ABSTRACT
OBJECTIVE The authors sought to assess the efficacy of functional remediation, a novel intervention program, on functional improvement in a sample of euthymic patients with bipolar disorder. METHOD In a multicenter, randomized, rater-blind clinical trial involving 239 outpatients with DSM-IV bipolar disorder, functional remediation (N=77) was compared with psychoeducation (N=82) and treatment as usual (N=80) over 21 weeks. Pharmacological treatment was kept stable in all three groups. The primary outcome measure was improvement in global psychosocial functioning, measured blindly as the mean change in score on the Functioning Assessment Short Test from baseline to endpoint. RESULTS At the end of the study, 183 patients completed the treatment phase. Repeated-measures analysis revealed significant functional improvement from baseline to endpoint over the 21 weeks of treatment (last observation carried forward), suggesting an interaction between treatment assignment and time. Tukey's post hoc tests revealed that functional remediation differed significantly from treatment as usual, but not from psychoeducation. CONCLUSIONS Functional remediation, a novel group intervention, showed efficacy in improving the functional outcome of a sample of euthymic bipolar patients as compared with treatment as usual.
Subject(s)
Bipolar Disorder/rehabilitation , Cognition Disorders/rehabilitation , Cognitive Behavioral Therapy/methods , Rehabilitation, Vocational , Social Adjustment , Adult , Ambulatory Care , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Patient Education as Topic/methods , Single-Blind Method , SpainABSTRACT
Las graves violaciones a los derechos humanos (personas asesinadas, desaparecidas y torturadas) en varios países del continente Sud Americano acaecidos durante la segunda mitad del Siglo XX han sido efectuadas por personal militar adiestrado de una manera especial. La psiquiatría y la psicología recién comienza a preocuparse del tema del mal grupal o narcismo grupal como un fenómeno patológico resultante de un condicionamiento y selección que creemos deben ser estudiados, cuestionados y debatidos públicamente. Los autores hacen una revisión de la literatura sobre el tema e inician una reflexión sobre la necesidad de abrir el tema el tema como material de investigación y debate ético ante la responsabilidad de los profesionales de la salud mental en favor de la convivencia nacional en momentos de paz y conflicto
