Intervening early in children with bipolar disorder: is there a pot at the end of the Rainbow?

SETTING THE SCENE Children with bipolar disorder (BD) have considerable impairments in school, peer and family functioning and high rates of illness comorbidity. With age, their risk increases for suicide attempts, hospitalisation, substance abuse and medical complications. Pharmacotherapy is usually the first-line treatment for young people with BD, but paediatric patients may be less treatment-responsive than adults. Moreover, side effects (eg, weight gain) from commonly used mood stabilising medications can compromise children’s long-term health status. Three psychosocial interventions given adjunctively with medications have been tested and found effective in stabilising mood symptoms among bipolar children and adolescents: multifamily psychoeducation groups, dialectical behaviour therapy and family-focused therapy.