Family Therapy for Bipolar Disorder

Getting family members involved after a person with bipolar disorder has an acute episode can reduce the chances of a relapse, report researchers in this month’s Archives of General Psychiatry.

Most people with bipolar disorder are treated with drug therapy after an acute episode, and most do find relief from symptoms. However, drug therapy is less effective over the long term, with up to 60 percent of patients suffering a relapse within two years and 50 percent experiencing intermittent symptoms. Finding ways to supplement drug therapy, therefore, has become a top goal of researchers.

In this study, investigators from the University of North Carolina and Chapel Hill compared bipolar patients who were enrolled in a program called family-focused therapy with those who took part in a less intensive crisis management program. All had recently had an acute episode and were on standard drugs for the disorder. The family-focused therapy consisted of 21 sessions involving education about the disorder, communication training, and training in problem-solving skills. Patients took part in the sessions along with all of their available family members. The crisis management program consisted of two sessions of family education and crisis intervention sessions when needed. Both groups underwent the treatments for nine months and were followed for two years.

Results showed those who received the family-focused therapy had fewer relapses and longer times between relapses than those in the crisis management group, 35 percent vs. 54 percent, and 73.5 weeks vs. 53.2 weeks, respectively.

The authors conclude, “Psychosocial interventions are by no means substitutes for pharmacotherapy, but they may augment mood stabilizers in protecting patients from symptoms deterioration as well as enhance compliance with maintenance treatments.”

SOURCE: Archives of General Psychiatry, 2003;60:904-912