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Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A Randomized Clinical Trial.

Tina R Goldstein1, John Merranko1, Noelle Rode1

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Dialectical Behavior Therapy (DBT) significantly reduced suicide attempts in adolescents with bipolar disorder compared to standard care. This psychosocial intervention shows promise for this high-risk population.

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Area of Science:

  • Psychiatry
  • Adolescent Mental Health
  • Suicidology

Background:

  • Early-onset bipolar disorder (BP) presents a significant risk for suicidal behavior.
  • Existing psychosocial interventions do not specifically target suicidal behavior in this demographic.
  • Adolescents with bipolar spectrum disorder require effective treatments to mitigate suicide risk.

Purpose of the Study:

  • To compare the efficacy of Dialectical Behavior Therapy (DBT) against standard of care (SOC) psychotherapy in reducing suicide attempts among adolescents with bipolar spectrum disorder over a one-year period.
  • To evaluate DBT's effectiveness in managing mood symptoms and episodes in this population.

Main Methods:

  • A randomized clinical trial involving 100 adolescents (aged 12-18) diagnosed with bipolar spectrum disorder.
  • Participants were assigned to either 1 year of DBT (36 sessions) or SOC psychotherapy, with all receiving medication management.
  • Suicide attempts, mood symptoms (depression, hypomania/mania), and emotion dysregulation were assessed quarterly over one year.

Main Results:

  • Both DBT and SOC groups showed similar improvements in mood symptoms.
  • DBT participants reported significantly fewer suicide attempts over the follow-up period compared to SOC participants, as measured by both the ALIFE and C-SSRS.
  • The reduction in suicide attempts with DBT was moderated by a history of suicide attempts and mediated by improvements in emotion dysregulation.

Conclusions:

  • Dialectical Behavior Therapy (DBT) is effective in decreasing suicide attempts among adolescents with bipolar spectrum disorder.
  • DBT offers a targeted psychosocial intervention for high-risk adolescents, addressing suicidal behavior and emotion dysregulation.
  • This study supports the use of DBT as a valuable treatment for reducing suicide attempts in early-onset bipolar disorder.