Authors (including presenting author) :
Lo KC(1), Lee CK(1), Au CS(1), Leung WY(1), Wong WLM(1), Yu HSZ(1), Wong MCM(1), Chan KLP(1)
Affiliation :
(1) Department of Psychiatry, Queen Mary Hospital
Introduction :
Bipolar disorder (BD) is a complex disorder of mood and behavior with lifetime prevalence of about 4% in general population. Instability of emotion impairs social function including relationship with family, friends and partners and performance at study or employment, etc. Psychoeducation program for bipolar disorder is evidenced based for improved medication adherence, reducing relapse, and improving competence in self-management – a pilot program is developed in 2019 in the Department of Psychiatry.
Objectives :
(1) To develop a psychoeducation program for patients with Bipolar Disorder
(2) To improve psychological intervention for patients with severe mental illness
(3) To improve treatment adherence and reduce relapses
Methodology :
10 subjects were recruited from patients diagnosed with Bipolar Disorder under the care of Community Psychiatric Services. 9 out of 10 completed the 10-sessioned-program within 8 months. The current mental condition was euthymic, 5 males (55.6%), mean age of 38.6 years old (SD 15.4). The mean years of mental illness is 18 (SD 13.6). The mean number of previous admissions ever was 5.89 (Range 1-13).
This pilot includes 10 individual psychoeducation session for each participant followed by one group session with carers and all participants. The participants were evaluated with Brief Quality of Life for Bipolar Disorder (BQoL), Oxford Bipolar Knowledge (OBQ), Brief Medication Adherence Scale (BMAS), Internalized Stigma of Mental Illness Inventory (ISMII), and Satisfaction Survey. The number of psychiatric follow up, AED psychiatric consultation and psychiatric admission were evaluated.
Two advanced practice nurses (APN) of community psychiatric service were trained to conduct the program under supervision of Psychotherapy Committee of the Department.
Result & Outcome :
Among the 9 participants completed the 8-month program, there was no episode of psychiatric admission nor AED psychiatric consultation comparing to 3 episodes each prior to the pilot. The number of psychiatric follow up was noted to have decreased from 6.89 times to 5.44 times with significant difference (p< 0.05).
There is Increased quality of life measures, increase in knowledge in BD (p< 0.01), increased in medication adherence scale, decreased in internal stigmatization (p< 0.05).
The satisfaction rating was high with mean rating of 90.11% (SD 4.88, Range (81-96). Patients also verbalised that they felt respected, cared, and involved, learn more about BD, understood relapse signs and management, reflected program helpful and would recommend to others.
Conclusions:
The short-term outcome was promising that all patients had no psychiatric admission or emergency room attendance during and 6 months after completion of the program. The participants had increased knowledge on BD and level of stigma. The pilot was expanded and extended to train up more case managers in Community Psychiatric Services and to involve more patients.
