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Evidence Based Treatments for Bipolar Disorder in Children and Adolescents

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Abstract

Limited research has been devoted to developing and testing psychosocial treatments for bipolar disorder (BPD) in children and adolescents, a chronic and impairing mental illness that has received increased attention in recent years. Existing treatments are intended as adjuncts to medication, and share a family-based psychoeducation approach. Components of four treatments are discussed: family-focused treatment (FFT), the RAINBOW Program, multi-family psychoeducation groups (MFPG), and individual family psychoeducation (IFP). Evidence supporting each approach is detailed. Selected components of MFPG are described. A flowchart provides suggestions for sequencing interventions to maximize effectiveness. To illustrate the use of evidence-based treatment for children with BPD, a case example is provided.

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Notes

  1. This child’s name has been changed and other personal details have been masked to protect confidentiality. The authors wish to thank the family for permitting us to share their information.

References

  • Asarnow, J. R., Goldstein, M. J., Tompson, M., & Guthrie, D. (1993). One-year outcomes of depressive disorders in child psychiatric in-patients: Evaluation of the prognostic power of a brief measure of expressed emotion. Journal of Child Psychology and Psychiatry, 34, 129–137.

    Article  PubMed  CAS  Google Scholar 

  • Axelson, D., Birmaher, B. J., Brent, D., Wassick, S., Hoover, C., Bridge, J., et al. (2003). A preliminary study of the kiddie schedule for affective disorders and schizophrenia for school-age children mania rating scale for children and adolescents. Journal of Child and Adolescent Psychopharmacology, 13, 463–470.

    Article  PubMed  Google Scholar 

  • Axelson, D., Birmaher, B., Strober, M., Gill, M. K., Valeri, S., Chiappetta, L., et al. (2006). Phenomenology of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63(10), 1139–1148.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Axelson, D., Strober, M., Gill, M. K., Valeri, S., Chiappetta, L., et al. (2006). Clinical course of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63, 175–183.

    Article  PubMed  Google Scholar 

  • Badner, J. A. (2003). The genetics of bipolar disorder. In B. Geller & M. P. DelBello (Eds.), Bipolar disorder in childhood and early adolescence (pp. 247–254). New York: Guilford Press.

  • Butzlaff, R. L., & Hooley, M. (1998). Expressed emotion and psychiatric relapse. Archives of General Psychiatry, 55, 547–552.

    Article  PubMed  CAS  Google Scholar 

  • Davidson, K. H., & Fristad, M. A. Family psychoeducation for children with bipolar disorder. In B. Geller & M. DelBello (Eds.), Treating child and adolescent bipolar disorder. New York: Guilford Press, (in press).

  • Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.

    Article  PubMed  Google Scholar 

  • Findling, R. L., Gracious, B. L., McNamara, N. K., Youngstrom, E. A., Demeter, C. A., Branicky, L. A., & Calabrese, J. R. (2001). Rapid, continuous cycling and psychiatric comorbidity in pediatric bipolar I disorder. Bipolar Disorders, 3, 202–210.

    PubMed  CAS  Google Scholar 

  • Fristad, M. A. (2006). Psychoeducational treatment for school-aged children with bipolar disorder. Development and Psychopathology, 18, 1289–1306.

    Article  PubMed  Google Scholar 

  • Fristad, M. A., Davidson, K. H., & Leffler, J. M. Thinking-feeling-doing: A therapeutic technique for children with bipolar disorder & their parents. Journal of Family Psychotherapy, (in press).

  • Fristad, M. A., Gavazzi, S. M., & Mackinaw-Koons, B. (2003). Family psychoeducation: An adjunctive intervention for children with bipolar disorder. Biological Psychiatry, 53, 1000–1008.

    Article  PubMed  Google Scholar 

  • Fristad, M. A., Gavazzi, S. M., & Soldano, K. W. (1999). Naming the enemy: Learning to differentiate mood disorder “symptoms” from the “self” that experiences them. Journal of Family Psychotherapy, 10, 81–88.

    Article  Google Scholar 

  • Fristad, M. A., Goldberg-Arnold, J. S., & Gavazzi, S. M. (2002). Multifamily psychoeducation groups (MFPG) for families of children with bipolar disorder. Bipolar Disorders, 4, 254–262.

    Article  PubMed  Google Scholar 

  • Fristad, M. A., Goldberg-Arnold, J. S., & Gavazzi, S. M. (2003). Multi-family psychoeducation groups in the treatment of children with mood disorders. Journal of Marital & Family Therapy, 29, 491–504.

    Article  Google Scholar 

  • Geller, B., Craney, J. L., Bolhofner, K., DelBello, M. P., Axelson, D., & Luby, J. (2003). Phenomenology and longitudinal course of children with a prepubertal and early adolescent bipolar disorder phenotype. In B. Geller & M. P. DelBello (Eds), Bipolar disorder in childhood and early adolescence (pp. 25–50). New York: Guilford Press.

  • Geller, B., Craney, J. L., Bolhofner, K., Nickelsburg, M. J., Williams, M., & Zimerman, B. (2002). Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar disorder phenotype. American Journal of Psychiatry, 159, 927–933.

    Article  PubMed  Google Scholar 

  • Geller, B., & DelBello, M. P. (Eds) (2003). Bipolar disorder in childhood and early adolescence. New York: Guilford Press.

  • Goldberg-Arnold, J. S., & Fristad, M. A. (2003). Psychotherapy for children with bipolar disorder. In B. Geller & M. P. DelBello (Eds.), Bipolar disorder in childhood and early adolescence (pp. 272–294). New York: Guilford Press.

  • Goldberg-Arnold, J. S., Fristad, M. A., & Gavazzi, S. M. (1999). Family psychoeducation: Giving caregivers what they want and need. Family Relations: Interdisciplinary Journal of Applied Family Studies, 48, 411–417.

    Google Scholar 

  • Grave, J., & Blissett, J. (2004). Is cognitive behavior therapy developmentally appropriate for young children? A critical review of the evidence. Clinical Psychology Review, 399–420.

  • Izard, C. (1994). Intersystem connections. In P. Ekman & R. Davidson (Eds.), The nature of emotion: fundamental questions. New York: Oxford University Press.

    Google Scholar 

  • Klaus, N., & Fristad A. (2005). Family psychoeducation as a valuable adjunctive intervention for children with bipolar disorder. Directions in Psychiatry, 25, 217–230.

    Google Scholar 

  • Kowatch, R. A., Fristad, M. A., Birmaher, B., Wagner, K. D., Findling, R. L., Hellander, M., et al. (2005). Treatment guidelines for children and adolescents with bipolar disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 213–235.

    Article  Google Scholar 

  • Leffler, J., Fristad, M., & Walters, K. (2006). Pilot results from individual family psychoeducation (IFP)-24: Adaptation in children with bipolar disorder. Poster presentation at the Kansas Conference in Clinical Child and Adolescent Psychology: Translating Research into Practice, Lawrence, KS, 10/21/06.

  • Lewinsohn, P. M., Klein, J.R., & Seeley, J. R. (1995). Bipolar disorder in a community sample of older adolescents: Prevalence, phenomenology, comorbidity, and course. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 454–463.

    Article  PubMed  CAS  Google Scholar 

  • Lewinsohn, P. M., Seeley, J. R., & Klein, D. N. (2003). Epidemiology and suicidal behavior. In B. Geller & M. P. DelBello (Eds.), Bipolar disorder in childhood and early adolescence (pp. 25–50). New York: Guilford Press.

  • Lofthouse, N., & Fristad, M. (2004). Psychosocial interventions for children with early-onset bipolar spectrum disorder. Clinical Child and Family Psychology Review, 7, 71–88.

    Article  PubMed  Google Scholar 

  • Lukens, E. P., & McFarlane, W. R. (2004). Psychoeducation as evidence-based practice: Considerations for practice, research, and policy. Brief Treatment and Crisis Intervention, 4, 205–225.

    Article  Google Scholar 

  • Malkoff-Schwartz, S., Frank, E., Anderson, B., Sherrill, J. T., Siegel, L., Patterson D., et al. (1998). Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes. Archives of General Psychiatry, 55, 702–707.

    Article  PubMed  CAS  Google Scholar 

  • Miklowitz, D. J., George, E. L., Axelson, D. A., Kim, E. Y., Birmaher, B., Schneck, C., et al. (2004). Family-focused treatment for adolescents with bipolar disorder. Journal of Affective Disorders, 82, S113–S128.

    Article  PubMed  Google Scholar 

  • Miklowitz, D. J., Goldstein, M. J., Nuechterlein, K. H., Snyder, K. S., & Mintz, J. (1988). Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225–231.

    PubMed  CAS  Google Scholar 

  • Pavuluri, M. N., Birmaher, B., & Naylor, M. W. (2005). Pediatric bipolar disorder: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 846–871.

    Article  Google Scholar 

  • Pavuluri, M. N., Graczyk, P. A., Henry, D. B., Carbray, J. A., Heidenreich, J., & Miklowitz, D. J. (2004). Child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: Development and preliminary results. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 528–537.

    Article  Google Scholar 

  • Pollock, K. M. (2001). Exercise in treating depression: Broadening the psychotherapist’s role. Journal of Clinical Psychology, 57, 1289–1300.

    Article  PubMed  CAS  Google Scholar 

  • Weller, E. B., Weller, R. A., Rooney, M. T., & Fristad, M. A. (1999). Children’s interview for psychiatric syndromes (ChIPS). Washington, D.C.: American Psychiatric Association.

    Google Scholar 

  • Youngstrom, E. A., Findling, R. L., Youngstrom, J. K., & Calabrese, J. R. (2005). Toward an evidence-based assessment of pediatric bipolar disorder. Journal of Clinical Child and Adolescent Psychology, 34, 433–448.

    Article  PubMed  Google Scholar 

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Acknowledgment

This paper was supported in part by a grant to the second author from the National Institute of Mental Health (NIMH: 1 RO1 MH61512-01A1).

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Authors and Affiliations

  1. Division of Child and Adolescent Psychiatry, The Ohio State University, 1670 Upham Dr Suite 460G, Columbus, OH, 43210, USA

    Matthew E. Young & Mary A. Fristad

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  1. Matthew E. Young
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  2. Mary A. Fristad
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Correspondence to Mary A. Fristad.

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Young, M.E., Fristad, M.A. Evidence Based Treatments for Bipolar Disorder in Children and Adolescents. J Contemp Psychother 37, 157–164 (2007). https://doi.org/10.1007/s10879-007-9050-4

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