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Family therapy helps relieve depression symptoms in bipolar teens
September 02, 2008Family-focused therapy, when combined with medication, appears effective in stabilizing symptoms of depression among teens with bipolar disorder, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Between one-half and two-thirds of patients with bipolar disorder develop the condition before age 18, according to background information in the article. "Early onset of illness is associated with an unremitting course of illness, frequent switches of polarity, mixed episodes, psychosis, a high risk of suicide and poor functioning or quality of life," the authors write. "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. There has been comparatively little controlled examination of psychotherapy for pediatric patients."
David J. Miklowitz, Ph.D., of the University of Colorado, Boulder, and colleagues conducted an outpatient randomized controlled trial among 58 adolescents (average age 14.5) with bipolar disorder who had experienced a mood episode in the prior three months. Between 2002 and 2005, 30 teens were randomly assigned to receive pharmacotherapy plus family-focused treatment for adolescents. Over nine months, they participated in 21 50-minute sessions. 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 three 50-minute family sessions that focused on preventing relapse. Independent evaluators, who did not know patient group assignments, assessed the teens every three to six months for two years.
A total of 60 percent of the family-focused therapy group and 64.3 percent of the enhanced care group completed the two-year follow-up; of those, 53 (91.4 percent) experienced a full recovery from their original mood episode. There were no differences between the two 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 two-year period and had an overall more favorable 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 stabilization," the authors conclude. 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."
JAMA and Archives Journals
The other 28 teens were assigned to pharmacotherapy plus enhanced care, which involved three 50-minute family sessions that focused on preventing relapse. Independent evaluators, who did not know patient group assignments, assessed the teens every three to six months for two years.
A total of 60 percent of the family-focused therapy group and 64.3 percent of the enhanced care group completed the two-year follow-up; of those, 53 (91.4 percent) experienced a full recovery from their original mood episode. There were no differences between the two 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 two-year period and had an overall more favorable 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 stabilization," the authors conclude. 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."
JAMA and Archives Journals
Young adolescent girls' depression is tied to more stressful life events
Children's conduct problems—skipping school, sneaking out of the house, lying to parents, shoplifting, or bullying other children—are a major source of concern for parents and teachers.
Parents' genes, not parents' arguing, may cause children's conduct problems
Children's conduct problems—skipping school, sneaking out of the house, lying to parents, shoplifting, or bullying other children—are a major source of concern for parents and teachers.
Are You Tired Of Adjusting To Your Environment? A New Psychotherapeutic Approach Will Teach You How To Change It
Three Imperial College researchers in London (Peter Tyrer, Tom Sensky and Sarah Mitchard describe a new psychotherapeutic technique in the Nov-Dec 2003 issue of Psychotherapy and Psychosomatics. The principles of a psychological intervention for psychiatric disorders, nidotherapy, are described following its use in the treatment of patients with severe mental illness, most of whom also have personality disorders. Nidotherapy is the collaborative systematic assessment and modification of the environment to minimise the impact of any form of mental disorder on the individual or on society. It is particularly appropriate to consider for chronic and recurring disorders in which there is no pros
Family therapy helps get young ME sufferers back to school
Family therapy seems to help get young sufferers of chronic fatigue syndrome (ME) back to school, suggests research in the Archives of Disease in Childhood. ME is characterised by physical and mental fatigue. In children, symptoms include muscle pain, headache, sore throat and sleepiness. And specialist treatment often requires long periods away from school and leisure activities, and jeopardises friendships. Twenty three people with chronic fatigue syndrome, only three of whom were boys, were enrolled in a programme of cognitive behaviour therapy (CBT) with their families. Their average age was 15. Most of the sufferers had had symptoms for around two years, and most attributed the start o
Lesbians, gay men and family life
The view that lesbians and gay men pose a threat to the traditional family is challenged in a symposium held today, Tuesday 15 December, at The British Psychological Society's London Conference, held at the Institute of Education.
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