola, Víctor, Vieta, Eduard, Colom, Francesc
• Format: Article
• Language: English
• Subjects: Bipolar disorder; Bipolar Disorder - therapy; Group; Humans; Longitudinal Studies; Male; Predictors; Prospective Studies; Psychoeducation; Recurrence; Recurrences; Treatment Outcome; Treatment response
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2020.02.047

•Fifty-two percent of subjects with bipolar disorder responded to psychoeducation (absence of recurrences at 18 months).•Recurrences were higher during the follow-up than during the group, the most common being depression.•Responders and non-responders differed in gender, age at diagnosis and delay, temperament, attention and BDNF.•Gender, age at diagnosis and cyclothimic temperament contributed to the treatment response.•The identification of predictors to treatment response could help guide therapeutic decisions. The efficacy of adjunctive group psychoeducation in bipolar disorder has been proven although treatment response differ among individuals. The aim of this study was to characterize responders and non-responders to group psychoeducation in order to identify baseline variables that could predict treatment response. The sample was composed of 103 medicated euthymic patients with bipolar disorder referred to 21 sessions of group psychoeducation (6 months). Sociodemographic and clinical variables, temperament, circadian rhythms, BDNF, cognitive and psychosocial functioning were collected. At the 18-month endpoint, the patients were split in two groups on the basis of having suffered any recurrence. Significant group differences were included in a logistic regression analysis. Ninety patients out of 103 engaged in group psychoeducation, 47 of whom (52.2%) responded to psychoeducation and 43 (47.8%) did not. Recurrences occurred more often in the follow-up, the most common being depression. Responders and non-responders differed in gender, age at diagnosis, latency of diagnosis, temperament, attention composite score and BDNF. Lower age at diagnosis of bipolar disorder, lower cyclothimic temperament scores and being male -which was associated with bipolar type I and a trend to more previous manic episodes- were significantly related to a better response to psychoeducation in the regression analysis. No control group. This study identifies age at diagnosis as a significant modifiable risk factor of treatment response, highlighting the need for early identification of bipolar disorder. Existing programs should be adjusted to the characteristics of specific subpopulations in the framework of a personalized approach.