The Effectiveness of Family-Based Intervention on Symptom Severity, Expressed Emotion and Coping Styles of Bipolar Patients

Abstract

Background: There is a growing body of literature on the effectiveness of family-based interventions in bipolar disorder (BD). Objectives: The present study aimed to determine the effectiveness of a family-based intervention on expressed emotion, coping styles of family and symptoms severity of bipolar patients. Methods: An experimental design using pretest, posttest, and a three-month follow-up was used. The population comprised family members of patients with one type of bipolar disorder spectrum who were hospitalized in a referral Psychiatric Hospital in Tehran, Iran, during the second half of 2017. Sixty-two patients were selected randomly and assigned randomlyinto two groups of experimental and control. Then, the main caregiver of their family was invited for participation in the research. They had no diagnosis in axis I and they were eager to participate in the study. 12 sessions of family-focused therapy (FFT) based on the Micklowitz protocol with some adaptation for Iranian families were used for the experimental group. The control group was on the waiting list and received no intervention. The following measurement tools were used: the Young Mania Rating Scale (YMRS), Coping Inventory for Stressful Situations (CISS), and Emotional Expressiveness Questionnaire (EEQ). Data were analyzed via repeated measures analysis of variance test. Results: The results showed that there was a significant difference between the two groups in coping styles and expressed emotion (P = 0.023). The symptoms severity was 46.4 ± 5.9 in patients and 54.5 ± 6.9 in controls (P = 0.038). The results remained at follow-up (P = 0.041). The effect size of 0.8 indicated a high promotion after treatment. Conclusions: The family-focused therapy was effective in decreasing emotion expression in families and improving coping styles of family members. It led to an improvement in symptoms severity in patients. Therefore, it is recommended as supplementary to pharmacotherapy in patients with bipolar disorder and their families.