Impacto da psicoeducação na recuperação sintomática e funcional dos pacientes bipolares / Impact of psychoeducation in symptomatic and functional recovery in bipolar patients

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Introduction: The goals of treatment of bipolar affective disorder (BD) expanded beyond symptomatic recovery, also including functional recovery, the focus of psychosocial approaches as psychoeducation. Objective: To investigate the impact of psychoeducation (PE) in the symptomatic and functional recovery in bipolar patients. Methods: This is a randomized controlled trial with 51 patients with BD type I or II, according to the DSM-IV TR; in remission (score 7 on the HDRS - 17 items and 6 on the YMRS); in outpatient in the GRUDA IPq HC FMUSP, or in psychiatric care in private or CAPS Del Rei - MG. The distribution of subjects in the groups was made by stratified randomization, the subjects first were divided into blocks stratified by gender, age, number of previous episodes of illness, education and marital status. Subsequently, within each block, subjects were randomly divided into two groups, through the launch of the coin again and again, in which experimental group (EG) was expensive and control group (CG) crown. Thus were formed two homogeneous groups, avoiding trends and favors. The EG consisted of 29 patients who received, in addition to pharmacological treatment, the psychoeducational intervention. The CG consisted of 22 patients who received, in addition to pharmacological treatment, meetings "placebo". Both groups had 16 meetings, twice a week with 90 minutes. The assessment instruments were applied at the beginning (TA), in the middle (TB) and at the end of treatment (TC), and following six (TD) and 12 months (TE). The scales used to assess symptomatic recovery were: HDRS for depression, and YMRS for mania. Scales to assess functional recovery were WHOQOL-Bref and the Social Adjustment Scale- EAS. Clinical improvement was assessed by the CGI. Results: HDRS increased significantly over time (p = 0.002), no difference between groups (p = 0.890) and the interaction was not significant (p = 0.373), the increase was equivalent between groups; YMRS not change significantly over time (p = 0.359) and there was no significant difference between groups (p = 0.294), the averages started lower and remained low; WHOQOL-Bref in 4, there was a trend decrease in mean over time in both groups (p = 0.059), although there was no significant difference between groups (p = 0.175), there seems to be a trend (p = 0.084) lower in the EG than the CG , and EAS has increased significantly over time (p = 0.044), no difference between groups (p = 0.167), and the interaction was not significant (p = 0.410), the increase was equivalent in both groups. CGI after the end of treatment: 92.5% for PE and 78.2% of the control group showed clinical improvement overall, after one year were 87.5% for PE and 75.1% of GC. Conclusion: The results showed that the PE has tended to impact positively on the welfare of individuals in their environment, promoted a greater overall clinical improvement at all times evaluated than control and this improvement was maintained at one year. EG and CG maintained recovery symptomatic manic. Nevertheless, the PE did not protect depressive relapses and worsening of social adequacy. Therefore, the PE was effective in well-being of the patient in his environment, the global clinical improvement and protection of manic relapses.

ASSUNTO(S)

qualidade de vida psychoeducation psychosocial approach transtorno bipolar psicoterapia symptomatic recovery bipolar functional recovery educação de pacientes como assunto

ACESSO AO ARTIGO

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