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Title: Family-Focused Therapy Helps Relieve Depression Symptoms in Bipolar Teens
URL: http://www.pslgroup.com/dg/22A6AA.htm
Doctor's Guide
September 2, 2008

CHICAGO -- September 2, 2008 -- Family-focused therapy, when combined with medication, appears effective in stabilising symptoms of depression among teens with bipolar disorder, according to a study in the September issue of Archives of General Psychiatry.

"The past decade has witnessed a remarkable increase in diagnoses of bipolar disorder in children and adolescents and, correspondingly, drug trials for patients with early-onset disorder," the authors wrote. "There has been comparatively little controlled examination of psychotherapy for paediatric patients."

David J. Miklowitz, PhD, University of Colorado, Boulder, Colorado, and colleagues conducted an outpatient randomised controlled trial among 58 adolescents (mean age 14.5 y) with bipolar disorder who had experienced a mood episode in the prior 3 months.

Between 2002 and 2005, the researchers randomised 30 of the teens to receive pharmacotherapy plus family-focused treatment for adolescents. Over 9 months, they participated in 21 sessions each lasting 50 minutes. Therapy included the patient, parents, and siblings and consisted of education about their disease, communication training, and problem-solving skills training.

The other 28 teens were assigned to pharmacotherapy plus enhanced care, which involved 3 family sessions each lasting 50 minutes that focused on preventing relapse. Independent evaluators, who did not know patient group assignments, assessed the teens every 3 to 6 months for 2 years.

A total of 60% of the family-focused therapy group and 64.3% of the enhanced care group completed the 2-year follow-up. Of those, 53 (91.4%) experienced a full recovery from their original mood episode.

There were no differences between the 2 groups in rates of recovery or in the amount of time that elapsed before a subsequent mood episode. However, patients in the family-focused therapy group recovered from depressive symptoms more quickly, spent fewer weeks in depressive episodes over the 2-year period, and had an overall more favourable trajectory of depressive symptoms than those in the enhanced care group.

"To enhance full symptomatic and functional recovery among adolescents, family-focused treatment for adolescents may need to be supplemented with collaborative care interventions found effective in mania stabilisation," the authors said.

The program's emphasis on "reducing conflict in family relationships, enhancing social supports, and teaching interpersonal skills may underlie its stronger effects on bipolar depression."


SOURCE: Archives of General Psychiatry

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