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Psychosocial Intervention Programs for Family Members of Individuals with Bipolar Disorder: A Systematic Review

Year 2025, Volume: 17 Issue: 3, 507 - 519
https://doi.org/10.18863/pgy.1515303

Abstract

Bipolar disorder can create a dynamic that complexly affects not only the individual's life but also the entire family. Research includes a wide range of intervention strategies, from cognitive behavioral therapy to psychoeducational programs. This review aims to analyze the results of psychosocial intervention programs developed for the family members of individuals diagnosed with bipolar disorder. Studies related to the topic conducted in Türkiye and worldwide, accessible in full text, have been reviewed using the Pubmed and Scopus databases, and the results have been compiled considering the objectives of the studies. As a result of the literature review, 14 articles were included in the review. In 4 studies, Family-Focused Therapy was applied, while psychoeducation aimed at families was observed in 10 studies. The applied psychoeducation programs consist of six training sessions aimed at families, focusing on disease information and caregiving burden. In a study, psychoeducation aimed at increasing problem-solving skills was provided to individuals with a partner who has bipolar disorder and who have experienced abuse. The results of the study examined the effects of the interventions on families' caregiving burden, their level of knowledge about the illness, self-esteem, quality of life, internalized stigma, and individuals diagnosed with bipolar disorder. The studies included in the review show positive results highlighting the beneficial effects of family-based psychosocial interventions for families of individuals with bipolar disorder

References

  • Barbeito S, Vega P, Ruiz de Azua S, Gonzalez-Ortega I, Alberich S, Gonzalez-Pinto A (2023) Two-year evaluation of a multifamily psychoeducational program (PROTEC) in the family burden and prognosis of bipolar patients. Span J Psychiatry Ment Health, 16:225-234.
  • Beentjes TA, Goossens PJ, Poslawsky IE (2012) Caregiver burden in bipolar hypomania and mania: a systematic review. Perspect Psychiatr Care, 48:187-197.
  • Bernhard B, Schaub A, Kümmler P, Dittmann S, Severus E, Seemüller F et al. (2006) Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives. Eur Psychiatry, 21:81-86.
  • Bilir MK (2018) Deinstitutionalization in mental health policy: From institutional-based to community-based mental healthcare services. Hacettepe Journal of Health Administration, 21:563-576.
  • Casarez RL, Soares JC, Meyer TD (2021) Psychoeducation for caregivers of patients with bipolar disorder-Lessons learned from a feasibility study. J Affect Disord, 287:367-371.
  • Chessick CA, Perlick DA, Miklowitz DJ, Dickinson LM, Allen MH, Morris CD et al. (2009) Suicidal ideation and depressive symptoms among bipolar patients as predictors of the health and well‐being of caregivers. Bipolar Disord, 11:876-884.
  • de Souza MS, da Silva RA, Molina MA, Jansen K, de Lima Ferreira L, Kelbert EF et al. (2016) Six-session caregiver psychoeducation on bipolar disorder: Does it bring benefits to caregivers? Int J Soc Psychiatry, 62:377-385.
  • Eisner LR, Johnson SL (2008) An acceptance-based psychoeducation intervention to reduce expressed emotion in relatives of bipolar patients. Behav Ther, 39:375-385.
  • Fiorillo A, Del Vecchio V, Luciano M, Sampogna G, De Rosa C, Malangone C et al. (2015) Efficacy of psychoeducational family intervention for bipolar I disorder: A controlled, multicentric, real-world study. J Affect Disord, 172:291-299.
  • González-Pinto A, Balanzá-Martínez V, Hernández AB, Gutiérrez-Rojas L, Montes JM, de Dios Perrino C et al. (2021) Expert consensus on information sheet proposals for patients under treatment with lithium. Span J Psychiatry Ment Health, 14:27-39.
  • Goossens PJ, Van Wijngaarden B, Knoppert-Van Der Klein EA, Van Achterberg T (2008) Family caregiving in bipolar disorder: caregiver consequences, caregiver coping styles, and caregiver distress. Int J Soc Psychiatry, 54:303-316.
  • Huang XY, Hung BJ, Sun FK, Lın JD, Chen CC (2009) The experiences of carers in Taiwanese culture who have long‐term schizophrenia in their families: a phenomenological study. J Psychiatr Ment Health Nurs, 16:874-883.
  • Hubbard AA, McEvoy PM, Smith L, Kane RT (2016) Brief group psychoeducation for caregivers of individuals with bipolar disorder: A randomized controlled trial. J Affect Disord, 200:31-36.
  • Jahnke S, Philipp K, Hoyer J (2015) Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse Negl, 40:93-102.
  • Justo LP, Soares BG, Calil HM (2007) Family interventions for bipolar disorder. Cochrane Database Syst Rev. 2007(4):CD005167.
  • Lannin DG, Vogel DL, Brenner RE, Tucker JR (2015) Predicting self-esteem and intentions to seek counseling: The internalized stigma model. Couns Psychol, 43:64-93.
  • Latifian M, Raheb G, Abdi K, Alikhani R, Shariful Islam SM (2023) The effectiveness of psychoeducation in improving attitudes towards psychological disorders and internalized stigma in the family members of bipolar patients: A quasi-experimental study. Psych J, 12:272-279.
  • Lee HJ, Lin EC, Chen MB, Su TP, Chiang LC (2018) Randomized, controlled trial of a brief family-centred care programme for hospitalized patients with bipolar disorder and their family caregivers. Int J Ment Health Nurs, 27:61-71.
  • Madigan K, Egan P, Brennan D, Hill S, Maguire B, Horgan F et al. (2012) A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. Eur Psychiatry, 27:281-284.
  • McIntyre RS, Berk M, Brietzke E, Goldstein BI, López-Jaramillo C, Kessing LV et al. (2020) Bipolar disorders. Lancet, 396:1841-1856.
  • Miklowitz DJ, Chung B (2016) Family‐focused therapy for bipolar disorder: Reflections on 30 years of research. Fam Process, 55:483-499.
  • Milin R, Kutcher S, Lewis SP, Walker S, Wei Y, Ferrill N et al. (2016) Impact of a mental health curriculum on knowledge and stigma among high school students: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry, 55:383-391.
  • O'Donnell LA, Weintraub MJ, Ellis AJ, Axelson DA, Kowatch RA, Schneck CD et al. (2020) A randomized comparison of two psychosocial interventions on family functioning in adolescents with bipolar disorder. Fam Process, 59:376-389.
  • Perlick DA, Hohenstein JM, Clarkin JF, Kaczynski R, Rosenheck RA (2005) Use of mental health and primary care services by caregivers of patients with bipolar disorder: a preliminary study. Bipolar Disord, 7:126-135.
  • Perlick DA, Miklowitz DJ, Lopez N, Chou J, Kalvin C, Adzhiashvili V et al. (2010) Family-focused treatment for caregivers of patients with bipolar disorder. Bipolar Disord, 12:627-637.
  • Platt S (1985) Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychol Med, 15:383-393.
  • Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M et al. (2006) What really matters to bipolar patients' caregivers: sources of family burden. J Affect Disord, 94:157-163.
  • Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M et al. (2004) Impact of a psychoeducational family intervention on caregivers of stabilized bipolar patients. Psychother Psychosom, 73:312-319.
  • Seyyedi Nasooh Abad M, Vaghee S, Aemmi SZ (2021) Effect of psychoeducation group training based on problem-solving skills for women experiencing bipolar spouse abuse. Front Public Health, 9:561369.
  • Sharif F, Mahmoudi A, Shooshtari AA, Vossoughi M (2016) The effect of family-centered psycho-education on mental health and quality of life of families of adolescents with bipolar mood disorder: a randomized controlled clinical trial. Int J Community Based Nurs Midwifery, 4:229.
  • Simoneau TL, Miklowitz DJ, Richards JA, Saleem R, George EL (1999) Bipolar disorder and family communication: effects of a psychoeducational treatment program. J Abnorm Psychol, 108:588-597.
  • Van Der Sanden RL, Bos AE, Stutterheim SE, Pryor JB, Kok G (2015) Stigma by association among family members of people with a mental illness: A qualitative analysis. J Community Appl Soc Psychol, 25:400-417.
  • Van Der Voort TY, Goossens PJ, Van Der Bijl JJ (2009) Alone together: A grounded theory study of experienced burden, coping, and support needs of spouses of persons with a bipolar disorder. Int J Ment Health Nurs, 18:434-443.

Bipolar Bozukluk Tanılı Bireylerin Aile Üyelerine Yönelik Psikososyal Müdahale Programları: Sistematik Derleme

Year 2025, Volume: 17 Issue: 3, 507 - 519
https://doi.org/10.18863/pgy.1515303

Abstract

Bipolar bozukluk, sadece bireyin yaşamını değil, aynı zamanda bütün aileyi karmaşık bir şekilde etkileyen bir dinamik yaratabilmektedir. Araştırmalar, bilişsel davranışçı terapiden psikoeğitim programlarına kadar geniş bir yelpazede müdahale stratejilerini içerir. Bu derlemede, bipolar bozukluk tanısı almış bireylerin aile üyelerine yönelik geliştirilen psikososyal müdahale programlarının sonuçlarının analiz edilmesi amaçlanmıştır. Pubmed ve Scopus veri tabanları kullanılarak Türkiye ve dünyada konu ile ilgili yapılan ve tam metinlerine ulaşılan çalışmalar gözden geçirilmiş ve sonuçlar, çalışma amaçları dikkate alınarak derlenmiştir. Literatür incelemesi sonucu 14 makale derlemeye dahil edilmişti. 4 çalışmada Aile Odaklı Terapi uygulandığı, 10 çalışmada ise ailelere yönelik psikoeğitim uygulandığı görülmüştür. Uygulanan Psikoeğitim programlarının 6 tanesi ailelere yönelik hastalık bilgisi ve bakım yükü hakkında verilen eğitimlerden oluşmaktadır. Bir çalışmada ise eşinde bipolar bozukluk olan ve istismara uğrayan kişilere problem çözme becerilerini arttırmaya yönelik psikoeğitim verilmişti. Çalışma sonuçlarında uygulanan müdahalelerin ailelerin bakım yükü, hastalık hakkında bilgi düzeyleri, benlik saygısı, yaşam kalitesi, içselleştirilmiş damgalama ve bipolar bozukluk tanılı bireyler üzerindeki etkileri incelenmiştir. Araştırma kapsamına alınan çalışmalar bipolar bozukluk tanılı bireylerin ailelerine yönelik aile temelli psikososyal müdahalelerin olumlu etkilerini ortaya koyan olumlu sonuçlar içermektedir.

References

  • Barbeito S, Vega P, Ruiz de Azua S, Gonzalez-Ortega I, Alberich S, Gonzalez-Pinto A (2023) Two-year evaluation of a multifamily psychoeducational program (PROTEC) in the family burden and prognosis of bipolar patients. Span J Psychiatry Ment Health, 16:225-234.
  • Beentjes TA, Goossens PJ, Poslawsky IE (2012) Caregiver burden in bipolar hypomania and mania: a systematic review. Perspect Psychiatr Care, 48:187-197.
  • Bernhard B, Schaub A, Kümmler P, Dittmann S, Severus E, Seemüller F et al. (2006) Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives. Eur Psychiatry, 21:81-86.
  • Bilir MK (2018) Deinstitutionalization in mental health policy: From institutional-based to community-based mental healthcare services. Hacettepe Journal of Health Administration, 21:563-576.
  • Casarez RL, Soares JC, Meyer TD (2021) Psychoeducation for caregivers of patients with bipolar disorder-Lessons learned from a feasibility study. J Affect Disord, 287:367-371.
  • Chessick CA, Perlick DA, Miklowitz DJ, Dickinson LM, Allen MH, Morris CD et al. (2009) Suicidal ideation and depressive symptoms among bipolar patients as predictors of the health and well‐being of caregivers. Bipolar Disord, 11:876-884.
  • de Souza MS, da Silva RA, Molina MA, Jansen K, de Lima Ferreira L, Kelbert EF et al. (2016) Six-session caregiver psychoeducation on bipolar disorder: Does it bring benefits to caregivers? Int J Soc Psychiatry, 62:377-385.
  • Eisner LR, Johnson SL (2008) An acceptance-based psychoeducation intervention to reduce expressed emotion in relatives of bipolar patients. Behav Ther, 39:375-385.
  • Fiorillo A, Del Vecchio V, Luciano M, Sampogna G, De Rosa C, Malangone C et al. (2015) Efficacy of psychoeducational family intervention for bipolar I disorder: A controlled, multicentric, real-world study. J Affect Disord, 172:291-299.
  • González-Pinto A, Balanzá-Martínez V, Hernández AB, Gutiérrez-Rojas L, Montes JM, de Dios Perrino C et al. (2021) Expert consensus on information sheet proposals for patients under treatment with lithium. Span J Psychiatry Ment Health, 14:27-39.
  • Goossens PJ, Van Wijngaarden B, Knoppert-Van Der Klein EA, Van Achterberg T (2008) Family caregiving in bipolar disorder: caregiver consequences, caregiver coping styles, and caregiver distress. Int J Soc Psychiatry, 54:303-316.
  • Huang XY, Hung BJ, Sun FK, Lın JD, Chen CC (2009) The experiences of carers in Taiwanese culture who have long‐term schizophrenia in their families: a phenomenological study. J Psychiatr Ment Health Nurs, 16:874-883.
  • Hubbard AA, McEvoy PM, Smith L, Kane RT (2016) Brief group psychoeducation for caregivers of individuals with bipolar disorder: A randomized controlled trial. J Affect Disord, 200:31-36.
  • Jahnke S, Philipp K, Hoyer J (2015) Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse Negl, 40:93-102.
  • Justo LP, Soares BG, Calil HM (2007) Family interventions for bipolar disorder. Cochrane Database Syst Rev. 2007(4):CD005167.
  • Lannin DG, Vogel DL, Brenner RE, Tucker JR (2015) Predicting self-esteem and intentions to seek counseling: The internalized stigma model. Couns Psychol, 43:64-93.
  • Latifian M, Raheb G, Abdi K, Alikhani R, Shariful Islam SM (2023) The effectiveness of psychoeducation in improving attitudes towards psychological disorders and internalized stigma in the family members of bipolar patients: A quasi-experimental study. Psych J, 12:272-279.
  • Lee HJ, Lin EC, Chen MB, Su TP, Chiang LC (2018) Randomized, controlled trial of a brief family-centred care programme for hospitalized patients with bipolar disorder and their family caregivers. Int J Ment Health Nurs, 27:61-71.
  • Madigan K, Egan P, Brennan D, Hill S, Maguire B, Horgan F et al. (2012) A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. Eur Psychiatry, 27:281-284.
  • McIntyre RS, Berk M, Brietzke E, Goldstein BI, López-Jaramillo C, Kessing LV et al. (2020) Bipolar disorders. Lancet, 396:1841-1856.
  • Miklowitz DJ, Chung B (2016) Family‐focused therapy for bipolar disorder: Reflections on 30 years of research. Fam Process, 55:483-499.
  • Milin R, Kutcher S, Lewis SP, Walker S, Wei Y, Ferrill N et al. (2016) Impact of a mental health curriculum on knowledge and stigma among high school students: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry, 55:383-391.
  • O'Donnell LA, Weintraub MJ, Ellis AJ, Axelson DA, Kowatch RA, Schneck CD et al. (2020) A randomized comparison of two psychosocial interventions on family functioning in adolescents with bipolar disorder. Fam Process, 59:376-389.
  • Perlick DA, Hohenstein JM, Clarkin JF, Kaczynski R, Rosenheck RA (2005) Use of mental health and primary care services by caregivers of patients with bipolar disorder: a preliminary study. Bipolar Disord, 7:126-135.
  • Perlick DA, Miklowitz DJ, Lopez N, Chou J, Kalvin C, Adzhiashvili V et al. (2010) Family-focused treatment for caregivers of patients with bipolar disorder. Bipolar Disord, 12:627-637.
  • Platt S (1985) Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychol Med, 15:383-393.
  • Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M et al. (2006) What really matters to bipolar patients' caregivers: sources of family burden. J Affect Disord, 94:157-163.
  • Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M et al. (2004) Impact of a psychoeducational family intervention on caregivers of stabilized bipolar patients. Psychother Psychosom, 73:312-319.
  • Seyyedi Nasooh Abad M, Vaghee S, Aemmi SZ (2021) Effect of psychoeducation group training based on problem-solving skills for women experiencing bipolar spouse abuse. Front Public Health, 9:561369.
  • Sharif F, Mahmoudi A, Shooshtari AA, Vossoughi M (2016) The effect of family-centered psycho-education on mental health and quality of life of families of adolescents with bipolar mood disorder: a randomized controlled clinical trial. Int J Community Based Nurs Midwifery, 4:229.
  • Simoneau TL, Miklowitz DJ, Richards JA, Saleem R, George EL (1999) Bipolar disorder and family communication: effects of a psychoeducational treatment program. J Abnorm Psychol, 108:588-597.
  • Van Der Sanden RL, Bos AE, Stutterheim SE, Pryor JB, Kok G (2015) Stigma by association among family members of people with a mental illness: A qualitative analysis. J Community Appl Soc Psychol, 25:400-417.
  • Van Der Voort TY, Goossens PJ, Van Der Bijl JJ (2009) Alone together: A grounded theory study of experienced burden, coping, and support needs of spouses of persons with a bipolar disorder. Int J Ment Health Nurs, 18:434-443.
There are 33 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Review
Authors

Ramazan Aydar 0009-0000-2863-816X

Cemile Hürrem Ayhan 0000-0002-6326-2177

Mehmet Cihad Aktaş 0000-0002-6529-9766

Pınar Güzel Özdemir 0000-0002-2135-2553

Early Pub Date December 23, 2024
Publication Date
Submission Date July 12, 2024
Acceptance Date November 2, 2024
Published in Issue Year 2025 Volume: 17 Issue: 3

Cite

AMA Aydar R, Ayhan CH, Aktaş MC, Güzel Özdemir P. Psychosocial Intervention Programs for Family Members of Individuals with Bipolar Disorder: A Systematic Review. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. 17(3):507-519. doi:10.18863/pgy.1515303

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