A Randomized Controlled Trial of Individual Family Psychoeducational Psychotherapy and Omega-3 Fatty Acids in Youth with Subsyndromal Bipolar Disorder

Mary A. Fristad, Andrea S. Young, Anthony T. Vesco, Elias S. Nader, K. Zachary Healy, William Gardner, Hannah L. Wolfson, L. Eugene Arnold

Research output: Contribution to journalArticle

Abstract

Objective: This pilot study evaluates efficacy of omega-3 fatty acid supplementation (ω3), individual family psychoeducational psychotherapy (IF-PEP), and their combination in youth with subsyndromal bipolar disorders (bipolar disorder not otherwise specified [BP-NOS], cyclothymic disorder [CYC]). Methods: This study was a 12 week, randomized trial of ω3 versus placebo and IF-PEP versus active monitoring (AM) using a 2 × 2 design (ω3 + PEP: n = 5; ω3 + AM: n = 5; placebo + PEP: n = 7; placebo + AM: n = 6). Twenty-three youth ages 7-14 with BP-NOS or CYC were recruited via community advertisements and clinician referrals. Participants could be taking stable medication for attention-deficit/hyperactivity disorder and sleep aids, but no other psychotropics. Independent evaluators assessed participants at screen, baseline, and 2, 4, 6, 9, and 12 weeks. Primary outcome measures were the Kiddie Schedule for Affective Disorders (K-SADS) Depression (KDRS) and Mania (KMRS) Rating Scales, Children's Depression Rating Scale-Revised (CDRS-R), and Young Mania Rating Scale (YMRS). ω3/placebo conditions were double-blind; independent evaluators were blind to psychotherapy condition. Results: Most participants (83%) completed the 12 week trial. Side effects were uncommon and mild. Intent-to-treat analyses indicated significant improvement in depressive symptoms (KDRS) for combined treatment relative to placebo and AM (p = 0.01, d = 1.70). Across groups, manic symptoms improved over time without significant treatment effects. Effect of IF-PEP on child depression compared with AM was medium (d = 0.63, CDRS-R) to large (d = 1.24, KDRS). Effect of ω3 on depression was medium (d = 0.48, KDRS). Conclusion: IF-PEP and ω3 are well tolerated and associated with improved mood symptoms among youth with BP-NOS and CYC.

Original languageEnglish (US)
Pages (from-to)764-774
Number of pages11
JournalJournal of child and adolescent psychopharmacology
Volume25
Issue number10
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)

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