Family-Focused Therapy Helps Bipolar Patients
Cope
Sept. 13, 2003
When patients with bipolar
disorder and their families participate in an intensive
family-focused therapy
program, the patients have less severe mood swings, are able to function
better, and can even avoid being hospitalized.
Bipolar disorder, also called manic-depressive illness, is
a psychiatric condition marked by extreme mood swings that impair a person's
ability to function.
"It's not just having highs and lows," says Dr. David J.
Miklowitz, a psychiatrist at the University of Colorado, Boulder. Because of
episodic shifts from euphoria and excessive energy to severe depression and
hopelessness, bipolar patients often have difficulty holding down a job and
maintaining healthy relationships. Medications such as lithium and Depakote are
usually used in its treatment.
Miklowitz and his colleagues found that involving the family in therapy
"boosts" the effectiveness of patients' treatment by helping them
stay on the medication, improving their communication skills, and learning new
techniques for solving problems.
In family therapy groups, "it's critical that patients be involved and
learn about the disorder and how to cope with it," Miklowitz emphasized.
His group's studied 101 patients and their families who participated either
in a typical-treatment group with two 1-hour sessions and emergency sessions
when needed, or in family-focused therapy with 21 one-hour sessions in
patients' homes.
As they report in the Archives of General Psychiatry, 54 percent of
patients in the typical treatment group had a relapse, often requiring
hospitalization, over a two-year period.
In the family-focused treatment group, substantially fewer patients -- 35
percent -- had relapses. They also had fewer problems with mood swings, extreme
depression and mania.
The physicians also found that patients in the family-focused treatment
group took all their medication more of the time than those in the control
group.
"Families should request psychological treatment as well as
medications" for bipolar disorder, Miklowitz said. "They may need to
look for therapists or support groups on their own, if their physician can't
recommend one."
"The National Alliance for the Mentally Ill and the Depressive and
Bipolar Support Alliance are both great support for families members," he
added. "If families can't get the therapy they want, they can at least
talk with other people who are going through the same things as they are."
His group is currently involved in a similar trial involving adolescent
patients with bipolar disorder. "These kids are often very sick, with
frequent cycling and trouble staying in school," Miklowitz said.
"They often have (other) conditions, such as attention deficit disorder or
anxiety, and they're at high risk for suicide. So we want to see if we can
extend our results to a younger age cohort."
SOURCE: Archives of General Psychiatry for September, 2003.
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