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Maintenance model of integrated psychosocial treatment in pediatric bipolar disorder: A pilot feasibility study.

West AE, Henry DB, Pavuluri MN

Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA. awest@psych.uic.edu

OBJECTIVE: The chronic and refractory course of pediatric bipolar disorder merits the study of adjunctive psychosocial interventions designed to facilitate long-term improvements. The objective of this study is to conduct a pilot study of a maintenance model of the child- and family-focused cognitive-behavioral therapy program (CFF-CBT), which comprises psychosocial booster sessions and optimized pharmacotherapy, and to assess whether positive effects seen after the acute phase of treatment could be sustained over time with the use of this model. METHOD: The study design was an open trial with the goal of assessing feasibility of such a maintenance model over time. Thirty-four patients 5 to 17 years of age who underwent CFF-CBT were delivered the maintenance model of treatment over a 3-year period and assessed for symptom changes (Children's Global Impressions Scale-Bipolar) and global functioning (Children's Global Assessment Scale). RESULTS: Results indicated that participation in the maintenance model of CFF-CBT treatment was associated with positive effects in symptoms and functioning over the 3-year follow-up period. There were no statistically significant differences in postacute-phase treatment scores and scores at years 1, 2, or 3 on any study measures, indicating the maintenance of clinically significant improvements. CONCLUSIONS: These findings suggest that maintenance treatment models are feasible and may help facilitate the long-term management of symptoms. Controlled clinical trials that build on this model will help advance treatments for pediatric bipolar disorder toward addressing the low recovery and high relapse rates associated with the disorder.

Published 23 January 2007 in J Am Acad Child Adolesc Psychiatry, 46(2): 205-12.
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