Psychoeducation for patients with bipolar disorder receiving lithium: short and long term impact on locus of control and knowledge about lithium.

BACKGROUND: Psychoeducation is now considered as part of the integrated treatment for bipolar disorder. But the psychological changes involved in it have been poorly studied. METHOD: We compared the locus of control (LOC, a key variable for health-related behaviours as well as for education practices), the knowledge about lithium [Lithium Knowledge Questionnaire (LKQ)] and attitude about lithium [Attitude towards Lithium Questionnaire (ALQ)] before and after a brief hospital based psychoeducational programme for euthymic patients with bipolar disorder (ICD-10 criteria) receiving lithium prophylaxis. The occurrence of hospitalisations was recorded during the two years before and after the patients underwent psychoeducation. All patients were reassessed after 24 months. RESULTS: 50 consecutive participants at a psychoeducational programme were evaluated. The LKQ but not the ALQ scores increased significantly after the programme. The external "powerful others" component of the LOC significantly increased after psychoeducation. The observed changes were maintained after 24 months. The patients' level of satisfaction was excellent and sustained. There was only a trend for a decrease in the rate of hospitalisations. LIMITATIONS: The knowledge about lithium was assessed with an experimental instrument. Patients followed in a university department may not be representative of bipolar patients at large. CONCLUSIONS: Psychoeducation enduringly increases the knowledge about lithium and induces long term changes in the locus of control that may reflect a shift in illness representations. The LOC may be an important target of psychoeducation for euthymic patients with bipolar disorder.

Effect of face familiarity on age decision.

The present experiment was planned to check whether the extraction of apparent age is affected by face identity (familiarity) or not. According to the traditional view, age estimation should be carried out independently of face identity, because it is one of the visually derived semantic codes (like gender and ethnicity). However, little is known about its underlying mechanisms. Moreover, some recent studies have cast doubt on the parallel thesis regarding facial expression, facial speech, ethnicity, and gender. Given the promising results of a pilot experiment (n=24), 16 Caucasian participants were enrolled in an "age decision" task on morphed faces derived from one old and one young source-face, in the proportion 70:30. The respondents had previously been familiarised with half the source faces by a learning procedure (associating the face, surname, occupation and city of residence of the person displayed), while the remaining half were unfamiliar. The results showed that age decision was affected by face familiarity, at least when the task was perceptually difficult enough. This adds support to the thesis that the identification of identity and the extraction of visually derived semantic codes are not made independently from each other. The status of age, within the visually derived semantic codes, is also discussed.