Despite several guidelines recommend the use of psychoeducational family interventions (PFIs) as add-on in the treatment of patients with bipolar I disorder (a), their implementation on a large scale remains limited (b).

To identify benefits and obstacles in implementing a PFI in the clinical routine care.

This was a multicentre, real-world, controlled, outpatient trial, carried out in 11 randomly recruited Italian mental health centres. Mental health professionals received a training on PFI and provided the intervention to patients with bipolar I disorder and their relatives. Difficulties and benefits in performing PFI were collected through an ad-hoc schedule, which was administered at baseline and 5 times during the different stages of the intervention.

Mental health professionals report significant improvements in the intervention-related benefits over time (T0=5.3±2.0 vs. T5=7.9±0.9; P<.0001), in particular in their professional skills (T0=6.5±2.3 vs. T5=8.0±0.8; P<.01). They also report to be more satisfied with their own work (T0=6.6±2.3 vs. T5=8.0±1.3; P<.05). The most relevant difficulties were related to the need to integrate the PFI with other work responsibilities and to the lack of time, which did not decrease overtime.

PFIs are feasible in routine care for the treatment of patients with bipolar I disorder and their relatives, and main obstacles are related to the organization of mental health centres, and not to the characteristics of the intervention itself.