Psychosocial intervention for pediatric bipolar disorder: current and future directions

Weinstein, Sally M.; West, Amy E.; Pavuluri, Mani N.

doi:10.1586/14737175.2013.811985

Cited by 15 publications

(6 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Results are consistent with extant studies involving youth with mood disorders more broadly and adolescents with BD indicating that targeted evidence-based treatment for PBD may optimize outcomes for these families 53 . These results are also consistent with findings from randomized trials of adults with BD, which have found that adaptations of CBT, family-focused therapy (FFT), group psychoeducation, IPSRT, and systematic care management programs can be effective in hastening stabilization, delaying relapses, reducing symptom severity over time, or enhancing psychosocial and family functioning 54 .…”

Section: Discussionsupporting

confidence: 79%

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

West¹,

Weinstein²,

Peters³

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

Objective Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD). The objective of this study was to compare the efficacy of adjunctive Child- and Family-Focused Cognitive Behavioral Therapy (CFF-CBT) to psychotherapy as usual (control) for mood symptom severity and global functioning in children with BD. Method Sixty-nine youth, aged 7–13 (M = 9.19, SD = 1.61) with DSM-IV-TR bipolar I, II, or not otherwise specified (NOS) disorder were randomly assigned to CFF-CBT or control groups. Both treatments consisted of 12 weekly sessions followed by 6 monthly booster sessions delivered over a total of 9 months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (posttreatment), and week 39 (6-month follow-up). Results Participants in CFF-CBT attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared to the control in reducing parent-reported mania at posttreatment and depression symptoms at posttreatment and follow-up. Global functioning did not differ at posttreatment but was higher among CFF-CBT participants at follow-up. Conclusion CFF-CBT may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with BD.

show abstract

Section: Discussionsupporting

confidence: 79%

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

West¹,

Weinstein²,

Peters³

et al. 2014

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

show abstract

“…While pharmacotherapy is often an essential component of the regimen (McClellan et al, 2007; Pavuluri et al, 2004b), psychosocial interventions are also important for teaching families about symptoms and course of PBD and fostering symptom management skills, such as affect regulation, problem solving, and effective communication (Fristad & MacPherson, 2014; Weinstein, West, & Pavuluri, 2013). Currently, approaches that incorporate family-focused psychoeducation and Cognitive-Behavioral Therapy (CBT) have the most empirical support (Fristad & MacPherson, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, MF-PEP helped parents become better mental health consumers and advocates, and access to higher-quality services resulted in children’s decreased symptom severity (Fristad et al, 2009). Although not yet studied, it is also expected that improvements in parenting skills and coping, family functioning, and the home environment would facilitate children’s symptom improvement, as these deficits are associated with PBD in cross-sectional studies (Keenan-Miller et al, 2012; Nader et al, 2013; Schenkel, West, Harral, Patel, & Pavuluri, 2008), predictive of worse course in longitudinal analyses (Geller et al, 2008; Kim et al, 2007; Sullivan, Judd, Axelson, & Miklowitz, 2012), and thus directly targeted in Evidence-Based Treatments (EBTs) for PBD (Fristad & MacPherson, 2014; Weinstein et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

Mediators in the randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy for pediatric bipolar disorder

MacPherson

Weinstein

Henry

et al. 2016

Behaviour Research and Therapy

View full text Add to dashboard Cite

Mediation analyses can identify mechanisms of change in Cognitive-Behavioral Therapy (CBT). However, few studies have analyzed mediators of CBT for youth internalizing disorders; only one trial evaluated treatment mechanisms for youth with mixed mood diagnoses. This study evaluated mediators in the randomized trial of Child- and Family-Focused CBT (CFF-CBT) versus Treatment As Usual (TAU) for pediatric bipolar disorder (PBD), adjunctive to pharmacotherapy. Sixty-nine children ages 7-13 with PBD were randomly assigned to CFF-CBT or TAU. Primary outcomes (child mood, functioning) and candidate mediators (family functioning, parent/child coping) were assessed at baseline and 4-, 8-, 12- (post-treatment), and 39-weeks (follow-up). Compared with TAU, children receiving CFF-CBT exhibited greater improvement in mania, depression, and global functioning. Several parent and family factors significantly improved in response to CFF-CBT versus TAU, and were associated with the CFF-CBT treatment effect. Specifically, parenting skills and coping, family flexibility, and family positive reframing showed promise as mediators of child mood symptoms and global functioning. Main or mediating effects for youth coping were not significant. CFF-CBT may impact children’s mood and functioning by improving parenting skills and coping, family flexibility, and family positive reframing. Findings highlight the importance of parent coping and family functioning in the treatment of PBD.

show abstract

“…Few treatment options have proven to be effective for treating the depressive phase of bipolar disorder in children and adolescents. In addition to pharmacotherapy, it is important to consider the use of promising psychosocial interventions such as child- and family-focused cognitive behavioral therapy, dialectical behavioral therapy, interpersonal and social rhythm therapy, multifamily psychoeducation group psychotherapy, and family-focused treatment [ 46 ]. Psychosocial interventions have yielded positive results in combination with pharmacotherapy and may enhance or help maintain improvements in QoL.…”

Section: Discussionmentioning

confidence: 99%

Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination

Walker

DelBello

Landry

et al. 2017

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

BackgroundWe examined the efficacy of olanzapine/fluoxetine combination (OFC) in improving health-related quality of life (QoL) in the treatment of bipolar depression in children and adolescents.MethodsPatients aged 10–17 years with bipolar I disorder, depressed episode, baseline children’s depression rating scale-revised (CDRS-R) total score ≥40, Young Mania Rating Scale (YMRS) total score ≤15, and YMRS-item 1 ≤ 2 were randomized to OFC (6/25–12/50 mg/day olanzapine/fluoxetine; n = 170) or placebo (n = 85) for up to 8 weeks of double-blind treatment. Patients and parents completed the revised KINDL questionnaire for measuring health-related QoL in children and adolescents (KINDL-R) at baseline and endpoint. The mean change in CDRS-R total and item scores were used to compare improvement in symptomatology in patients taking OFC and placebo. Tests were 2-sided using a Type I error cutoff of 0.05, and no adjustments for multiple comparisons were made.ResultsBaseline QoL as measured by the KINDL-R was substantially impaired relative to published norms for a healthy school-based sample. OFC-treated patients demonstrated an improvement over placebo at endpoint with respect to mean change from baseline in the patient-rated KINDL-R Self-esteem subscale score (p = 0.028), and in the parent KINDL-R ratings of emotional well-being (p = 0.020), Self-esteem (p = 0.030), and Family (p = 0.006). At endpoint, OFC-treated patients still had a lower QoL compared to the normative population. OFC showed significant improvement (p ≤ 0.05) versus placebo on the CDRS-R total score and on 7 of the 17 CDRS-R items.ConclusionsPatients aged 10–17 years with an acute episode of bipolar depression and their parents reported greater improvements (parents noticed improvements in more areas than did their offspring) on some aspects of QoL when treated with OFC compared with placebo. However, after 8 weeks of treatment, KINDL-R endpoint scores remained lower than those of the, presumably healthy, control population. Clinical trial registration information A Study for Assessing Treatment of Patients Ages 10–17 with Bipolar Depression; http://www.clinicaltrials.gov; NCT00844857

show abstract

Psychosocial intervention for pediatric bipolar disorder: current and future directions

Cited by 15 publications

References 57 publications

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial

Mediators in the randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy for pediatric bipolar disorder

Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination

Contact Info

Product

Resources

About