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CompletedNCT00332098Updated May 20, 2014

Effectiveness of Family-Focused Treatment Plus Pharmacotherapy for Bipolar Disorder in Adolescents

A Phase 3 interventional study of Family-Focused Treatment Plus Pharmacotherapy and Enhanced Care Plus Pharmacotherapy in Bipolar Disorder, sponsored by University of California, Los Angeles. Completed at 3 sites in United States. Open to participants aged 13 Years to 17 Years. Per ClinicalTrials.gov, last updated 2014-05-20.

Sponsored by University of California, Los Angeles · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
145
Allocation
Randomized
Ages
13 Years to 17 Years
Sex
All
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Study summary

This study will evaluate the effectiveness of family-focused treatment (FFT) plus pharmacotherapy in treating adolescents with bipolar disorder.

Read the detailed description

Bipolar disorder is a serious mental illness that causes drastic shifts in a person's mood, energy, and ability to function. Bipolar disorder can strike at any age, but it most commonly develops in late adolescence or early adulthood. The disorder is characterized by alternating episodes of mania and depression, often with periods of normal mood in between. Some symptoms of a manic episode include the following behaviors: increased energy, activity, and restlessness; excessively "high," overly good, euphoric mood; and extreme irritability. In contrast, a depressive episode is characterized by a lasting sad, anxious, or empty mood; feelings of hopelessness or pessimism; and decreased energy. Adolescents with bipolar disorder have high rates of disease recurrence, suicide attempts, functional impairment, and mental health service utilization, even with aggressive treatment with mood stabilizers and antipsychotic drugs. Research has suggested that FFT, a behavioral intervention consisting of psychoeducation, communication training, and problem solving training, may lead to improvements in mood symptoms in adolescents with bipolar disorder. This study will evaluate the effectiveness of FFT plus pharmacotherapy in treating adolescents with bipolar illness.

Participants in this 2-year, single-blind study will be randomly assigned to receive a combination of either FFT and pharmacotherapy or enhanced care and pharmacotherapy. Medications used for the pharmacotherapy portion of the study will include mood stabilizers, such as lithium or divalproex sodium, and atypical antipsychotics, such as quetiapine. Participants will also receive anti-anxiety medications, psychostimulants, or antidepressants as needed. All participants will receive pharmacotherapy for the full 2 years. Participants assigned to enhanced care will take part in weekly brief psychoeducation sessions for 3 weeks. Participants assigned to FFT will take part in weekly treatment sessions with their families for 12 weeks, biweekly for 12 weeks, monthly for 3 months, and then trimonthly until Month 24. Both FFT and enhanced care treatment sessions will include psychoeducation focusing on appropriate ways to manage bipolar disorder and its cycling nature. Crisis intervention sessions will also be offered to all participants on an as-needed basis for the duration of the study. Outcomes, including bipolar disorder symptoms, functioning, and service utilization, will be measured at study visits at Months 3, 6, 9, 12, 18, and 24.

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Conditions studied

  • Bipolar Disorder

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Keywords

  • Childhood Mood Disorders
  • Family Treatment
  • Psychoeducation
  • Pharmacotherapy
  • Family Functioning
  • Psychosocial Intervention
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In context

Bipolar Disorder

1,601 studies on the registry are indexed under Bipolar Disorder; 254 are open to participants now.

This study's enrollment of 145 is above the median of 64 across 1,223 interventional studies indexed under Bipolar Disorder.

Browse Bipolar Disorder studies →

Lead sponsor

University of California, Los Angeles is the lead sponsor of 1,142 studies on the registry; 192 are open to participants now.

Of its 91 completed or terminated interventional studies of FDA-regulated products, 66 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
13 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Between the ages of 13 years, 0 months and 17 years, 11 months
  • Meets The Diagnostic and Statistical Manual of Mental Disorders - IV criteria for either of the following conditions: bipolar I or bipolar II disorder with a manic, mixed, or hypomanic episode within 3 months of study entry; or a depressed episode within 3 months of study entry with a prior history of a manic, hypomanic, or mixed episode (if the participant only meets criteria for a current hypomanic episode, there must also be a history of at least one prior depressive, manic, or mixed episode)
  • Has experienced severe depression, hypomania, or mania symptoms for a period of at least 1 week within the 3 months prior to study entry
  • Lives with at least one biological or step-parent who is available and willing to participate in treatment (parents not currently living with the adolescent participant may also participate)

Exclusion criteria

Exclusion Criteria:

  • Currently in full recovery (experienced minimal symptoms for at least 8 continuous weeks)
  • Meets Diagnostic and Statistical Manual of Mental Disorders, IV criteria for substance abuse disorder or substance dependence disorder within 3 months of study entry (based on the Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version )
  • Meets current criteria for bipolar, not otherwise specified, or substance-induced mood disorder
  • Diagnosis of mental retardation, autism, or organic central nervous system disorder
  • Severe, unremitting psychosis that is unresponsive to neuroleptic medications, and has lasted more than 3 months
  • Requires extended inpatient treatment (although participant can be hospitalized at the time of intake into the study)
  • Current life-threatening eating disorder, neurological condition, or other medical problem that requires immediate treatment
  • Exhibits or expresses serious homicidal tendencies
  • Victim of current sexual or physical abuse by parents or is in an environment marked by domestic violence among the parents or step-parents
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Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
145 participants (actual)

Study arms

  • Experimental
    1

    Family-Focused Treatment Plus Pharmacotherapy

    Behavioral: Family-Focused Treatment Plus Pharmacotherapy

  • Active comparator
    2

    Enhanced Care Plus Pharmacotherapy

    Behavioral: Enhanced Care Plus Pharmacotherapy

Interventions

  • BehavioralFamily-Focused Treatment Plus Pharmacotherapy

    Participants assigned to FFT will take part in weekly treatment sessions with their families for 12 weeks, biweekly for 12 weeks, monthly for 3 months, and then trimonthly until Month 24. Medications used for the pharmacotherapy portion of the study will include mood stabilizers, such as lithium or divalproex sodium, and atypical antipsychotics, such as quetiapine. Participants will also receive anti-anxiety medications, psychostimulants, or antidepressants as needed.

  • BehavioralEnhanced Care Plus Pharmacotherapy

    Participants assigned to Enhanced Care will take part in weekly brief psychoeducation sessions for 3 weeks. The pharmacotherapy treatment will be the same as for the FFT participants.

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What researchers measure

Primary outcomes

  1. Time to recovery

    Time frame: Measured at Month 24

  2. Time to recurrence

    Time frame: Measured at Month 24

  3. Severity of manic and depressive symptoms

    Time frame: Measured at Month 24

Secondary outcomes

  1. Functioning

    Time frame: Measured at Month 24

  2. Quality of life

    Time frame: Measured at Month 24

  3. Service utilization

    Time frame: Measured at Month 24

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Study locations

3 sites
  • University of Colorado, Dept. of Psychology
    Boulder, Colorado 80309-0345, United States
  • Cincinnati Children's Hospital Medical Center/MLC 3014
    Cincinnati, Ohio 45229, United States
  • University of Pittsburgh Medical Center Western Psychiatric Institute
    Pittsburgh, Pennsylvania 15213, United States
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References and documents

Publications

  • Miklowitz DJ, George EL, Axelson DA, Kim EY, Birmaher B, Schneck C, Beresford C, Craighead WE, Brent DA. Family-focused treatment for adolescents with bipolar disorder. J Affect Disord. 2004 Oct;82 Suppl 1(Suppl 1):S113-28. doi: 10.1016/j.jad.2004.05.020. PubMed 15571785 ↗
  • Miklowitz DJ, Axelson DA, Birmaher B, George EL, Taylor DO, Schneck CD, Beresford CA, Dickinson LM, Craighead WE, Brent DA. Family-focused treatment for adolescents with bipolar disorder: results of a 2-year randomized trial. Arch Gen Psychiatry. 2008 Sep;65(9):1053-61. doi: 10.1001/archpsyc.65.9.1053. PubMed 18762591 ↗
  • Miklowitz DJ, Schneck CD, George EL, Taylor DO, Sugar CA, Birmaher B, Kowatch RA, DelBello MP, Axelson DA. Pharmacotherapy and family-focused treatment for adolescents with bipolar I and II disorders: a 2-year randomized trial. Am J Psychiatry. 2014 Jun;171(6):658-67. doi: 10.1176/appi.ajp.2014.13081130. PubMed 24626789 ↗
  • O'Donnell LA, Weintraub MJ, Ellis AJ, Axelson DA, Kowatch RA, Schneck CD, Miklowitz DJ. A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder. Fam Process. 2020 Jun;59(2):376-389. doi: 10.1111/famp.12521. Epub 2020 Feb 3. PubMed 32012257 ↗
  • Weintraub MJ, Schneck CD, Axelson DA, Birmaher B, Kowatch RA, Miklowitz DJ. Classifying Mood Symptom Trajectories in Adolescents With Bipolar Disorder. J Am Acad Child Adolesc Psychiatry. 2020 Mar;59(3):381-390. doi: 10.1016/j.jaac.2019.04.028. Epub 2019 May 28. PubMed 31150753 ↗
  • O'Donnell LA, Axelson DA, Kowatch RA, Schneck CD, Sugar CA, Miklowitz DJ. Enhancing quality of life among adolescents with bipolar disorder: A randomized trial of two psychosocial interventions. J Affect Disord. 2017 Sep;219:201-208. doi: 10.1016/j.jad.2017.04.039. Epub 2017 Apr 28. PubMed 28570966 ↗
  • Keenan-Miller D, Peris T, Axelson D, Kowatch RA, Miklowitz DJ. Family functioning, social impairment, and symptoms among adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2012 Oct;51(10):1085-94. doi: 10.1016/j.jaac.2012.08.005. Epub 2012 Aug 28. PubMed 23021483 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 20, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00332098
Lead sponsor
University of California, Los Angeles
Collaborators
National Institute of Mental Health (NIMH)
Responsible party
David J. Miklowitz, Ph.D. (Professor of Psychiatry, University of California, Los Angeles) — Principal investigator
First posted
Jun 1, 2006
Start date
Aug 2006
Primary completion
Jul 2012
Completion
Jul 2012
Last update
May 20, 2014

Study contacts

David J. Miklowitz, PhD
principal investigator · University of Colorado at Boulder
Robert A. Kowatch, MD
principal investigator · University of Cincinnati
David A. Axelson, MD
principal investigator · University of Pittsburgh Medical Center

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2014. You cannot join it, but the record below documents what was studied.

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