Pharmacotherapy and family-focused treatment for adolescents with bipolar I and II disorders: a 2-year randomized trial.
|Title||Pharmacotherapy and family-focused treatment for adolescents with bipolar I and II disorders: a 2-year randomized trial.|
|Publication Type||Journal Article|
|Year of Publication||2014|
|Authors||Miklowitz DJ, Schneck CD, George EL, Taylor DO, Sugar CA, Birmaher B, Kowatch RA, DelBello MP, Axelson DA|
|Journal||Am J Psychiatry|
|Date Published||2014 Jun|
|Keywords||Adolescent, Antipsychotic Agents, Bipolar Disorder, Family Therapy, Female, Humans, Male, Psychiatric Status Rating Scales, Psychotherapy, Brief, Time Factors, Treatment Outcome|
OBJECTIVE: Previous studies have found that family-focused treatment is an effective adjunct to pharmacotherapy in stabilizing symptoms in adult bipolar disorder. The authors examined whether pharmacotherapy and family-focused treatment for adolescents with bipolar disorder was more effective than pharmacotherapy and brief psychoeducation (enhanced care) in decreasing time to recovery from a mood episode, increasing time to recurrence, and reducing symptom severity over 2 years.
METHOD: A total of 145 adolescents (mean age, 15.6 years) with bipolar I or II disorder and a DSM-IV-TR manic, hypomanic, depressive, or mixed episode in the previous 3 months were randomly assigned, with family members, either to pharmacotherapy and family-focused treatment, consisting of psychoeducation (i.e., recognition and early intervention with prodromal symptoms), communication enhancement training, and problem-solving skills training, delivered in 21 sessions over 9 months; or to pharmacotherapy and three weekly sessions of enhanced care (family psychoeducation). Independent evaluators assessed participants at baseline, every 3 months during year 1, and every 6 months during year 2, using weekly ratings of mood.
RESULTS: Twenty-two participants (15.2%) withdrew shortly after randomization. Time to recovery or recurrence and proportion of weeks ill did not differ between the two treatment groups. Secondary analyses revealed that participants in family-focused treatment had less severe manic symptoms during year 2 than did those in enhanced care.
CONCLUSIONS: After an illness episode, intensive psychotherapy combined with best-practice pharmacotherapy does not appear to confer advantages over brief psychotherapy and pharmacotherapy in hastening recovery or delaying recurrence among adolescents with bipolar disorder.
|Alternate Journal||Am J Psychiatry|
|PubMed Central ID||PMC4083000|
|Grant List||R01 MH073871 / MH / NIMH NIH HHS / United States |
R01 MH073871 / MH / NIMH NIH HHS / United States
R01 MH093676 / MH / NIMH NIH HHS / United States
R01MH073817 / MH / NIMH NIH HHS / United States
R01MH074033 / MH / NIMH NIH HHS / United States
R21 MH097007 / MH / NIMH NIH HHS / United States
R33 MH097007 / MH / NIMH NIH HHS / United States
R34MH077856 / MH / NIMH NIH HHS / United States