Mood disorders are heavily influenced by not only genetic factors, but also family history and other environmental influences. The patterns of mood regulation that are learned in a family can have an impact on how a child or adolescent processes the emotions they experience. A recent study conducted by UCLA and Stanford researchers provides evidence that involving the family in the treatment of an individual with a mood disorder may lead to better outcomes. The researchers, led by David J. Miklowitz, Ph.D., of the UCLA School of Medicine and Kiki D. Chang, M.D., of the Stanford University School of Medicine, found that children as well as adolescents who have sub-threshold forms of bipolar disorder or depression had better outcomes when family focused treatment was provided. Each of the participants had a minimum of one relative who had been diagnosed with bipolar disorder. The study compared the effects of a 12-week therapy treatment with a shorter education-based treatment among 40 children and adolescents with an average age of 12 years. The participants were recruited through the two universities. The participants were diagnosed with major depressive disorder, bipolar disorder that was not otherwise specified (indicating brief but recurring periods of mania) or cyclothmic disorder and also had at least one first-degree relative with bipolar disorder. The participants assigned randomly were able to receive family focused therapy, which consisted of 12 family therapy sessions over a four-month period of learning skills pertaining to communication, problem-solving and strategies for regulating mood swings. The other participants were given one or two informational sessions that included their family members. Those who received the 12 weeks of therapy recovered from depressive symptoms in a nine-week period, on average, compared with a 21-week recovery in the shorter treatment program. Those who participated in the full therapy session also experienced more weeks symptom-free over the one-year study period. Improvements were also measured using the Young Mania Rating Scale, showing that those in the 12-week group experienced a greater improvement. Among the participants, those who were members of families that for expressed emotion scored high, an indication of critical or overprotective parents, required almost twice as much time to recover from mood symptoms when compared with those families that scored low in expressed emotion. The 12-week family-focused therapy was also more effective for those in families with high expressed emotion when compared to the results found with the shorter treatment program. While the authors note that the follow-up period was not adequate to determine whether the therapy prevented the children from developing full bipolar disorder. However, the therapy may be helpful in teaching families how to effectively work with the child’s mood swings and improve the overall outcome.
