Abstract
Background: Few studies have examined the combined effects of psychosocial treatment
and pharmacotherapy for bipolar disorder. This study used a randomized, 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 comparison treatment involving two family education sessions and follow-up
crisis management (CM; n = 70). Both treatments were delivered over 9 months; patients were simultaneously
maintained on mood stabilizing medications. Patients were evaluated every 3 months
for 1 year as to relapse status, symptom severity, and medication compliance.
Results: Patients assigned to FFT had fewer relapses and longer delays before relapses
during the study year than did patients in CM. Patients in FFT also showed greater
improvements in depressive (but not manic) symptoms. The most dramatic improvements
were among FFT patients whose families were high in expressed emotion. The efficacy
of FFT could not be explained by differences among patients in medication regimes
or compliance.
Conclusions: Family-focused psychoeducational treatment appears to be an efficacious
adjunct to pharmacotherapy for bipolar disorder. Future studies should evaluate family
treatment against other forms of psychotherapy matched in amount of therapist–patient
contact.
Keywords
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Article info
Publication history
Accepted:
May 17,
2000
Received in revised form:
May 12,
2000
Received:
January 13,
2000
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
