Early intervention for youth at high risk for bipolar disorder: A multisite randomized trial of family-focused treatment.
Early intervention for youth at high risk for bipolar disorder: A multisite randomized trial of family-focused treatment.
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DOI：
10.1111/eip.12463
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发表时间：
2019-04
影响因子：
2
通讯作者：
Chang KD
中科院分区：
文献类型：
--
作者：
Miklowitz DJ;Schneck CD;Walshaw PD;Garrett AS;Singh MK;Sugar CA;Chang KD
尽管双相情感障碍（BD）有相当大的公共卫生影响，但在其早期阶段还没有对社会心理干预措施进行系统评估。我们描述了一项以家庭为中心的高风险青年BD （FFT-HR）治疗的3点随机试验的基本原理、设计和分析方法。参与者（年龄9 - 17岁）被诊断为未明确的双相障碍或重度抑郁症，当前的情绪症状，并且至少有一个一或二度亲属有双相障碍I或II的终生病史。参与者被随机分配到FFT-HR（4个月的12次家庭心理教育和技能培训）或强化护理（EC； 4个月的6次个人和家庭会议），并根据需要提供药物治疗。一部分参与者在进行面部评估和家庭问题解决任务时接受治疗前和治疗后的功能磁共振成像扫描，这些任务旨在激活皮质边缘电路。独立评估人员每4 - 6个月评估一次参与者的状态，为期4年。我们假设FFT-HR在降低情绪症状的严重程度（主要结局）和4年内首次躁狂发作的危险（次要结局）方面比EC更有效。其次，我们将探讨FFT-HR是否与治疗前后杏仁核激活的更大下降和背外侧、腹外侧或前额叶前部内侧皮层激活的增加有关。描述了133名受试者在基线时的临床特征。这项研究将测试一种新的干预措施，以减少双相障碍的早期症状，并确定可能有助于改进未来治疗的神经和行为机制。NCT01483391, 2011年11月26日注册，网址：www.clinicaltrials.gov
Despite the considerable public health impact of bipolar disorder (BD), no psychosocial interventions have been systematically evaluated in its early stages. We describe the rationale, design, and analytic methods for a 3-site randomized trial of family-focused treatment for youth at high risk for BD (FFT-HR). Participants (ages 9 to 17 years) have a diagnosis of unspecified BD or major depressive disorder, current mood symptoms, and at least one first- or second-degree relative with a lifetime history of BD I or II. Participants are randomly assigned to FFT-HR (12 sessions in 4 months of family psychoeducation and skills training) or enhanced care (EC; 6 individual and family sessions over 4 months), with pharmacotherapy provided as needed. A subset of participants undergo pre- and post-treatment fMRI scans while performing face-rating and family problem-solving tasks designed to activate corticolimbic circuitry. Independent evaluators assess participants’ status every 4–6 months for up to 4 years. We hypothesize that FFT-HR will be more effective than EC in reducing the severity of mood symptoms (primary outcome) and the hazard of a first manic episode (secondary) over 4 years. Secondarily, we will explore whether FFT-HR is associated with greater decreases in amygdala activation and increases in dorsolateral, ventrolateral, or anterior medial prefrontal cortex activation from pre- to post-treatment. Clinical characteristics of 133 subjects enrolled at baseline are described. This study will test a novel intervention to reduce the early symptoms of BD, and identify neural and behavioral mechanisms that may help refine future treatments. NCT01483391, registered Nov. 26, 2011 at www.clinicaltrials.gov
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影响因子：
5.4
作者：
Findling, RL;Youngstrom, EA;Calabrese, JR
通讯作者：
Calabrese, JR
影响因子：
--
作者：
Miklowitz, David J.;Axelson, David A.;Brent, David A.
通讯作者：
Brent, David A.
影响因子：
4.2
作者：
Johnson, Marcia K.;Nolen-Hoeksema, Susan;Levin, Yael
通讯作者：
Levin, Yael
DOI：
10.1111/j.1469-7610.2010.02210.x
发表时间：
2010-04-01
影响因子：
7.6
作者：
Luby, Joan L.;Navsaria, Neha
通讯作者：
Navsaria, Neha
影响因子：
1.9
作者：
Carlson, Gabrielle A.;Findling, Robert L.;Tohen, Mauricio
通讯作者：
Tohen, Mauricio