Article

Integrated Family and Individual Therapy for Bipolar Disorder

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 03/2003; 64(2):182-91. DOI: 10.4088/JCP.v64n0211
Source: PubMed

ABSTRACT

Several studies have established the efficacy of psychosocial interventions as adjuncts to pharmacotherapy in the symptom maintenance of bipolar disorder. This study concerned a new psychosocial approach - integrated family and individual therapy (IFIT) - that synthesizes family psychoeducational sessions with individual sessions of interpersonal and social rhythm therapy.
Shortly after an acute illness episode, 30 bipolar patients (DSM-IV criteria) were assigned to open treatment with IFIT (up to 50 weekly sessions of family and individual therapy) and mood-stabilizing medications in the context of a treatment development study. Their outcomes over 1 year were compared with the outcomes of 70 patients from a previous trial who received standard community care, consisting of 2 family educational sessions, mood-stabilizing medications, and crisis management (CM). Patients in both samples were evaluated as to symptomatic functioning at entry into the project and then every 3 months for 1 year.
Patients in IFIT had longer survival intervals (time without relapsing) than patients in CM. They also showed greater reductions in depressive symptoms over 1 year of treatment relative to their baseline levels. The results could not be explained by group differences in baseline symptoms or pharmacologic treatment regimens.
Combining family and individual therapy with medication may protect episodic bipolar patients from early relapse and ongoing depressive symptoms. Further examination of this integrative model within randomized controlled trials is warranted.

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Available from: Kristin Powell, Feb 17, 2014
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    • "Al contrario, la TCC e la PE di gruppo possono apportare maggiori benefici se attuate dopo un adeguato periodo di eutimia. Un approccio psicosociale integrato (definito Integrated Family and Individual Therapy, IFIT) ha combinato elementi della FFT con elementi della IPSRT [44]; gli autori hanno sottoposto 30 pazienti bipolari di tipo I, subito dopo un episodio acuto, a un trattamento che prevedeva 25 sessioni di IPSRT e 25 sessioni di FFT. Il decorso a 12 mesi di tali pazienti è stato U. Albert et al. confrontato con quello di un gruppo costituito da 70 pazienti arruolati come controlli (crisis management group) in un altro studio [35]. "
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    • "The present study did not include direct measures of important constructs such as expressed emotion or parent-child attachment (e.g., Hammen et al. 1990). These more proximal family variables may also be explanatory factors in families with bipolar disorder for both adults (Hooley and Hiller 2001) as well as youths (Geller et al. 2003; Miklowitz et al. 2003b). Despite these limitations, these findings lay the groundwork for future testing of causal pathways linking parental bipolar disorder, family functioning and conflict, and children's bipolar disorder and hold important implications for clinicians treating families with bipolar disorder. "
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    • "A similar study by Rea and colleagues (Rea et al., 2003) found no benefit of FFT in reducing the risk of relapse; however, patients receiving FFT had fewer relapses than those receiving individually focused treatment. Other benefits of FFT included greater reductions in affective symptom scores (Miklowitz et al., 2003), better medication adherence (Miklowitz et al., 2003), and lower risk of rehospitalization over a 2-year period (Rea et al., 2003). The results of these studies provide evidence that FFT may be a useful adjunct to pharmacotherapy for decreasing the risk of relapse and hospitalization frequently associated with bipolar disorder. "
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