Dj. Miklowitz et al., Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy, BIOL PSYCHI, 48(6), 2000, pp. 582-592
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.