Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy
Objective: Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in...
| Autori principali: | , , , , , , , , , |
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| Natura: | Journal article |
| Lingua: | English |
| Pubblicazione: |
2013
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| _version_ | 1826272307935444992 |
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| author | Miklowitz, D Schneck, C Singh, M Taylor, DO George, E Cosgrove, V Howe, M Dickinson, L Garber, J Chang, K |
| author_facet | Miklowitz, D Schneck, C Singh, M Taylor, DO George, E Cosgrove, V Howe, M Dickinson, L Garber, J Chang, K |
| author_sort | Miklowitz, D |
| collection | OXFORD |
| description | Objective: Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in youth at high familial risk for BD, and explored its comparative benefits among youth in families with high versus low expressed emotion (EE). Method: Participants were 40 youth (mean 12.3±2.8 years, range 9-17) with BD not otherwise specified, major depressive disorder, or cyclothymic disorder who had a first-degree relative with BD I or II and active mood symptoms (Young Mania Rating Scale [YMRS]>11 or Child Depression Rating Scale>29). Participants were randomly allocated to FFT-High Risk version (FFT-HR; 12 sessions of psychoeducation and training in communication and problem-solving skills) or an education control (EC; 1-2 family sessions). Results: Youth in FFT-HR had more rapid recovery from their initial mood symptoms (hazard ratio = 2.69, p =.047), more weeks in remission, and a more favorable trajectory of YMRS scores over 1 year than youth in EC. The magnitude of treatment effect was greater among youth in high-EE (versus low-EE) families. Conclusions: FFT-HR may hasten and help sustain recovery from mood symptoms among youth at high risk for BD. Longer follow-up will be necessary to determine whether early family intervention has downstream effects that contribute to the delay or prevention of full manic episodes in vulnerable youth. Clinical trial registration information - Early Family-Focused Treatment for Youth at Risk for Bipolar Disorder; http://www.clinicaltrials.gov/; NCT00943085. © 2013 American Academy of Child and Adolescent Psychiatry. |
| first_indexed | 2024-03-06T22:10:29Z |
| format | Journal article |
| id | oxford-uuid:51a12bcc-6f56-4974-a2a3-9f7a916f32e8 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:10:29Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:51a12bcc-6f56-4974-a2a3-9f7a916f32e82022-03-26T16:20:48ZEarly intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:51a12bcc-6f56-4974-a2a3-9f7a916f32e8EnglishSymplectic Elements at Oxford2013Miklowitz, DSchneck, CSingh, MTaylor, DOGeorge, ECosgrove, VHowe, MDickinson, LGarber, JChang, KObjective: Depression and brief periods of (hypo)mania are linked to an increased risk of progression to bipolar I or II disorder (BD) in children of bipolar parents. This randomized trial examined the effects of a 4-month family-focused therapy (FFT) program on the 1-year course of mood symptoms in youth at high familial risk for BD, and explored its comparative benefits among youth in families with high versus low expressed emotion (EE). Method: Participants were 40 youth (mean 12.3±2.8 years, range 9-17) with BD not otherwise specified, major depressive disorder, or cyclothymic disorder who had a first-degree relative with BD I or II and active mood symptoms (Young Mania Rating Scale [YMRS]>11 or Child Depression Rating Scale>29). Participants were randomly allocated to FFT-High Risk version (FFT-HR; 12 sessions of psychoeducation and training in communication and problem-solving skills) or an education control (EC; 1-2 family sessions). Results: Youth in FFT-HR had more rapid recovery from their initial mood symptoms (hazard ratio = 2.69, p =.047), more weeks in remission, and a more favorable trajectory of YMRS scores over 1 year than youth in EC. The magnitude of treatment effect was greater among youth in high-EE (versus low-EE) families. Conclusions: FFT-HR may hasten and help sustain recovery from mood symptoms among youth at high risk for BD. Longer follow-up will be necessary to determine whether early family intervention has downstream effects that contribute to the delay or prevention of full manic episodes in vulnerable youth. Clinical trial registration information - Early Family-Focused Treatment for Youth at Risk for Bipolar Disorder; http://www.clinicaltrials.gov/; NCT00943085. © 2013 American Academy of Child and Adolescent Psychiatry. |
| spellingShingle | Miklowitz, D Schneck, C Singh, M Taylor, DO George, E Cosgrove, V Howe, M Dickinson, L Garber, J Chang, K Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title | Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title_full | Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title_fullStr | Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title_full_unstemmed | Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title_short | Early intervention for symptomatic youth at risk for bipolar disorder: A randomized trial of family-focused therapy |
| title_sort | early intervention for symptomatic youth at risk for bipolar disorder a randomized trial of family focused therapy |
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