Tuesday, January 21, 2020

Family Therapy May Delay Mood Episodes in Youth at High Risk of Bipolar Disorder

Family therapy focused on building communication and problem-solving skills may benefit youth at high risk of bipolar disorder, according to a report in JAMA Psychiatry. Specifically, the study found that youth with mood symptoms and a family history of bipolar disorder who participated in a four-month program with their parents (and, when possible, siblings) had longer periods between symptoms of depression, mania, hypomania, or mixed episodes (mood episodes) than those who participated in a program with less intensive family involvement.

Previous studies show that youth at highest risk of progressing to bipolar disorder early in life are those with mood symptoms and with a family history of the disorder. Still, there is “little agreement on what treatments are most effective in preventing symptom progression among high-risk children,” wrote David J. Miklowitz, Ph.D., of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues.

For the current study, Miklowitz and colleagues recruited 127 youth aged 9 to 17 years with major depressive disorder or unspecified (subthreshold) bipolar disorder, active mood symptoms, and at least one first- or second-degree relative with bipolar disorder I or II. The youth and their families were randomly assigned to one of two treatments over a four-month period: family-focused therapy or enhanced care. Youth and families assigned to family-focused therapy participated in 12 60-minute sessions of psychoeducation, communication-enhancement training (which the authors described as “practicing active listening or expressing positive or negative feelings”), and problem-solving skills training. Youth and families assigned to enhanced care participated in three 60-minute family psychoeducation sessions a week; then only the youth participated in three monthly sessions on mood management.

The researchers evaluated the participants’ symptoms at the start of the study, every four months for the first year, and every six months for up to four years. Of the 127 youth who participated in the study, 75 had major depressive disorder and 52 had unspecified bipolar disorder.

Youth in the group that received family-focused therapy had longer intervals between mood episodes compared with youth in enhanced care. “Specifically, FFT [family-focused therapy] was associated with longer intervals to depressive episodes but did not differ from enhanced care in time to manic or hypomanic episodes, conversions to bipolar disorder, or symptom trajectories,” the authors noted.

“Delaying or preventing episodes of mood disorder may have enduring effects on psychosocial functioning for youth with high-risk syndromes, as well as among parents in terms of the considerable burden of caregiving for a young person with early-onset BD [bipolar disorder],” they concluded.

For related information, see the Psychiatric News article “Researchers Sum Up Current Knowledge of Bipolar Disorder, Call for More Study.”

(Image: iStock/PeopleImages)

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