Projects / Programmes
Evaluation of a psychoeducation and pharmacotherapeutic effects in patients with bipolar mood disorder
| Code |
Science |
Field |
Subfield |
| 3.09.00 |
Medical sciences |
Psychiatry |
|
| Code |
Science |
Field |
| B650 |
Biomedical sciences |
Psychiatry, clinical psychology, psychosomatics |
bipolar mood disorder, psychoeducation, cognitive dysfunction, atypical antipsychotic, evaluation
Researchers (3)
Organisations (2)
Abstract
Psychosocial interventions, including psychoeducation, are helpful adjunctions to traditional pharmacological treatment of bipolar mood disorder (BMD). They appear to reduce acute symptoms, prevent new episodes, increase compliance with medications, and decrease rates of hospitalisations. Psychoeducation refers to a special educational programme for teaching patients and their relatives on the disorder, effective coping strategies for dealing with everyday distress, and recognition and management of early signs of incipient relapse or recurrence. Amongst frequently used drugs for BMD is also atypical antipsychotic quetiapine. Although the effects of quetiapine on cognitive functions at schizophrenia are well known, the knowledge about the effects of quetiapine on cognitive functioning in patients with BMD is still scarce. The aim of the study is quantitative and qualitative evaluation of a psychoeducation and pharmacotherapeutic effects in patients with BMD. A neuropsychological approach and focal groups method will be used in regard to define the effects of prescribed pharmacotherapy on BMD patient’s cognitive functioning and the influence of psychoeducational programme on their social and cognitive rehabilitation. Particular attention will be assigned to atypical antipsychotic drug quetiapine. We will introduce a new clinical instrument (BIS/BAS scale) for assessment of sensibilization for approach and avoidance motivated behaviour. BIS/BAS scale will be validated with neuropsychological approach for attention, behavioural inhibition and social cognition screening in order to gain the neuropsychological report with prognostic value and an estimation of psychoeducational and pharmacotherapeutic effects, as well.
Significance for science
Until recently a research work on BMD was in domain of medicine, pharmacology and psychology, that on peculiar and at the same time "disciplinarily restricted" manner discovered specialities and consequences of this disorder. Every discipline endeavours to show eventually common and special characteristics of BMD to support the hypothesis, that BMD importantly marks a part of population on different manners. This research project methodologically surpasses a disciplinary straitness of BMR studies, by introducing a multidisciplinary research approach in framework of psychiatry, neuropsychology and of social anthropology.
Studies in the field of BMD psychoeducation evaluations in general checked up a number of episodes, improved compliance, better understanding of the disorder and a more appropriate sleep-wake rhythm. Almost undiscovered is the field of psychoeducation effects on neurocognitive deficits in patients with BMD which are importantly involved in patient’s quality of life, social functioning and working ability. Current research did enlighten some of psychoeducational aspects which are linked with BMD patient’s cognitive and social rehabilitation, because of applied neurocognitive approach.
A qualitative and quantitative evaluation approach for psychoeducation and pharmacotherapy effects screening have used in research project, which is novelty in the field of BMD research work. Therefore our study will contribute to better understanding of mechanisms involved in progressiveness and in treatment of bipolar mood disorder. Data concerning a mutual influences and interactions between cognitive dysfunctions and specific sensitivity regarding to emotional context in BMD are also one of the main and important outcomes of our research.
In this study we are focused on atypical antipsychotic drug quetiapine which is frequently used drug for BMD treatment. Although the effects of quetiapine on cognitive functions in schizophrenia are well known, the knowledge concerning the impact of quetiapine on the cognitive functions in BMD is still scarce. The results are in this regard an important contribution to understanding of favourable effects on emotional and cognitive dysfunctions in patients with BMD. At the same time this results will upgrade the knowledge concerning the advantages and deficiencies of quetiapine, as users experienced them.
In order to evaluate the effects of psychoeducation and pharmacotherapy, some new neuropsychological instruments were introduced and validated in the group of healthy volunteers and BMR patients. This is a novelty in the field of the BMD treatment since we gain a research tool and diagnostic instrument as well. That enables screening of the cognitive emotional factors and tracing for more or less favourable effects of psychoeducation and pharmacotherapy at the same time. This can subserve as foundation for additional interventions in planning of BMD treatment.
The results of study will importantly contribute to upgrade of the theoretical and methodological background at BMD. We additionally clarified some cognitive and behavioural mechanisms engaged in the clinical picture of BMD patients and cognitive emotional responses to different approaches of BMD treatment.
Significance for the country
The relationship of governmental institutions to mental disorders should not be negligible, since from the national perspective healthy population is a basic strategic capital for development. Mental disorders present a huge socioeconomic burden for individual, their relatives and the whole community. In case of severe and debilitating disorders this burden can be enormous and of long duration. Its consequences are particularly relevant in light of increasing incapacitation of active population, increasing health-related costs, sick leave, decreasing the population of military recruits, and reducing the number of inhabitants (parents). Therefore evaluation of various treatment approaches in management of BMD is important, especially in regard to cognitive and social rehabilitation.
Until very recently there have been no special activities organized for patients with BMD and their relatives. The programme of psychoeducation, organized in 2005 by University Psychiatric Hospital Ljubljana was well accepted. It encompasses a simple, available, cost-effective, and very useful method of education which provides good results. It is of particular importance that users like the programme and regard it as helpful. Better management of BMD-related problems has both short-term and long-term effects. Among the former are better awareness of the importance of taking medications, better coping with everyday distress, using mood-stabilising strategies, higher self esteem, better coping with the disorder and lower use of psychoactive substances (both legal and illicit ones). Long-term effects include lower need for hospital treatment (both voluntary and involuntary), which is by far the most costly of all treatments. In addition there are fewer or lees severe episodes, improved working and academic ability, better management of social, financial or legal affairs and related issues.
Better understanding of effects of psychoeducation with special emphasis on cognitive rehabilitation of patients with BMD will significantly elucidate available data on its short and long-term effects. It is noticeable that in routine use psychoeducation is not available for all patients. Psychoeducational activities are directed both towards prevention and treatment. It empowers the patient to better coping with the disorder. The results of the study will provide a firm scientific basis for further development and increasing the availability of psychoeducation by underlining the fact that the effect of group psychoeducation of patients and their relatives is measurable.
With the emphasis that BMD is the most frequently misdiagnosed mental disorder which may take over 10 years to obtain the correct diagnosis it is of particular importance that clinicians have appropriate diagnostic instruments. In this research we are introducing and validating a several new clinical assessment instruments: Internal State Scale (ISS), Behavioural Activation / Inhibition System Scale (BIS/BAS Scale), computerized neuropsychological testing of selective attention (emotional and word/colour Stroop Task), behavioural inhibition (emotional Go/NoGo Task) and social cognition (Recognition of facial emotion test - Ekman) and Facial recognition test - Benton). Those instruments will enable a relatively quick assessment of individual’s cognitive functions in various emotional contexts, the prognosis of disorder and follow-up of therapeutic effects.
Most important scientific results
Annual report
2008,
final report,
complete report on dLib.si
Most important socioeconomically and culturally relevant results
Annual report
2008,
final report,
complete report on dLib.si
