Family functioning linked to disease course in adolescent BD

By Mark Cowen, Senior medwireNews Reporter

Family cohesion, adaptability, and conflict are associated with disease course in adolescent patients with bipolar disorder (BD), US researchers report.

Aimee Sullivan (University of Colorado at Boulder) and team found that family cohesion, adaptability, and conflict scores were associated with depression levels, while reductions in family conflict over time were associated with reductions in levels of mania among adolescents with the mood disorder.

"Given the demonstrated association between interpersonal stressors and the symptom course of adolescent BD, the present findings suggest that familial conflict may be a potent target in the treatment of adolescent BD," comment the researchers in Behavior Therapy.

The findings come from a study of 58 adolescents, aged a mean of 14 years, with BD and their families who participated in a 2-year trial of family-focused treatment.

Parent- and adolescent-reported family functioning was assessed at baseline and at 3, 6, 9, 12, 18, and 24 months using the Family Adaptability and Cohesion Evaluation Scale (FACES)-II and the Conflict Behavior Questionnaire (CBQ).

Adolescent mood symptoms were assessed over the course of the study using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version Mania Rating Scale (KSADS MRS) and Depression Rating Scale (KSADS DRS).

The researchers note that parent- and adolescent-reported FACES-II cohesion and adaptability scores did not change significantly over the course of the study.

By contrast, parent- and adolescent-reported CBQ scores fell from 12.1 to 6.7 and from 6.9 to 4.8, respectively, over the study period.

Overall, parent- and adolescent-reported FACES-II cohesion and adaptability scores, and CBQ scores were longitudinally correlated with adolescents' KSADS DRS scores.

Furthermore, reductions in parent-reported CBQ scores predicted decreases in adolescents' KSADS MRS scores over the 2-year study period.

Sullivan and team conclude: "Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms."

They add: "Investigating the relationships between family functioning and treatment adherence (ie, psychotherapy session attendance or medication consistency) may also prove useful in improving the treatment of adolescent BD."

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