The overall aim of this study is to improve our knowledge concerning the most effective treatments bipolar disorder. More specifically, we propose to investigate the efficacy of adding two types of family interventions (Psychoeducational Intervention, Family Therapy) to """"""""Standard Treatment"""""""" composed of pharmacotherapy + clinical management. Additionally, we propose to subdivide families of bipolar patients into """"""""dysfunctional"""""""" and """"""""functional"""""""" groups and to explore the treatment response of these two types of families to the three treatment conditions. 162 bipolar patients will be recruited from new inpatient admissions to a psychiatric hospital. All patients will receive certain common treatments, including hospital milieu, psychopharmacology and clinical management sessions. Patients in the Standard Treatment condition will receive no additional treatment. The patients in the Psychoeducational condition will receive an additional psychoeducational intervention consisting of a videotaped informational presentation and a six session, multifamily psychoeducational group, while the Family Therapy condition will receive 10-15 family therapy sessions. All treatments will begin in the hospital and will continue for a two year period on an outpatient basis. Using this design, we propose to test the following hypotheses. 1. Patients receiving either type of additional family intervention (Psychoeducation or Family Therapy) will respond better than those receiving Standard Treatment. However, due to the hypothesized superiority of Family Therapy for patients with highly dysfunctional families (see Hypothesis 2 below), the Family Therapy intervention should produce a stronger effect than the Psychoeducation. 2. For patients with high levels of family dysfunction, Family Therapy will be more effective than Standard Treatment or Psychoeducation. 3. Patients with low levels of family dysfunction will not differ in their response to Psychoeducational and Family Therapy. Both types of family interventions will be more effective than the Standard Treatment condition for this type of patient.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH048171-01A1
Application #
2248014
Study Section
Treatment Development and Assessment Research Review Committee (TDA)
Project Start
1992-09-30
Project End
1997-08-31
Budget Start
1992-09-30
Budget End
1993-08-31
Support Year
1
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Butler Hospital (Providence, RI)
Department
Type
DUNS #
069847804
City
Providence
State
RI
Country
United States
Zip Code
02906
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Weinstock, Lauren M; Wenze, Susan J; Munroe, Mary K et al. (2013) Concordance between patient and family reports of family functioning in bipolar I disorder and major depressive disorder. J Nerv Ment Dis 201:377-83
Weinstock, Lauren M; Miller, Ivan W (2010) Psychosocial predictors of mood symptoms 1 year after acute phase treatment of bipolar I disorder. Compr Psychiatry 51:497-503
Sheets, Erin S; Miller, Ivan W (2010) Predictors of relationship functioning for patients with bipolar disorder and their partners. J Fam Psychol 24:371-9
Gaudiano, Brandon A; Uebelacker, Lisa A; Miller, Ivan W (2008) Impact of remitted substance use disorders on the future course of bipolar I disorder: findings from a clinical trial. Psychiatry Res 160:63-71
Solomon, David A; Keitner, Gabor I; Ryan, Christine E et al. (2008) Preventing recurrence of bipolar I mood episodes and hospitalizations: family psychotherapy plus pharmacotherapy versus pharmacotherapy alone. Bipolar Disord 10:798-805
Miller, Ivan W; Keitner, Gabor I; Ryan, Christine E et al. (2008) Family treatment for bipolar disorder: family impairment by treatment interactions. J Clin Psychiatry 69:732-40
Johnson, Sheri L; Cuellar, Amy K; Cueller, Amy K et al. (2008) Life events as predictors of mania and depression in bipolar I disorder. J Abnorm Psychol 117:268-77
Weinstock, Lauren M; Miller, Ivan W (2008) Functional impairment as a predictor of short-term symptom course in bipolar I disorder. Bipolar Disord 10:437-42
Gaudiano, Brandon A; Uebelacker, Lisa A; Miller, Ivan W (2007) Course of illness in psychotic mania: is mood incongruence important? J Nerv Ment Dis 195:226-32

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