Mary A Fristad1, Michelle E Roley-Roberts2, Sarah R Black3, L Eugene Arnold4. 1. Nationwide Children's Hospital, Big Lots Behavioral Health Services and Division of Child and Family Psychiatry, Columbus, Ohio; The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, Columbus, Ohio. Electronic address: Mary.fristad@nationwidechildrens.org. 2. Creighton University, Department of Psychiatry, Omaha, Nebraska. 3. University of New Orleans, Department of Psychology, New Orleans, Louisiana. 4. The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, Columbus, Ohio.
Abstract
BACKGROUND: This naturalistic follow-up study examines outcomes for youth with depression (n = 25) or subsyndromal bipolar disorder (n = 13) 2-5 years after participation in randomized clinical trials (RCTs) of omega-3 fatty acids (Ω3), individual family psychoeducational psychotherapy (IF-PEP), and their combination METHODS: Forty percent (38/95) of RCT families completed a follow-up assessment RESULTS: Relapse rates and conversion to bipolar disorder were consistent with published literature. Original treatment assignment did not impact current functioning. Overall, participants' mood severity, executive functioning, and global functioning continued to be better than at RCT baseline. Depressive symptoms increased significantly from end of RCT. Manic symptom severity, executive functioning, and global functioning remained comparable to end of RCT. The majority of parents and youth reported improved youth emotion regulation skills and family communication. They considered study participation beneficial, with increased understanding of mood disorders being the top reason. Half of youth commenced or continued Ω3 and 58% commenced or continued psychotherapy post-RCT, suggesting some degree of consumer satisfaction; these youth had lower depression severity than other participants. LIMITATIONS: Only 40% returned to this naturalistic follow-up; they were less likely to have an African-American parent, were of higher income, and youth were more symptomatic at end of RCT than those who did not return CONCLUSIONS: Improvement from RCT baseline continued although depressive symptom severity increased from end of RCT to follow-up. Meaningful improvements in youth and family functioning persisted 2-5 years later. Interventions that prevent relapse or conversion to BPSD are still needed for these vulnerable populations.
BACKGROUND: This naturalistic follow-up study examines outcomes for youth with depression (n = 25) or subsyndromal bipolar disorder (n = 13) 2-5 years after participation in randomized clinical trials (RCTs) of omega-3 fatty acids (Ω3), individual family psychoeducational psychotherapy (IF-PEP), and their combination METHODS: Forty percent (38/95) of RCT families completed a follow-up assessment RESULTS: Relapse rates and conversion to bipolar disorder were consistent with published literature. Original treatment assignment did not impact current functioning. Overall, participants' mood severity, executive functioning, and global functioning continued to be better than at RCT baseline. Depressive symptoms increased significantly from end of RCT. Manic symptom severity, executive functioning, and global functioning remained comparable to end of RCT. The majority of parents and youth reported improved youth emotion regulation skills and family communication. They considered study participation beneficial, with increased understanding of mood disorders being the top reason. Half of youth commenced or continued Ω3 and 58% commenced or continued psychotherapy post-RCT, suggesting some degree of consumer satisfaction; these youth had lower depression severity than other participants. LIMITATIONS: Only 40% returned to this naturalistic follow-up; they were less likely to have an African-American parent, were of higher income, and youth were more symptomatic at end of RCT than those who did not return CONCLUSIONS: Improvement from RCT baseline continued although depressive symptom severity increased from end of RCT to follow-up. Meaningful improvements in youth and family functioning persisted 2-5 years later. Interventions that prevent relapse or conversion to BPSD are still needed for these vulnerable populations.
Authors: David Axelson; Boris Birmaher; Michael Strober; Mary Kay Gill; Sylvia Valeri; Laurel Chiappetta; Neal Ryan; Henrietta Leonard; Jeffrey Hunt; Satish Iyengar; Jeffrey Bridge; Martin Keller Journal: Arch Gen Psychiatry Date: 2006-10
Authors: John R Weisz; Michael A Southam-Gerow; Elana B Gordis; Jennifer K Connor-Smith; Brian C Chu; David A Langer; Bryce D McLeod; Amanda Jensen-Doss; Alanna Updegraff; Bahr Weiss Journal: J Consult Clin Psychol Date: 2009-06
Authors: Laura Mufson; Kristen Pollack Dorta; Priya Wickramaratne; Yoko Nomura; Mark Olfson; Myrna M Weissman Journal: Arch Gen Psychiatry Date: 2004-06
Authors: Eric A Youngstrom; Barbara L Gracious; Carla K Danielson; Robert L Findling; Joseph Calabrese Journal: J Affect Disord Date: 2003-11 Impact factor: 4.839
Authors: David J Miklowitz; Christopher D Schneck; Elizabeth L George; Dawn O Taylor; Catherine A Sugar; Boris Birmaher; Robert A Kowatch; Melissa P DelBello; David A Axelson Journal: Am J Psychiatry Date: 2014-06 Impact factor: 18.112
Authors: Bret R Rutherford; Timothy M Cooper; Amanda Persaud; Patrick J Brown; Joel R Sneed; Steven P Roose Journal: J Clin Psychiatry Date: 2013-07 Impact factor: 4.384