Mood disorders and suicide in youth represent major health concerns. Clinicians working with these youth need effective intervention strategies. However, there are no well established psychosocial interventions for prepubertal children with depression or manic-depression. Existing literature suggests that reducing expressed emotion (EE) via family psychoeducation improves outcome for adults with mood disorders, but similar studies in children are lacking. We developed an eight session, manual-driven, multi-family psychoeducation group therapy program (MFPG) designed to serve as an adjunct to the ongoing medication management and individual/family psychotherapy a child receives. Preliminary studies suggest MFPG is associated with multiple improvements for families, including: increased knowledge about mood disorders and improved coping skills in parents; improved family climate; increased perceptions of social support for parents and children; and increased effective treatment utilization. However, these studies have had significant methodologic limitations. In the proposed study, we hope to rigorously test the efficacy of MFPG with 165 mood disordered children aged 8 to 11. Participants will be recruited from multiple settings to obtain variability in socioeconomic status (SES), ethnicity, prior treatment history, and typical access to mental health services. Children and their primary and secondary parents/caregivers will complete pre-treatment assessment batteries at Time 1, then will be randomized into immediate MFPG plus treatment-as-usual (TAU) or a wait-list condition (WLC) plus TAU. All will be reassessed at Time 2 (approximately 3 months after study entry), Time 3 (7 months), and Time 4 (12 months). After the Time 4 assessment, WLC+TAU families will receive MFPG. A final assessment (Time 5, 15 months) will occur post-treatment. Hypotheses are: 1) MFPG+TAU families will function better than WLC+TAU families at Times 2, 3 and 4; 2) all families will improve functioning from immediately pre-treatment to immediately post-treatment; 3) several baseline variables (healthier child and parent functioning, higher caregiver concordance regarding treatment, and greater access to services) will be associated with better outcome for all participants; and 4) differences in gender and ethnicity will be unrelated to outcome.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH061512-01A1
Application #
6283549
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Vitiello, Benedetto
Project Start
2001-05-01
Project End
2006-04-30
Budget Start
2001-05-01
Budget End
2002-04-30
Support Year
1
Fiscal Year
2001
Total Cost
$328,212
Indirect Cost
Name
Ohio State University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
098987217
City
Columbus
State
OH
Country
United States
Zip Code
43210
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MacPherson, Heather A; Algorta, Guillermo Perez; Mendenhall, Amy N et al. (2014) Predictors and moderators in the randomized trial of multifamily psychoeducational psychotherapy for childhood mood disorders. J Clin Child Adolesc Psychol 43:459-72
Boylan, Khrista; Macpherson, Heather A; Fristad, Mary A (2013) Examination of disruptive behavior outcomes and moderation in a randomized psychotherapy trial for mood disorders. J Am Acad Child Adolesc Psychiatry 52:699-708
Martinez, Molly S; Fristad, Mary A (2013) Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion. J Affect Disord 148:431-4
Nadkarni, Redha B; Fristad, Mary A (2012) Stress and support for parents of youth with bipolar disorder. Isr J Psychiatry Relat Sci 49:104-10
Cummings, Colleen M; Fristad, Mary A (2012) Anxiety in children with mood disorders: a treatment help or hindrance? J Abnorm Child Psychol 40:339-51
Nadkarni, Radha B; Fristad, Mary A (2010) Clinical course of children with a depressive spectrum disorder and transient manic symptoms. Bipolar Disord 12:494-503
Mendenhall, Amy N; Fristad, Mary A; Early, Theresa J (2009) Factors influencing service utilization and mood symptom severity in children with mood disorders: effects of multifamily psychoeducation groups (MFPGs). J Consult Clin Psychol 77:463-73
Fristad, Mary A; Verducci, Joseph S; Walters, Kimberly et al. (2009) Impact of multifamily psychoeducational psychotherapy in treating children aged 8 to 12 years with mood disorders. Arch Gen Psychiatry 66:1013-21
Cummings, Colleen M; Fristad, Mary A (2008) Pediatric bipolar disorder: recognition in primary care. Curr Opin Pediatr 20:560-5

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