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Caregiver Group Support and Education Associated with Longer Relapse Intervals for People with Bipolar Disorder

Caregivers are relied upon by both patients and medical professionals to bridge the gap between medical care and homelife. They may be needed to deliver medicines and medical care, ensure basic tasks of daily living, or monitor health. Caregivers are often close relatives without medical expertise, but they play an important role in overall wellness and disease management. Bipolar disorder is a psychiatric condition associated with episodes of mania and depression. Because of these potential mood swings, many people with bipolar disorder may require some degree of help or monitoring from a caregiver. Medicine and behavioral steps may also help protect against the onset of mania or depression. Since caregivers are so involved in patients' lives, it may be important for the caretaker to better understand bipolar disorder so they understand treatment and know the signs of worsening mood in the patient.

Researchers from Spain examined the impact on patients when caregivers attended groups that provided psychological support and bipolar education classes (psychoeducation). The study, published in Bipolar Disorder, found that psychoeducation for caregivers may decrease recurrence of mania or hypomania in patients.

About the Study    TOP

This study was a randomized trial that included care-givers of 113 patients with bipolar disorder. The caregivers were randomized to psychoeducation classes or no intervention at all. The 12 classes were all 90 minutes long. The classes included information about bipolar disorder and coping skills. Patients' mood recurrence and number of hypomanic/manic recurrences were recorded over a 15-month period. Patients whose caregiver attended classes had:

  • Reduced likelihood of any mood recurrence
  • Longer periods of time without relapse
  • Fewer hypomanic/manic recurrences
  • Greater time to hypomanic/manic recurrence
A second analysis was performed on information from this trial after the trial was completed. The second analysis found that the benefits of caretaker education was greatest if the patient had stage 1 (mildest form) bipolar disorder . There was no significant difference in time to recurrence for patients with more severe types of bipolar disorder.

How Does This Affect You?    TOP

The design of this study is generally considered very reliable. One point of concern in this study design is something called attention control. The participants in the treatment group met with a professional and their fellow caretakers 12 times, but the control group did not have any meetings at all. Because of this difference, it is hard to determine if the specific treatment was effective or if the benefit simply came from regular meetings and support from others.

If you are caring for someone with bipolar disorder, look for support options. Ask those providing medical care if there are options to help you best care for someone with bipolar disease. There may also be local support groups and classes or online groups to connect you to others who take care of people with bipolar disorder. These groups may not only provide emotional but also practical support. As a caretaker, it is also important to make sure you have some help and downtime. Look for other family members or medical/social services that can provide you with relief when needed.


Depression and Bipolar Support Alliance
National Institute of Mental Health


Reinares M, Colom F, Sanchez-Moreno J, etal. Impact of caregiver group psychoeducation on the course and outcome of bipolar patients in remission: a randomized controlled trial. Bipolar Disord. 2008 Jun;10(4):511-9.
Reinares M, Colom F, Rosa AR, Bonnín CM, Franco C, Solé B, Kapczinski F, Vieta E. The impact of staging bipolar disorder on treatment outcome of family psychoeducation. J Affect Disord. 2010 Jun;123(1-3):81-6.
Last reviewed June 2010 by Brian P. Randall, MD
Last updated

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