Diffusione dell'intervento psicoeducativo familiare per il disturbo bipolare tipo I nei CSM italiani

Objectives: This study, funded by the Italian Ministry of Health and coordinated by the Department of Psychiatry of the University of Naples SUN, aims to: 1) promote the use of a structured family psychoeducational intervention in patients with bipolar I disorder and their families in Italian mental health centres; 2) assess its implementation in routine care; c) evaluate its effects on psychopathological status and social functioning of patients and their relatives. Methods: This study included the following phases: 1) random selection of 11 Italian mental health centres; 2) development of informative materials and of assessment instruments; 3) training of 2 mental health workers per centre; 4) selection of 8 families of patients with bipolar I disorder for each centre and administration of family psychoeducational intervention. The difficulties and benefits encountered by professionals in implementing the intervention were registered on the Family Intervention Schedule (FIS), a 46-item self-report instrument collecting information on: 1) number of families to whom the intervention was proposed; 2) clinical and organisational difficulties experienced by the staff in the provision of the intervention; 3) advantages reported by the staff. Results: The intervention has been proposed to 79 patients and their relatives. Six of them did not accept it, further 9 families left the study after receiving the informative packages. Mental health workers reported several advantages in the conduction of the intervention, in particular, improvement of their professional skills and job satisfaction, which tend to increase over time. The most frequent difficulties in implementing the intervention are the integration of family work with other responsibilities and the allowance of time to perform the intervention. These difficulties are already high at the end of the training course and tend to be stable over time. Conclusions: The results of this study suggest that family psychoeducational interventions are feasible in routine settings of Italian mental health centres for the treatment of bipolar I disorder. However, in order to facilitate the dissemination of this intervention on a large scale, organisational changes are needed.