Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy

Background: Few studies have examined the combined effects of psychosocial treatment and pharmacotherapy for bipolar disorder This study used a random ized controlled design to examine a 9-month, manual-based program of family -focused psychoeducational treatment (FFT). Methods: Bipolar patients (N = 101) were recruited shortly after an illness episode and randomly assigned to 21 sessions of FFT(n = 31) or to a compar ison treatment involving two family education sessions and follow-up crisis management (CM; n = 70). Both treatments were delivered over 9 months; pat ients were simultaneously maintained on mood stabilizing medications. Patie nts were evaluated every 3 months for I year as to relapse status, symptom severity, and medication compliance. Results: Patients assigned to FFT had fewer relapses and longer delays befo re relapses during the study year than did patients in CM. Patients in FFT also showed greater improvements in depressive (but not manic) symptoms. Th e most dramatic improvements were among FFT patients whose families were hi gh in expressed emotion. The efficacy of FFT could not be explained by diff erences among patients in medication regimes or compliance. Conclusions: Family-focused psychoeducational treatment appears to be an ef ficacious adjunct to pharmacotherapy for bipolar disorder. Future studies s hould evaluate family treatment against other forms of psychotherapy matche d in amount of therapist-patient contact. (C) 2000 Society of Biological Ps ychiatry.