The child's predicament in families with a mood disorder. Research findings and family interventions.
A family psychiatry approach to mood disorders brings together genetic and family history studies with epidemiologic patterns of individuals at risk to understand the child's predicament. Strands from different areas of research are woven together to argue for the powerful impact of family environment on the developing child. In response to an acute mood episode, family functioning is globally disturbed but may resolve. Family therapy is helpful during the mood episode for both crisis resolution and prevention. Unresolved problems may induce relapse. Dysfunctional family interaction patterns include rigidity, polarizations, and using the child as a go-between. The child's predicament is a cascade of risk factors including exposure to the ill parent, consequences of the illness on family relationships, and the impact on the child's coping capacities. Two common child response patterns are the child who acts as regulator of the family system and the child who opts out of the family. Clinical interventions, adapted to working with mood-disordered families, are illustrated through case vignettes. The need for a broad-based approach is stressed, in which family therapy is part of a package that includes hospitalization, psychopharmacology, and family education.
DiNicola
V F
VF
Department of Psychiatry, University of Ottawa, Ontario, Canada.
D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D001714:Bipolar Disorder / Q000523:psychology*; D002648:Child; D003866:Depressive Disorder / Q000523:psychology*; D005190:Family; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D010553:Personality Development; D012931:Social Environment