A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of XXXX .

@entity1 @entity162 @entity308 @entity3935 @entity1316
BACKGROUND: Bipolar @entity1 are at risk for relapses of their illness even when undergoing optimal pharmacotherapy. This study was performed to determine whether combining family-focused therapy (FFT) with pharmacotherapy during a postepisode interval enhances @entity1 ' mood stability during maintenance treatment. METHODS: In a randomized controlled trial, 101 @entity162 @entity1 were assigned to FFT and pharmacotherapy or a less intensive @entity3935 ( @entity3935 ) intervention and pharmacotherapy. Outcome assessments were conducted every 3 to 6 months for 2 years. @entity1 (mean +/- SD age, 35.6 +/- 10.2 years) were referred from inpatient or outpatient clinics after onset of a @entity162 , mixed, or @entity308 episode. FFT consisted of 21 sessions of psychoeducation, communication training, and problem-solving skills training. Crisis management consisted of 2 sessions of family education plus crisis intervention sessions as needed. Both protocols lasted 9 months. @entity1 received pharmacotherapy for 2 study years. Main outcome measures included time to relapse, @entity308 and @entity162 , and medication adherence. RESULTS: Rates of study completion did not differ across the FFT (22/31, 71%) and @entity3935 groups (43/70, 61%). @entity1 undergoing FFT had fewer relapses (11/31, 35%) and longer survival intervals (mean +/- SD, 73.5 +/- 28.8 weeks) than @entity1 undergoing @entity3935 (38/70, 54%; mean +/- SD, 53.2 +/- 39.6 weeks; hazard ratio, 0.38; 95% confidence interval, 0.20-0.75; P =.003; intent to treat). @entity1 undergoing FFT showed greater reductions in @entity1316 symptoms and better medication adherence during the 2 years than @entity1 undergoing @entity3935 . CONCLUSION: Combining family psychoeducation with pharmacotherapy enhances the postepisode symptomatic adjustment and drug adherence of @entity162 @entity1 .
