Family-Focused Therapy May Benefit Bipolar Adolescents

KOLOA, HAWAII – Two studies show encouraging results for the effectiveness of including family-focused therapy in the treatment of adolescents with bipolar disorder.

Although patients must be “stabilized and treated with the appropriate medication, clearly with bipolar adolescents I think that there's a huge need for the family to be there and be involved in the therapy,” said W. Edward Craighead, Ph.D., the J. Rex Fuqua chair in child psychiatry at Emory University, Atlanta.

Speaking at a premeeting session of the annual meeting of the American College of Psychiatrists, Dr. Craighead referred first to a preliminary open study of 20 bipolar adolescent patients that he and his colleagues conducted over the course of 12 months (J. Affect. Disord. 2004;82:S113-28).

In the study, combined treatment with family-focused therapy (FFT) and medication was associated with much improved ratings by parents on the Child Behavior Checklist and reductions in the Schedule for Affective Disorders and Schizophrenia for School-Age Children depression and mania scores.

In bipolar patients, “medications are much better at reducing and managing the mania, but are not as good with the depression side,” Dr. Craighead observed, adding that “what's encouraging about [FFT] is that the effect is primarily on the depressive side.”

The second study of bipolar adolescents, in which Dr. Craighead is also an investigator, is currently under review by a journal. This two-site study compared the effectiveness of FFT plus medication versus crisis-management intervention plus medication. “There was a significantly larger effect for FFT,” he said, “and the primary effect was on fewer depressive symptoms over 2 years.”

The results of this new study in adolescents support the findings of earlier trials that examined the effectiveness of FFT in bipolar adults. He described one such study–a randomized trial of 101 adults in which FFT with pharmacotherapy showed significant benefits over crisis management with pharmacotherapy in reducing symptoms of mood disorder (Arch. Gen. Psychiatry 2003;60:904-12).

Family-focused therapy, Dr. Craighead noted, involves 21 outpatient sessions in which patients and their families receive psychoeducation about bipolar disorder, communication enhancement training, and problem-solving skills training.

The treatment, developed by David Miklowitz, Ph.D., and the late Michael Goldstein, Ph.D., is described in their book “Bipolar Disorder: A Family-Focused Treatment Approach” (New York: The Guilford Press, 1997). Dr. Miklowitz's new edition of the book was published in April.

Dr. Craighead holds stock in, consults with, or has contractual arrangements with Forest Laboratories, NovaDel Pharma, and John Wiley & Sons. He also disclosed that he had received an honorarium from Forest Laboratories.

KOLOA, HAWAII – Two studies show encouraging results for the effectiveness of including family-focused therapy in the treatment of adolescents with bipolar disorder.

Although patients must be “stabilized and treated with the appropriate medication, clearly with bipolar adolescents I think that there's a huge need for the family to be there and be involved in the therapy,” said W. Edward Craighead, Ph.D., the J. Rex Fuqua chair in child psychiatry at Emory University, Atlanta.

Speaking at a premeeting session of the annual meeting of the American College of Psychiatrists, Dr. Craighead referred first to a preliminary open study of 20 bipolar adolescent patients that he and his colleagues conducted over the course of 12 months (J. Affect. Disord. 2004;82:S113-28).

In the study, combined treatment with family-focused therapy (FFT) and medication was associated with much improved ratings by parents on the Child Behavior Checklist and reductions in the Schedule for Affective Disorders and Schizophrenia for School-Age Children depression and mania scores.

In bipolar patients, “medications are much better at reducing and managing the mania, but are not as good with the depression side,” Dr. Craighead observed, adding that “what's encouraging about [FFT] is that the effect is primarily on the depressive side.”

The second study of bipolar adolescents, in which Dr. Craighead is also an investigator, is currently under review by a journal. This two-site study compared the effectiveness of FFT plus medication versus crisis-management intervention plus medication. “There was a significantly larger effect for FFT,” he said, “and the primary effect was on fewer depressive symptoms over 2 years.”

The results of this new study in adolescents support the findings of earlier trials that examined the effectiveness of FFT in bipolar adults. He described one such study–a randomized trial of 101 adults in which FFT with pharmacotherapy showed significant benefits over crisis management with pharmacotherapy in reducing symptoms of mood disorder (Arch. Gen. Psychiatry 2003;60:904-12).

Family-focused therapy, Dr. Craighead noted, involves 21 outpatient sessions in which patients and their families receive psychoeducation about bipolar disorder, communication enhancement training, and problem-solving skills training.

The treatment, developed by David Miklowitz, Ph.D., and the late Michael Goldstein, Ph.D., is described in their book “Bipolar Disorder: A Family-Focused Treatment Approach” (New York: The Guilford Press, 1997). Dr. Miklowitz's new edition of the book was published in April.

Dr. Craighead holds stock in, consults with, or has contractual arrangements with Forest Laboratories, NovaDel Pharma, and John Wiley & Sons. He also disclosed that he had received an honorarium from Forest Laboratories.

KOLOA, HAWAII – Two studies show encouraging results for the effectiveness of including family-focused therapy in the treatment of adolescents with bipolar disorder.

Although patients must be “stabilized and treated with the appropriate medication, clearly with bipolar adolescents I think that there's a huge need for the family to be there and be involved in the therapy,” said W. Edward Craighead, Ph.D., the J. Rex Fuqua chair in child psychiatry at Emory University, Atlanta.

Speaking at a premeeting session of the annual meeting of the American College of Psychiatrists, Dr. Craighead referred first to a preliminary open study of 20 bipolar adolescent patients that he and his colleagues conducted over the course of 12 months (J. Affect. Disord. 2004;82:S113-28).

In the study, combined treatment with family-focused therapy (FFT) and medication was associated with much improved ratings by parents on the Child Behavior Checklist and reductions in the Schedule for Affective Disorders and Schizophrenia for School-Age Children depression and mania scores.

In bipolar patients, “medications are much better at reducing and managing the mania, but are not as good with the depression side,” Dr. Craighead observed, adding that “what's encouraging about [FFT] is that the effect is primarily on the depressive side.”

The second study of bipolar adolescents, in which Dr. Craighead is also an investigator, is currently under review by a journal. This two-site study compared the effectiveness of FFT plus medication versus crisis-management intervention plus medication. “There was a significantly larger effect for FFT,” he said, “and the primary effect was on fewer depressive symptoms over 2 years.”

The results of this new study in adolescents support the findings of earlier trials that examined the effectiveness of FFT in bipolar adults. He described one such study–a randomized trial of 101 adults in which FFT with pharmacotherapy showed significant benefits over crisis management with pharmacotherapy in reducing symptoms of mood disorder (Arch. Gen. Psychiatry 2003;60:904-12).

Family-focused therapy, Dr. Craighead noted, involves 21 outpatient sessions in which patients and their families receive psychoeducation about bipolar disorder, communication enhancement training, and problem-solving skills training.

The treatment, developed by David Miklowitz, Ph.D., and the late Michael Goldstein, Ph.D., is described in their book “Bipolar Disorder: A Family-Focused Treatment Approach” (New York: The Guilford Press, 1997). Dr. Miklowitz's new edition of the book was published in April.

Dr. Craighead holds stock in, consults with, or has contractual arrangements with Forest Laboratories, NovaDel Pharma, and John Wiley & Sons. He also disclosed that he had received an honorarium from Forest Laboratories.