Child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: a randomized clinical trial

J Am Acad Child Adolesc Psychiatry. 2014 Nov;53(11):1168-78, 1178.e1. doi: 10.1016/j.jaac.2014.08.013. Epub 2014 Sep 8.

Abstract

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 to 13 years (mean = 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 treatment 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.

Keywords: cognitive-behavioral therapy; family-focused intervention; pediatric bipolar disorder; randomized clinical trial.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Bipolar Disorder / therapy*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy
  • Family Therapy / methods*
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Psychotropic Drugs / therapeutic use
  • Social Adjustment

Substances

  • Psychotropic Drugs