title: An evidence map of psychosocial interventions for the earliest stages of bipolar disorder.
abstract: Depression, schizophrenia, and bipolar disorder are three of the four most burdensome problems in people aged under 25 years. In psychosis and depression, psychological interventions are effective, low-risk, and high-benefit approaches for patients at high risk of first-episode or early-onset disorders. We review the use of psychological interventions for early-stage bipolar disorder in patients aged 15-25 years. Because previous systematic reviews had struggled to identify information about this emerging sphere of research, we used evidence mapping to help us identify the extent, distribution, and methodological quality of evidence because the gold standard approaches were only slightly informative or appropriate. This strategy identified 29 studies in three target groups: ten studies in populations at high risk for bipolar disorder, five studies in patients with a first episode, and 14 studies in patients with early-onset bipolar disorder. Of the 20 completed studies, eight studies were randomised trials, but only two had sample sizes of more than 100 individuals. The main interventions used were family, cognitive behavioural, and interpersonal therapies. Only behavioural family therapies were tested across all of our three target groups. Although the available interventions were well adapted to the level of maturity and social environment of young people, few interventions target specific developmental psychological or physiological processes (eg, ruminative response style or delayed sleep phase), or offer detailed strategies for the management of substance use or physical health.
authors.affiliation: Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Laboratory of Epidemiology and Social Psychiatry, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: Martine
authors.initials: M
authors.lastname: Vallarino
authors.affiliation: Faculté de médecine, Université Paris Est, Créteil, France; Pôle de Psychiatrie, APHP, Hôpital H Mondor-A Chenevier, Créteil, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Henry
authors.affiliation: Faculté de médecine, Université Paris Est, Créteil, France; Pôle de Psychiatrie, APHP, Hôpital H Mondor-A Chenevier, Créteil, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Etain
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Lillian J
authors.initials: LJ
authors.lastname: Gehue
authors.affiliation: Early Psychosis Prevention & Intervention Centre, Orygen Youth Health, Melbourne, VIC, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Macneil
authors.affiliation: Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia; School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Scott
authors.affiliation: Laboratory of Epidemiology and Social Psychiatry, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy; IRIS Postgraduate Psychotherapy School, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Barbato
authors.affiliation: Département Universitaire de Psychiatrie CHUV, Service de Psychiatrie Générale, Lausanne University, Clinique de Cery, Prilly, Lausanne, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Conus
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of Washington, WA, Seattle, USA.
authors.forename: Stefanie A
authors.initials: SA
authors.lastname: Hlastala
authors.affiliation: Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, and Ohio State University Harding Hospital, Columbus, OH, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Fristad
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California, Los Angeles, CA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.affiliation: Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Centre for Affective Disorders, IPPN, King's College, London, UK. Electronic address: jan.scott@newcastle.ac.uk.
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy*; D018479:Early Intervention, Educational; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult