Helping youth with bipolar disorder

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Schwartz, C., Barican, J., Yung, D., Gray-Grant, D., & Waddell, C. (2019). Helping youth with bipolar disorder. Children’s Mental Health Research Quarterly, 13(1), 1–18. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

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Background: Although bipolar disorder is rare in young people, effective treatments are critical for those experiencing it.

Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions for youth with bipolar disorder. Applying our inclusion criteria to the 50 studies identified from our searches, we accepted 12 RCTs.

Results: Among the five medications assessed, aripiprazole and lithium stood out. Aripiprazole significantly reduced disorder severity and manic symptoms while improving overall functioning. Lithium also reduced manic symptoms while improving overall functioning. Still, both had significant side effects. Among the three psychosocial interventions assessed — Multifamily Psychoeducational Psychotherapy, Child and Family-Focused Cognitive-Behavioural Therapy, and Family-Focused Therapy — all showed benefit. In contrast, the dietary supplement flax oil was not effective.

Conclusions: Most young people with bipolar disorder will need medication to manage this condition. Aripiprazole and lithium should be considered first, given their effectiveness and their regulatory approval. The three effective psychosocial treatments should also be considered as an adjunct to medication. 

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