[Psychotherapic interventions for bipolar disorder in children and adolescents]

Abstract

Objective: To review the options for psychosocial interventions in pediatric bipolar disorders.

Methods: A comprehensive literature review of randomized clinical trials and open-label studies was conducted.

Results: Randomized controlled trials show that psychosocial interventions involving families (i.e. family-focused treatment) or individual and family therapy (i.e. multi- or individual-family psychoeducational psychotherapy, child- and family-focused cognitive-behavioral therapy, dialectical behavior therapy) may be effective through added benefit to pharmacotherapy. All these interventions share numerous common therapeutic elements such as psychoeducation and skills training. Individual interventions (i.e. interpersonal and social rhythm therapy and cognitive-behavioral therapy) are to date less well documented. However that may be, outcome studies remain few, and numerous methodological limitations (small sample sizes, designs not very rigorous) restrict the interpretability and generalisability of their results. In addition, most studies were conducted in specialty centers with highly trained therapists, and the feasibility and acceptability of these interventions in practice settings remain to be shown.

Conclusion: Despite recent developments in identifying effective psychosocial interventions, numerous critical gaps remain, and more longitudinal studies are needed to clarify how these interventions work.

Keywords: Adolescents; Bipolar disorder; Children; Enfants; Psychotherapy; Psychothérapie; Trouble bipolaire.