Family-focused treatment benefits caregivers of bipolar patients
MedWire News: A family-focused intervention significantly reduces depression levels and health risk behaviors in caregivers of patients with bipolar disorder, US research shows.
The researchers also found that depression levels decreased in bipolar patients after their caregivers completed the family-focused intervention program.
Deborah Perlick (Mount Sinai School of Medicine, New York) and colleagues studied 43 primary caregivers of patients with bipolar I or II disorder who were assigned to the Family-Focused Treatment-Health Promoting Intervention (FFT-HPI) or to health education (HE) delivered via videotapes.
The FFT-HPI involved 12-15 sessions of family-focused, cognitive behavioral therapy designed to provide the caregiver with the skills for managing their relative's illness, attaining self-care goals, and reducing strain, depression, and health risk behavior.
Caregivers were assessed before and after the interventions for depression symptoms, health behaviors, and coping using the Quick Inventory of Depressive Symptomatology (QIDS), the Health Risk Behavior Scale (HRB), and the Ways of Coping Questionnaire (WCQ). The caregivers' relatives with bipolar disorder were also assessed for depression and mania symptoms before and after the interventions using the Hamilton Rating Scale for Depression (HAM-D), and the Young Mania Rating Scale (YMRS), respectively.
The researchers found that among caregivers assigned to FFT-HPI (n=24), mean QIDS and HRB scores fell from a respective 8.2 and 4.7 at baseline to 4.6 and 2.0 after the intervention - a significant improvement.
Caregivers assigned to HE showed significantly less improvement in QIDS and HRB scores, from a respective 9.0 and 3.8 at baseline to 8.5 and 3.7 after the intervention.
The bipolar relatives of caregivers assigned to FFT-HPI also showed greater improvements in HAM-D and YMRS scores, from a respective 15.2 and 8.1 at baseline to 5.6 and 1.6 after the intervention, compared with bipolar relatives of caregivers assigned to HE, whose scores fell from a respective 14.5 and 9.3 at baseline to 11.2 and 5.8 after the intervention.
Caregivers assigned to FFT-HPI also had greater reductions in subjective burden associated with the patients' symptoms than those assigned to HE.
The researchers note that reductions in caregivers' depression symptoms were partially mediated by reductions in their levels of avoidance coping, while reductions in patients' depression levels were partially mediated by reductions in caregivers' depression levels.
Perlick and team conclude in the journal Bipolar Disorders: "Caregivers treated with a psychoeducational and cognitive-behavioral approach in the FFT-HPI condition experienced a significant reduction in depressive symptoms and improvement in health behaviors relative to caregivers who received education alone."
They add: "FFT-HPI offers a viable alternative for treating patients with bipolar disorder when concerned family members are available for treatment but the patient is not."
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By Mark Cowen