Peer support benefits psychoeducation for bipolar patients

Peer support for patients with bipolar disorder (BD) may help improve adherence to online psychoeducation programs, study findings suggest.

The researchers found that among recently diagnosed BD patients assigned to an online psychoeducation program, those with peer support had significantly greater adherence than those without.

Furthermore, patients with peer support had greater, albeit nonsignificant, improvements in depression symptoms and functioning than those without.

"The findings suggest that additional coaching and support provided throughout an online program for bipolar disorder may increase compliance and long-term symptom and functioning improvement, but further research is needed," comment Judith Proudfoot (Prince of Wales Hospital, Sydney, Australia) and team.

The findings come from a study of 407 patients, aged 18-75 years, who had been diagnosed with BD in the past 12 months. Of these, 134 were randomly assigned to an 8-week online psychoeducation program with peer support (BEP+IS), 139 to the same program without peer support (BEP), and 134 to a control group.

The online psychoeducation program comprised an eight-session audio-visual course that addressed topics such as the causes of bipolar disorder, diagnosis, medications, psychologic treatments, wellbeing plans, and the importance of support networks.

For patients in the BEP+IS group, the program was supplemented with coaching and support from "informed supporters" - people with BD who had been effectively managing their condition for at least 2 years.

Patients in the control group received an online text of simple facts about BD.

The researchers found that all three groups showed significant improvement in perceptions of control, and reductions in perceived stigma and levels of anxiety and depression over the study period, with no significant differences between the groups.

However, patients in the BEP+IS group were significantly more likely to be adherent to the program than those in the BEP group, at 79.9% versus 69.1%.

Patients in the BEP+IS group also showed slightly better improvement on the Goldberg Anxiety and Depression Scale and the Work and Social Adjustment Scale after 6 months compared with the BEP group, although the difference was not significant.

Proudfoot and colleagues conclude in the Journal of Affective Disorders: "While significant treatment effects were not observed between an attention control group and the online psychoeducation program, greater adherence to the online program occurred when participants received additional help from an Informed Supporter.

"Further research is required to examine the relationship between adjunctive support, compliance and efficacy in online interventions for different conditions."

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