CU professor to pioneer new bipolar disorder study

Research to look at early intervention with children and teens

Brittany Anas, Daily Camera

Published September 24, 2007 at midnight

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Bipolar disorder can rattle teenagers and scar development in their crucial coming-of-age years, as the disease might cause them to have suicidal thoughts and take high risks when it comes to sex, drugs and alcohol, mental-health experts say.

Adding to concerns in the mental-health field is how little research there is when it comes to identifying bipolar disorder in teens and children, and pinpointing how the manic and depressive stages can be controlled, says one official with the National Alliance on Mental Illness.

That crucial gap in research, though, is being addressed by a University of Colorado psychology professor who will be leading a new study on bipolar disorder. The findings will help determine whether early treatment of children with a high risk of developing bipolar disorder can curb some of its effects before it severely disrupts their lives.

David Miklowitz, who has been studying the disorder for more than 25 years, received a $600,000 grant from the National Institute of Mental Health for the study. He pioneered a treatment method for adults called family-focused therapy, which, used in conjunction with medication, allows patients and their family members to take part in therapy that addresses coping and problem solving.

Understanding bipolar disorder

What it is: Bipolar disorder is inherited and caused by a biochemical imbalance in the brain. It affects an estimated 5.7 million Americans, many of whom develop the disorder as teenagers or young adults. CU Professor David Miklowitz estimates that as many as 4 percent of the population is affected by the disease.

Symptoms of bipolar: During manic episodes, those affected may have inflated self-esteem or grandiosity, go without sleep, become impulsive and take part in high-risk behaviors — such as sex, drug and alcohol use, and excessive spending. During depressive stages, there can be depression, extreme appetite or weight changes, self-loathing and sleep changes.

Other research: Miklowitz was a co-principal investigator of the "Systematic Treatment Enhancement Program," the largest federally funded study of bipolar disorder. The $27-million, seven-year study found that patients who receive psychotherapy, including family-focused sessions, in addition to medicine, get better faster from the debilitating depressive phases and stay better longer. The results were published in the April edition of the Archives of General Psychiatry.

On the Web: A podcast featuring Miklowitz discussing his bipolar research can be heard at www.colorado.edu/news/podcasts.

Source: University of Colorado and National Alliance on Mental Illness

In the new study, Miklowitz will be working with Kiki Chang, of Stanford University. The researchers will design a version of family-focused treatment for children and teenagers from ages 9 to 17 who are at a high risk of developing bipolar disorder. Risks include having some bipolar symptoms, like extreme moodiness, but not enough for a formal diagnosis. Another factor is having an immediate family member with the disorder.

Current research suggests that onset of bipolar disorder during childhood is more common than previously thought, and is often a sign of a more severe form of the disorder.

"One of the key questions we're asking is, if you intervene early with family-focused treatment, do you actually delay the onset of the full disorder, or perhaps reduce its severity once it has manifested?" Miklowitz said.

He said that, typically, people undergo treatment only after they are diagnosed with bipolar disorder.

"This study is different in that it will help us determine whether we can minimize future impairments by intervening prior to the first illness episode," Miklowitz said.

Bipolar disorder can make it difficult for teenagers trying to develop relationships and social skills, said Darcy Gruttadaro, director of the Child and Adolescent Action Center at the National Alliance on Mental Illness.

"There is an absolute need to focus on early identification and prevention to the extent that is possible," Gruttadaro said.

Bipolar can torment affected individuals with wild mood swings between periods of abnormally high energy, called mania, and debilitating bouts of extreme depression. Left untreated, it can hurt family relationships, split up marriages, lead to unemployment or even suicide, experts say.

Fully controlling ups and downs of bipolar disorder is not possible, but doctors can delay patients' relapses.

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