Mood Disorders Program

PROGRAM SHOWS PROMISE FOR TREATING CHILDREN WITH MOOD DISORDERS

COLUMBUS, Ohio -- Researchers at Ohio State University have developed a new intervention program that shows early signs of helping children and teenagers with mood disorders.

The program is called psychoeducation and it helps families deal with children who have been diagnosed with depression, dysthymic disorder and bipolar disorder.

In a pilot study of 20 hospitalized youth, researchers found that a single 1.5 hour psychoeducation workshop helped parents -- especially fathers -- have a better understanding of their child’s mood disorder. Preliminary evidence suggests family interactions may also improve following participation.

The researchers are now testing a six-session psychoeducation workshop for families of 8- to 11-year-olds.

“The early signs are encouraging,” said Mary Fristad, one of the developers of the intervention program, and an associate professor of psychiatry at Ohio State.

“There have traditionally been very few ways to treat children and adolescents with serious mood disorders. But we think psychoeducation shows a lot of promise to help families in this difficult situation.”

The first goal of psychoeducation is to teach parents about the mood disorder their child suffers from -- everything from the symptoms, the normal course of the disorder, and the usual treatment, Fristad said. This helps parents understand what they’re dealing with and respond appropriately to their children’s symptoms.

This is important because parents can often unknowingly add to their child’s stress level by overreacting or reacting inappropriately to mood disorder symptoms, she said.

“Children who are depressed or anxious are particularly vulnerable to stress or tension in their homes,” Fristad said. “We teach family members to ‘back off’ from blaming or criticizing the patient,” Fristad said.

When parents need to set limits or make rules, they are taught to do it matter-of-factly, rather than in a critical or hostile way.

The goal is to reduce what mental health professionals call “expressed emotion” in the household, Fristad said. Parents who show a lot of expressed emotion tend to be emotionally overinvolved with their children and are constantly on-alert for problems they feel they must correct.

Research has shown that adults with schizophrenia, depression and manic-depression who go back to spouses or parents with high expressed emotion are much more likely to have relapses of their disease. Psychoeducation has been shown to help reduce expressed emotion in these families.

However, Fristad said the Ohio State team is the first to modify psychoeducation for use with children and adolescents and their families.

In the pilot study, 25 parents of 20 youth, aged 10 to 18, participated in a single psychoeducation workshop. The workshop discussed symptoms of the child’s disorder, the course of the disease and its treatment, and family factors that affected outcome.

Results showed that parents’ understanding of mood disorders increased after the workshop. Four months later, the parents reported more positive interactions and fewer negative interactions with their child. And after participation, mothers and fathers were more alike in their understanding of their child’s problems, and in their emotional reactions to the child. Fristad speculates this may contribute to less marital tension and overall family tension.

Fristad said it was not surprising that psychoeducation helped fathers the most. “Clinically, this makes sense because mothers often seem more in touch with their children’s issues and problems,” Fristad said. “It is encouraging that psychoeducation helped fathers catch up with mothers in terms of relationships with their children.”

The six-session psychoeducation group that is now being tested with 8- to 11-year-olds and their families expands on the single-workshop format. The researchers are seeking funding for a third stage of the study, which would involve using the six-session format for families of 12 to 14 year olds with mood disorders.

Fristad said psychoeducation is not designed to be the only treatment for children and their families. Many children will also participate in other therapies and take medication for their illness. “Psychoeducation is part of a treatment plan, but it shouldn’t be the only treatment,” she said.

Other researchers involved in the work include Stephen Gavazzi, associate professor of human development and family science at Ohio State; Kitty Soldano, clinical assistant professor of psychiatry at Ohio State; and Anne Robinson, president of the Alliance for the Mentally Ill in Franklin County.

Some of this research was presented recently at the annual meeting of the American Academy of Child and Adolescent Psychiatry. The research is currently being funded by the Ohio Department of Mental Health.

Contact: Mary Fristad, (614) 293-8235; Fristad.1@osu.edu Written by Jeff Grabmeier, (614) 292-8457; Grabmeier.1@osu.edu