{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:11:29Z","timestamp":1791223889453,"version":"4.1.0"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T00:00:00Z","timestamp":1586908800000},"content-version":"unspecified","delay-in-days":2237,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur. psychiatr."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0924933800241199_abs1\" sec-type=\"other\"><jats:title>Objective:<\/jats:title><jats:p>The aim of this research, which represents an additional and longer follow-up to a previous trial, was to evaluate a 5-year follow-up study of a combined treatment (pharmacological + psychoeducational and cognitive-behavioral therapy) as compared with a standard pharmacological treatment in patients with refractory bipolar disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0924933800241199_abs2\" sec-type=\"methods\"><jats:title>Method:<\/jats:title><jats:p>Forty patients were randomly assigned to either an Experimental group\u2013under combined treatment \u2014 or a Control group \u2014 under pharmacological treatment. Data were analyzed by analysis of variance (ANOVA), with repeated measures at different evaluation time points.<\/jats:p><\/jats:sec><jats:sec id=\"S0924933800241199_abs3\" sec-type=\"results\"><jats:title>Results:<\/jats:title><jats:p>Between-group differences were significant at all evaluation time points after treatment. Experimental group had less hospitalization events than Control group in the 12-month evaluation (<jats:italic>P<\/jats:italic> = 0.015). The Experimental group showed lower depression and anxiety in the 6-month (<jats:italic>P<\/jats:italic> = 0.006; <jats:italic>P<\/jats:italic> = 0.019), 12-month (<jats:italic>P<\/jats:italic> = 0.001; <jats:italic>P<\/jats:italic> &lt; 0.001) and 5-year (<jats:italic>P<\/jats:italic> &lt; 0.001, <jats:italic>P<\/jats:italic> &lt; 0.001) evaluation time points. Significant differences emerged in mania and misadjustment already in the post-treatment evaluation (<jats:italic>P<\/jats:italic> = 0.009; <jats:italic>P<\/jats:italic> &lt; 0.001) and were sustained throughout the study (6-month: <jats:italic>P<\/jats:italic> = 0.006, <jats:italic>P<\/jats:italic> &lt; 0.001; 12-month: <jats:italic>P<\/jats:italic> &lt; 0.001, <jats:italic>P<\/jats:italic> &lt; 0.001; 5-year: <jats:italic>P<\/jats:italic> = 0.004, <jats:italic>P<\/jats:italic> &lt; 0.001). After 5-year follow-up, 88.9% of patients in the Control group and 20% of patients in the Experimental group showed persistent affective symptoms and\/or difficulties in social-occupational functioning.<\/jats:p><\/jats:sec><jats:sec id=\"S0924933800241199_abs4\" sec-type=\"conclusions\"><jats:title>Conclusions:<\/jats:title><jats:p>A combined therapy is long-term effective for patients with refractory bipolar disorder. Suggestions for future research are commented.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.eurpsy.2012.11.002","type":"journal-article","created":{"date-parts":[[2012,12,28]],"date-time":"2012-12-28T23:12:55Z","timestamp":1356736375000},"page":"134-141","source":"Crossref","is-referenced-by-count":53,"title":["Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: A 5-year controlled clinical trial"],"prefix":"10.1017","volume":"29","author":[{"given":"A.","family":"Gonz\u00e1lez Isasi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Echebur\u00faa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.M.","family":"Limi\u00f1ana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gonz\u00e1lez-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,4,15]]},"reference":[{"key":"S0924933800241199_bib0145","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.2.324"},{"key":"S0924933800241199_bib0200","volume-title":"Psicofarmacolog\u00eda esencial de la depresi\u00f3n y del trastorno bipolar","author":"Stahl","year":"2002"},{"key":"S0924933800241199_bib0185","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.188.4.313"},{"key":"S0924933800241199_bib0180","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2006.12.007"},{"key":"S0924933800241199_bib0070","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2006.07.007"},{"key":"S0924933800241199_bib0170","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.4.419"},{"key":"S0924933800241199_bib0155","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v62n1208"},{"key":"S0924933800241199_bib0195","volume-title":"The state trait anxiety inventory","author":"Spielberger","year":"1970"},{"key":"S0924933800241199_bib0150","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(01)00239-0"},{"key":"S0924933800241199_bib0135","volume-title":"Cognitive therapy for bipolar disorder: a therapist's guide to concepts. 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