Depuis une quinzaine d’années, plusieurs types d’interventions psychothérapiques à destination des enfants et des adolescents présentant un trouble bipolaire ont été développés. Parmi celles-ci, celles centrées sur la famille (comme le programme family-focused treatment for adolescents with bipolar spectrum disorders) ou incluant enfants et parents (comme les programmes multi- or individual-family psychoeducational psychotherapy et child- and family-focused cognitive-behavioral therapy ou encore la thérapie comportementale dialectique) s’avèrent prometteuses. Les interventions individuelles (comme la thérapie interpersonnelle avec aménagement des rythmes sociaux et la thérapie cognitivo-comportementale) apparaissent à ce jour moins bien documentées. Quoi qu’il en soit, les études réalisées comportent toutes de nombreuses limites sur le plan méthodologique rendant difficiles l’interprétation et la généralisation de leurs résultats. C’est dire que des études complémentaires s’avèrent nécessaires pour juger de l’impact de ces interventions, notamment à long terme, sur le devenir des enfants et des adolescents bipolaires.

To review the options for psychosocial interventions in pediatric bipolar disorders.

A comprehensive literature review of randomized clinical trials and open-label studies was conducted.

Randomized controlled trials show that psychosocial interventions involving families (i.e. family-focused treatment) or individual and family therapy (i.e. multi- or individual-family psychoeducational psychotherapy, child- and family-focused cognitive-behavioral therapy, dialectical behavior therapy) may be effective through added benefit to pharmacotherapy. All these interventions share numerous common therapeutic elements such as psychoeducation and skills training. Individual interventions (i.e. interpersonal and social rhythm therapy and cognitive-behavioral therapy) are to date less well documented. However that may be, outcome studies remain few, and numerous methodological limitations (small sample sizes, designs not very rigorous) restrict the interpretability and generalisability of their results. In addition, most studies were conducted in specialty centers with highly trained therapists, and the feasibility and acceptability of these interventions in practice settings remain to be shown.

Despite recent developments in identifying effective psychosocial interventions, numerous critical gaps remain, and more longitudinal studies are needed to clarify how these interventions work.