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. 2025 Nov;70(11):834-844.
doi: 10.1177/07067437251342278. Epub 2025 May 20.

Early Psychoeducational Intervention for Youth and Young Adults at Risk for Bipolar Disorder: A Feasibility Study: Intervention psychoéducative précoce pour les adolescents et les jeunes adultes à risque de trouble bipolaire : Une étude de faisabilité

Kamyar Keramatian  1 , Alexander Levit  1 , Heeva Chavoshi-Nejad  2 , Clara Westwell-Roper  1 , John-Jose Nunez  1 , Ashley Forbes  3 , Emma Morton  4 , Erin E Michalak  1 , Eduard Vieta  5 , Lakshmi N Yatham  1
Affiliations

Early Psychoeducational Intervention for Youth and Young Adults at Risk for Bipolar Disorder: A Feasibility Study: Intervention psychoéducative précoce pour les adolescents et les jeunes adultes à risque de trouble bipolaire : Une étude de faisabilité

Kamyar Keramatian et al. Can J Psychiatry. 2025 Nov.

Abstract
in English, French

Objective: Bipolar disorder (BD) often goes unrecognized and untreated for several years leading to serious consequences. We have recently developed a manualized telehealth-based group psychoeducational and resilience enhancement program for individuals at high risk for bipolar disorder (PREP-BD). The primary objective of this study was to assess the feasibility of implementing PREP-BD to enhance help-seeking intentions among high-risk individuals.

Method: The intervention consisted of eight weekly, 60-minute group psychoeducation sessions conducted via Zoom. Participants (N = 21), aged 17 to 24 years, who met the bipolar at-risk criteria, were assigned to one of four cohorts. Primary outcomes for this feasibility trial included sign-up rate, completion rate, and acceptability as measured by the Client Satisfaction Questionnaire (CSQ-8). Preliminary efficacy was assessed using validated measures of help-seeking intentions, resilience, quality of life, and stigma, with pre- and post-intervention comparisons.

Results: Our findings indicate excellent feasibility as evidenced by timely recruitment, 100% sign-up rate, and 76.19% completion rate (defined as attending at least 75% of group sessions). The intervention showed preliminary improvements in help-seeking intentions, particularly for a hypomanic scenario. Quality of life also demonstrated significant improvement, while resilience and self-stigma showed non-significant trends toward improvement.

Conclusion: Our findings suggest the feasibility of implementing psychoeducation as an early identification strategy in individuals at risk for BD. Future randomized controlled trials are needed to investigate the effectiveness of PREP-BD.

Objectif:: Le trouble bipolaire (TB) passe souvent inaperçu et n’est pas traité pendant plusieurs années, ce qui entraîne de graves conséquences. Nous avons récemment mis au point un programme psychoéducatif de renforcement de la résilience basé sur la télésanté pour les personnes à risque élevé de trouble bipolaire (PREP-BD, Psychoeducational and Resilience Enhancement Program for individuals at high risk for Bipolar Disorder). Le principal objectif de cette étude était d’évaluer la faisabilité de la mise en œuvre du PREP-BD pour améliorer les intentions de recherche d’aide chez les personnes à risque élevé.

Méthode:: L’intervention consistait en huit séances hebdomadaires de psychoéducation de groupe de 60 minutes, sur Zoom. Les participants (N = 21), âgés de 17 à 24 ans, qui répondaient aux critères de risque de bipolarité, ont été affectés à l’une des quatre cohortes. Les principaux résultats de cette étude de faisabilité comprenaient le taux d’inscription, le taux d’achèvement et l’acceptabilité, tels que mesurés par le questionnaire de satisfaction des clients (CSQ-8). L’efficacité préliminaire a été évaluée à l’aide de mesures validées des intentions de recherche d’aide, de la résilience, de la qualité de vie et de la stigmatisation, avec des comparaisons avant et après l’intervention.

Résultats:: Nos résultats indiquent une excellente faisabilité, comme en témoignent le recrutement rapide, le taux d’inscription de 100 % et le taux d’achèvement de 76,19 % (c’est-à-dire la participation à au moins 75 % des séances de groupe). L’intervention a montré des améliorations préliminaires dans les intentions de recherche d’aide, en particulier dans un scénario d’hypomanie. La qualité de vie s’est également beaucoup améliorée, tandis que la résilience et l’autostigmatisation ont montré des tendances non significatives vers l’amélioration.

Conclusion:: Nos résultats suggèrent la faisabilité de mettre en œuvre la psychoéducation comme stratégie d’identification précoce chez les personnes à risque de trouble bipolaire. De futurs essais contrôlés à répartition aléatoire sont nécessaires pour étudier l’efficacité du programme PREP-BD.

Keywords: at-risk; bipolar disorders; early intervention; feasibility study; psychoeducation.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: KK has previously served on an advisory board of AbbVie.EM has received honorarium for advising on the development of educational materials for Neurotorium, an online educational platform supported by the Lundbeck Foundation.EEM has received funding to support unrelated patient education initiatives from Otsuka-Lundbeck.JJN has received funding from the BC Cancer Foundation, as well as an unrestricted research grant from Pfizer Canada.EV has received grants and served as consultant, advisor or CME speaker for the following entities: AB-Biotics, AbbVie, Adamed, Alcediag, Angelini, Biogen, Beckley-Psytech, Biohaven, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, HMNC, Idorsia, Johnson & Johnson, Lundbeck, Luye Pharma, Medincell, Merck, Newron, Novartis, Orion Corporation, Organon, Otsuka, Roche, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, Teva, and Viatris, outside the submitted work.LNY reports consultant/speaker fees from Alkermes, Allergan (currently Abbvie), Intracellular Therapies, LivaNova, Merck, Newron, Sumitomo Pharma, and grants from Allergan (now AbbVie), CIHR, and Sumitomo Pharma, outside the submitted work, over the last 3 years.AF, AL, CWR and HC have no conflict of interest to disclose.

Figures

Figure 1.
Figure 1.
Study recruitment flowchart.
Figure 2.
Figure 2.
Impact of group psychoeducation on measures of help-seeking intention for a depressed scenario. (A) Total help-seeking intention score shown both as group mean (horizontal line) and individual scores (black circles) pre-group psychoeducation and post-group psychoeducation. (B) Mean help-seeking intention scores for the 5 specific sources where participants would seek help pre-group psychoeducation and post-group psychoeducation. All error bars represent standard deviation; n = 21 (intention-to-treat analysis).
Figure 3.
Figure 3.
Impact of group psychoeducation on measures of help-seeking intention for a hypomanic scenario. (A) Total help-seeking intention score shown both as group mean (horizontal line) and individual scores (black circles) pre-group psychoeducation and post-group psychoeducation; *score increase was significant (p = 0.003). (B) Mean help-seeking intention scores for the 5 specific sources where participants would seek help pre-group psychoeducation and post-group psychoeducation; *score increase was signifcant (with Holm–Sidak correction for repeated measures; p < 0.03). All error bars represent standard deviation; n = 21 (intention-to-treat analysis).
Figure 4.
Figure 4.
Impact of group psychoeducation on measures of self-stigma, resilience, and quality of life. Group mean changes in measures of (A) self-stigma, (B) resilience, and (C) Quality of Life pre-group psychoeducation and post-group psychoeducation; *score increase was signifcant (p = 0.02). All error bars represent standard deviation; n = 21 (intention-to-treat analysis).
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