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Early intervention for youth at high risk for bipolar disorder: A multisite randomized trial of family-focused treatment.
Miklowitz, David J; Schneck, Christopher D; Walshaw, Patricia D; Garrett, Amy S; Singh, Manpreet K; Sugar, Catherine A; Chang, Kiki D.
Afiliación
  • Miklowitz DJ; Los Angeles (UCLA) Semel Institute, University of California, Los Angeles, California.
  • Schneck CD; Department of Psychiatry, University of Colorado Denver School of Medicine, Aurora, Colorado.
  • Walshaw PD; Los Angeles (UCLA) Semel Institute, University of California, Los Angeles, California.
  • Garrett AS; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
  • Singh MK; Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas.
  • Sugar CA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
  • Chang KD; Los Angeles (UCLA) Semel Institute, University of California, Los Angeles, California.
Early Interv Psychiatry ; 13(2): 208-216, 2019 Apr.
Article en En | MEDLINE | ID: mdl-28776930
AIMS: Despite the considerable public health impact of bipolar disorder (BD), no psychosocial interventions have been systematically evaluated in its early prodromal stages. We describe the rationale, design and analytic methods for a 3-site randomized trial of family-focused treatment for youth at high risk (FFT-HR) for BD. METHODS: Participants (ages 9-17 years) have a diagnosis of unspecified BD or major depressive disorder, current mood symptoms and at least one first- or second-degree relative with a lifetime history of BD I or II. Participants are randomly assigned to FFT-HR (12 sessions in 4 months of family psychoeducation and skills training) or enhanced care (EC; 6 individual and family sessions over 4 months), with pharmacotherapy provided as needed. A subset of participants undergo pre- and post-treatment functional MRI (fMRI) scans while performing face-rating and family problem-solving tasks designed to activate corticolimbic circuitry. Independent evaluators assess participants' status every 4 to 6 months for up to 4 years. RESULTS: We hypothesize that FFT-HR will be more effective than EC in reducing the severity of mood symptoms (primary outcome) and the hazard of a first manic episode (secondary) over 4 years. Secondarily, we will explore whether FFT-HR is associated with greater decreases in amygdala activation and increases in dorsolateral, ventrolateral or anterior medial prefrontal cortex activation from pre- to post-treatment. Clinical characteristics of 133 subjects enrolled at baseline are described. CONCLUSIONS: This study will test a novel intervention to reduce the early symptoms of BD, and identify neural and behavioural mechanisms that may help refine future treatments.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Bipolar / Trastorno Depresivo Mayor / Terapia Familiar Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Early Interv Psychiatry Asunto de la revista: PSIQUIATRIA Año: 2019 Tipo del documento: Article Pais de publicación: Australia
Texto completo
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Imprimir
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Bipolar / Trastorno Depresivo Mayor / Terapia Familiar Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Early Interv Psychiatry Asunto de la revista: PSIQUIATRIA Año: 2019 Tipo del documento: Article Pais de publicación: Australia