Effects of family-focused therapy on suicidal ideation and behavior in youth at high risk for bipolar disorder
Autor: | John Merranko, David J. Miklowitz, Manpreet K. Singh, Marc J. Weintraub, Kiki D. Chang, Patricia D. Walshaw, Christopher D. Schneck |
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Rok vydání: | 2020 |
Předmět: |
Bipolar Disorder
Family Conflict medicine.medical_treatment Suicidality Medical and Health Sciences law.invention 0302 clinical medicine Randomized controlled trial law Child Suicidal ideation Pediatric Psychiatry Depression Serious Mental Illness Justice and Strong Institutions Expressed Emotion Suicide Psychiatry and Mental health Clinical Psychology Mental Health Treatment Outcome Major depressive disorder Family Therapy Female medicine.symptom Psychosocial Clinical psychology Adolescent Article Suicidal Ideation 03 medical and health sciences Clinical Research Behavioral and Social Science medicine Psychoeducation Humans Expressed emotion Bipolar disorder Depressive Disorder Peace Depressive Disorder Major business.industry Prevention Psychology and Cognitive Sciences Major medicine.disease Brain Disorders 030227 psychiatry Psychotherapy Mood business 030217 neurology & neurosurgery |
Zdroj: | J Affect Disord |
ISSN: | 0165-0327 |
Popis: | Background Youth who are at clinical and familial risk for bipolar disorder (BD) often have significant suicidal ideation (SI). In a randomized trial, we examined whether family-focused therapy (FFT) is associated with reductions in SI and suicidal behaviors in high-risk youth. Methods Participants (ages 9–17 years) met diagnostic criteria for unspecified BD or major depressive disorder with active mood symptoms and had at least one relative with BD type I or II. Participants were randomly allocated to 12 sessions in 4 months of FFT or 6 sessions in 4 months of psychoeducation (enhanced care, EC), with pharmacotherapy as needed. Clinician- and child-rated assessments of mood, suicidal thoughts and behaviors, and family conflict were obtained at baseline and 4-6 month intervals over 1-4 years. Results Participants (N=127; mean 13.2±2.6 yrs., 82 female) were followed over an average of 105.9±64.0 weeks. Youth with high baseline levels of SI who received FFT had lower levels of (and fewer weeks with) SI at follow-up compared to youth with high baseline SI who received EC. Participants in FFT had longer intervals without suicidal behaviors than participants in EC. Youths’ ratings of family conflict significantly mediated the effects of treatment on SI at follow-up. Limitations Family conflict was based on questionnaires rather than observer ratings of family interactions. Conclusions Family psychoeducation with skill training can be an effective deterrent to suicidal thoughts and behaviors in youth at high risk for BD. Reducing parent/offspring conflict should be a central objective of psychosocial interventions for high-risk youth with SI. |
Databáze: | OpenAIRE |
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