Miklowitz David J
Division of Child and Adolescent Psychiatry, University of California, Los Angeles Semel Institute for Neuroscience and Behavior, California, U.S.A.
Isr J Psychiatry Relat Sci. 2012;49(2):95-101.
The course of bipolar disorder in children and adolescents is highly recurrent and impairing. This article describes the adaptation of family-focused treatment (FFT) for children and adolescents with bipolar disorder. FFT is given in 21 sessions over 9 months, and is usually initiated during the recovery period following an acute episode of depression or (hypo)mania. The treatment consists of an engagement phase followed by psychoeducation, communication enhancement training, and problem-solving skills training. Results of randomized trials in adults and adolescents find that patients with bipolar disorder who receive FFT and pharmacotherapy recover from episodes more quickly and have longer periods of sustained remission than patients who receive briefer forms of therapy and pharmacotherapy. The application of FFT to youth who are genetically at risk for bipolar disorder is described. Problems in disseminating empirically supported family interventions in community settings are discussed.
儿童和青少年双相情感障碍的病程具有高度复发性且会造成损害。本文描述了针对患有双相情感障碍的儿童和青少年的家庭聚焦治疗（FFT）的调整。FFT在9个月内进行21次治疗，通常在抑郁或（轻）躁狂急性发作后的恢复期开始。治疗包括一个参与阶段，随后是心理教育、沟通增强训练和问题解决技能训练。成人和青少年的随机试验结果发现，与接受更简短形式治疗和药物治疗的患者相比，接受FFT和药物治疗的双相情感障碍患者发作恢复得更快，持续缓解期更长。文中还描述了FFT在有双相情感障碍遗传风险的青少年中的应用。讨论了在社区环境中推广经实证支持的家庭干预措施存在的问题。
