Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010–2019)

2021 ◽  
Author(s):  
Andrea K. Wittenborn ◽  
Sarah B. Woods ◽  
Jacob B. Priest ◽  
Preston C. Morgan ◽  
Chi‐Fang Tseng ◽  
...  
Keyword(s):  
Bipolar Disorders ◽  
Evidence Base ◽  
Family Interventions

Family interventions in psychosis

2020 ◽  
pp. 531-537
Author(s):  
Juliana Onwumere ◽  
Elizabeth Kuipers
Keyword(s):  
Patient Outcomes ◽  
Family Involvement ◽  
Lived Experiences ◽  
Treatment Guidelines ◽  
Well Being ◽  
Evidence Base ◽  
Family Interventions ◽  
Improved Outcomes ◽  
The Impact

Families can play an important role in supporting individuals living with psychosis disorders and helping to facilitate their improved outcomes. This chapter, offered by Juliana Onwumere and Elizabeth Kuipers, provides an overview of the literature reporting on family involvement in the care of adults with lived experiences of psychosis, the impact of the caregiving role on carer well-being, and the predictive links between caregiving relationships and key patient outcomes including relapse. The chapter reports on the application of family interventions, the evidence base supporting its application and inclusion in treatment guidelines, and implementation issues.

Paediatric mood disorders

2012 ◽  
pp. 1669-1680
Author(s):  
David Brent ◽  
Boris Birmaher
Keyword(s):  
Risk Factors ◽  
Mood Disorders ◽  
Bipolar Disorders ◽  
Evidence Base ◽  
Future Research ◽  
Psychosocial Treatments

In this chapter, we describe the nosology and epidemiology of paediatric unipolar and bipolar disorders, risk factors and predictors of course, and the evidence base for pharmacological and psychosocial treatments. We conclude this chapter by suggesting areas for future research.

scholarly journals An Overview of the Evidence for Psychological Interventions for Psychosis: Results From Meta-Analyses

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Tania M. Lincoln ◽  
Anya Pedersen
Keyword(s):  
Psychotic Disorders ◽  
Skills Training ◽  
Evidence Base ◽  
Convincing Evidence ◽  
Psychotic Symptoms ◽  
Dissemination And Implementation ◽  
Family Interventions ◽  
Cognitive Behavioural ◽  
Main Target ◽  
Meta Analyses

There are numerous psychological approaches to psychosis that differ in focus, specificity and formats. These include psychodynamic, humanistic, cognitive-behavioural and third-wave-approaches, psychoeducation, various types of training-based approaches and family interventions. We briefly describe the main aims and focus of each of these approaches, followed by a review of their evidence-base in regard to improvement in symptoms, relapse and functioning. We conducted a systematic search for meta-analyses dating to 2017 for each of the approaches reviewed. Where numerous meta-analyses for an approach were available, we selected the most recent, comprehensive and methodologically sound ones. We found convincing short- and long-term evidence for cognitive behavioural approaches if the main aim is to reduce symptom distress. Evidence is also strong for psychoeducative family interventions that include skills training if the main aim is to reduce relapse and rehospitalisation. Acceptance and commitment therapy, mindfulness-based approaches, meta-cognitive and social skills training, as well as systemic family interventions, were also found to be efficacious, depending on the outcome of interest, but meta-analyses for these approaches were based on a comparatively lower number of outcome studies and a narrower selection of outcome measures. We found no convincing evidence for psychodynamic approaches, humanistic approaches or patient-directed psychoeducation (without including the family). An array of evidence-based psychological therapies is available for psychotic disorders from which clinicians and patients can choose, guided by the strength of the evidence and depending on the outcome area focused on. Increased effort is needed in terms of dissemination and implementation of these therapies into clinical practice. Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms. Meta-analyses show convincing evidence for family interventions if the main target is relapse. Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed. The array of effective approaches allows clinicians and patients to select the most appropriate one. Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms. Meta-analyses show convincing evidence for family interventions if the main target is relapse. Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed. The array of effective approaches allows clinicians and patients to select the most appropriate one.

Psychosis and the family: the role of family interventions

2018 ◽  
Author(s):  
Juliana Onwumere ◽  
Elizabeth Kuipers
Keyword(s):  
Expressed Emotion ◽  
Mental Health Problems ◽  
Family Care ◽  
Evidence Base ◽  
Family Interventions ◽  
Care And Support ◽  
Close Relationship ◽  
And Coping ◽  
The Impact

The development of psychotic illness exerts a significant impact on the affected individual but will also affect, in a variety of ways, their family and social networks. Although psychotic conditions are severe mental health problems, they are treatable, and family care and support play an important role in helping to achieve better recovery outcomes. In its first half, this chapter provides an overview of the impact of psychosis on family carers and the close relationship that exists between family wellbeing and patient outcomes, including the relevance of expressed emotion. The second half of the chapter offers an outline of family interventions—the psychological talking therapies designed to help individuals living with psychosis and their families to improve their understanding of the illness, develop skills in positive communication, problem-solving and coping, and identify appropriate support pathways. The evidence base underpinning the interventions and future developments in working with families is also discussed.

Addressing challenges in the evidence base for bipolar disorders: Diagnostic accuracy and attrition

2021 ◽  
Vol 23 (4) ◽  
pp. 321-323
Author(s):  
Priyanka Desai ◽  
Snežana Urošević ◽  
Mary Butler
Keyword(s):  
Diagnostic Accuracy ◽  
Bipolar Disorders ◽  
Evidence Base

JS01-04 - Rational optimization of bipolar disorders’ treatment

2011 ◽  
Vol 26 (S2) ◽  
pp. 1998-1998
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Healthy Lifestyle ◽  
Bipolar Depression ◽  
Treatment Options ◽  
Bipolar Disorders ◽  
Mood Stabilizer ◽  
Evidence Base ◽  
Term Therapy ◽  
Depressive Episodes

Bipolar disorder is difficult to treat. There are several options to treat acute mania, but combination of two or more drugs is the rule rather than the exception, indicating the limitations of currently available therapies. The evidence base for the treatment of bipolar depression is much weaker, and again combination is the rule. Although patients with bipolar disorder may experience resolution of symptoms with acute treatment, many will continue to experience impaired functioning due to the episodic, chronic, and progressive nature of the illness. Maintenance therapy is needed for a variety of reasons, including prevention of relapse, reduction of subthreshold symptoms, decreasing the risk of suicide, and reducing the frequency of rapid cycling and mood instability. Although long-term therapy is usually required to maintain or improve functioning and quality of life, it has been a significant challenge to identify clinically effective treatments for long-term management. There are few currently-available, well-tolerated treatment options that are effective in all phases of bipolar disorder and which prevent recurrence of manic and/or depressive episodes. Questions concerning when to discontinue one of the drugs when two or more are used, or how to switch from one mood stabilizer to another, have not been addressed in clinical trials. Electroconvulsive therapy may be effective in treatment resistant cases and can be used as maintenance when pharmacotherapy is not enough. Psychoeducation may help to enhance treatment adherence and healthy lifestyle. A rational combination of the above mentioned strategies may help to optimize the outcome of this challenging condition.

Classifying Disfluencies in Preschool- and School-Age Spanish–English Bilinguals Who Do Not Stutter: An Exploratory Study

2020 ◽  
Vol 5 (1) ◽  
pp. 119-130
Author(s):  
Raúl Rojas ◽  
Farzan Irani
Keyword(s):  
Exploratory Study ◽  
Evidence Base ◽  
Medium Effect ◽  
Bilingual Children ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Total Percentage ◽  
Narrative Production ◽  
Language Measures ◽  
Mean Length Of Utterance

Purpose This exploratory study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of Spanish–English bilingual children who do not stutter. Method A cross-sectional sample of 29 bilingual students (16 boys and 13 girls) enrolled in grades prekindergarten through Grade 4 produced a total of 58 narrative retell language samples in English and Spanish. Key outcome measures in each language included the percentage of normal (%ND) and stuttering-like (%SLD) disfluencies, percentage of words in mazes (%MzWds), number of total words, number of different words, and mean length of utterance in words. Results Cross-linguistic, pairwise comparisons revealed significant differences with medium effect sizes for %ND and %MzWds (both lower for English) as well as for number of different words (lower for Spanish). On average, the total percentage of mazed words was higher than 10% in both languages, a pattern driven primarily by %ND; %SLDs were below 1% in both languages. Multiple linear regression models for %ND and %SLD in each language indicated that %MzWds was the primary predictor across languages beyond other language measures and demographic variables. Conclusions The findings extend the evidence base with regard to the frequency and type of disfluencies that can be expected in bilingual children who do not stutter in grades prekindergarten to Grade 4. The data indicate that %MzWds and %ND can similarly index the normal disfluencies of bilingual children during narrative production. The potential clinical implications of the findings from this study are discussed.

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