Bipolar Disorder in Children - Treatment

Treatment

Medications can produce important side effects so interventions have been recommended to be closely monitored and families of patients be informed of the different possible problems that can arise. Atypical antipsychotics may produce weight gains as well as other metabolic problems, including diabetes mellitus type 2 and hyperlipidemia. Extrapyramidal secondary effects may appear with these medications. These include tardive dyskinesia, a difficult-to-treat movement disorder (dyskinesia) that can appear after long-term use of anti-psychotics. Liver and kidney damage are a possibility with mood stabilizers.

Psychological treatment usually includes some combination of education on the disease, group therapy and cognitive behavioral therapy. Children with BD and their families are informed, in ways accordingly to their age and family role, about the different aspects of BD and its management including causes, signs and symptoms and treatments. Group therapy aims to improve social skills and manage group conflicts, with role-playing as a critical tool. Finally cognitive-behavioral training is directed towards the participants having a better understanding and control over their emotions and behaviors.

Family therapy has strong support for treatment of pediatric bipolar disorder. Family Therapy is a branch of psychotherapy that works with families. It tends to view change in terms of the systems of interactions between family members. Families are seen as an interconnected force where the actions of the family members affect the health or dysfunction of each individual and the family as a whole. Family therapists focus on relationship patterns and are generally more interested in what goes on between family members rather than within one or more individuals. One family member may have a problem and the family relationships may be contributing to or maintaining that problem. For example, when a child has a behavior problem, family therapists may see the child as a 'scapegoat' and view the problem as actually residing within the family system. Family therapists avoid blaming any family member for the problem, and instead help the family interact in different ways that may solve the problem. There are both general, historical models of Family therapy (i.e., Structural, Strategic, Bowenian) and more specific, evidence-based approaches that are based on the earlier models. Strong research evidence suggests that both general and specific family therapy approaches are effective with a wide variety of clinical problems, including the treatment of bipolar spectrum disorders.

Cognitive behavioral therapy (CBT) is also effective in treating bipolar disorder in young people. CBT is the term used for a group of psychological treatments that are based on scientific evidence. These treatments have been proven to be effective in treating many psychological disorders among children and adolescents, as well as adults.

When all treatment options are ineffective clozapine and electroconvulsive therapy have been proposed as last choice possibilities.

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