A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder

Bibliographic Data

ID21319815
AuthorsLisa O’Donnell (0000-0001-6649-2894, School of Social Work Wayne State University Detroit MI, corresponding author), Marc J Weintraub (0000-0001-8724-120X, Department of Psychiatry Semel Institute University of California, Los Angeles Los Angeles CA), Alissa J Ellis (Department of Psychiatry Semel Institute University of California, Los Angeles Los Angeles CA), David Axelson (0000-0002-1348-0707, The Ohio State University), David A Axelson (The Ohio State University College of Medicine Columbus OH), Robert A Kowatch (0000-0002-9584-2256, The Ohio State University College of Medicine Columbus OH), Christopher D Schneck (0000-0002-7422-4707, Department of Psychiatry University of Colorado School of Medicine Aurora CO), David J Miklowitz (0000-0002-9647-6147, Department of Psychiatry Semel Institute University of California, Los Angeles Los Angeles CA)
Year2020
Volume59
Issue2
Pages376-389
Publication date2020-06-01
Open AccessYes
TypeARTICLE
VenueFamily Process (JOURNAL)
Journal identifiersISSN: 0014-7370 • E-ISSN: 1545-5300
PublisherWiley (PUBLISHER • GB)
DOI10.1111/famp.12521
PMID32012257
OpenAlexW3004455759
LanguageEN
Citations received1
References cited24

Impairments in family functioning are associated with more severe depressive and manic symptoms, earlier recurrences, and more suicidal behaviors in early‐onset bipolar disorder. This study examined whether family‐focused treatment for adolescents (FFT‐A) with BD I or II disorder led to greater increases in family cohesion and adaptability and decreases in conflict over 2 years compared to a briefer psychoeducational treatment (enhanced care, EC). Participants were 144 adolescents (mean age: 15.6 ± 1.4 years) with BD I or II with a mood episode in the previous 3 months. Adolescents and parents were randomized to either FFT‐A (21 sessions) or EC (three sessions). Patients received guideline‐based pharmacotherapy throughout the 2‐year study. Trajectories of adolescent‐ and parent‐rated family cohesion, adaptability, and conflict were analyzed over 2 years. FFT‐A had greater effects on adolescent‐rated family cohesion compared to EC over 2 years. Participants in FFT‐A and EC reported similar improvements in family conflict across the 2 years. In the FFT‐A group, low‐conflict families had greater adolescent‐rated family cohesion throughout the study compared to high‐conflict families. High‐conflict families in both treatment groups tended to show larger reductions in conflict over 2 years than low‐conflict families. Family psychoeducation and skills training may improve family cohesion in the early stages of BD. Measuring levels of family conflict at the start of treatment may inform treatment responsiveness among those receiving FFT‐A

Bipolar disorder · Developmental psychology · Family conflict · Family therapy · Mood · Psychiatry · Psychoeducation · Psychological intervention · Psychosocial · Adolescent and Pediatric Healthcare · Bipolar Disorder and Treatment · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Psychology