Integrating Pharmacotherapy and Psychotherapy for Paediatric Bipolar Disorder: Translating Science to Service

Abstract

Objective: For comprehensive management of paediatric bipolar disorder (PBD), it is imperative to combine psychopharmacotherapy with specific psychotherapy. This article proposes a model that incorporates (1) an overview of psychopathology, (2) a review of outcomes in psychopharmacotherapy trials, and (3) a summary of evidence-based forms of psychotherapy to complement pharmacotherapy. Results: The psychopathology of PBD is unique compared to that of adult bipolar disorder with prominent irritability, rapid cycling, high rates of co-morbid attention deficit hyperactivity disorder, mixed episodes and chronicity. Combination therapy with a second generation antipsychotic and a mood stabilizer is proving to be more effective than monotherapy with a mood stabilizer. Empirical findings for the support of family-focused, cognitive behavioral therapies with individual family or multifamily psychoeducation groups suggest that these psychosocial treatments are valuable complementary tools for clinicians who treat youths diagnosed with PBD. Conclusion: As pharmacotherapy and psychotherapy are most beneficial when applied together, the clinician’s understanding of the science behind these forms of treatment is likely to be of great value in effectively providing services to youths diagnosed with PBD.