DBT
Trial question
What is the role of dialectical behavior therapy in adolescents with bipolar spectrum disorder?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
85.0% female
15.0% male
N = 100
100 patients (85 female, 15 male).
Inclusion criteria: adolescents, aged 12-18 years, diagnosed with bipolar spectrum disorder.
Key exclusion criteria: developmental disability or autism spectrum disorder; engaged in other psychotherapy; life-threatening medical condition requiring immediate treatment; current victim of sexual or physical abuse.
Interventions
N=47 dialectical behavior therapy (36 sessions of the individual and family skills training delivered over 1 year plus pharmacotherapy).
N=53 standard of care psychotherapy (1 year of individual or family therapy with clinician trained in evidence-based treatments for youth plus pharmacotherapy).
Primary outcome
Adolescent Longitudinal Follow-Up Evaluation suicide attempts over follow-up
0.2
1.1
1.1
0.8
0.6
0.3
0.0
Dialectical behavior
therapy
Standard of care
psychotherapy
Significant
decrease ▼
Significant decrease in Adolescent Longitudinal Follow-Up Evaluation suicide attempts over follow-up (0.2 vs. 1.1; IRR 0.32, 95% CI 0.11 to 0.96).
Secondary outcomes
Significant decrease in Columbia-Suicide Severity Rating Scale Pediatric Version suicide attempts over follow-up (0.04 vs. 0.1; IRR 0.13, 95% CI 0.02 to 0.78).
Conclusion
In adolescents, aged 12-18 years, diagnosed with bipolar spectrum disorder, dialectical behavior therapy was superior to standard of care psychotherapy with respect to Adolescent Longitudinal Follow-Up Evaluation suicide attempts over follow-up.
Reference
Tina R Goldstein, John Merranko, Noelle Rode et al. Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2024 Jan 1;81(1):15-24.
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