Psychotherapy for bipolar depression: a phase-specific treatment strategy?
Psychotherapy for bipolar depression: a phase-specific treatment strategy?
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双相抑郁症的心理治疗：特定阶段的治疗策略？
DOI：
10.1034/j.1399-5618.2001.030102.x
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发表时间：
2001
影响因子：
5.4
通讯作者：
Frank,E
中科院分区：
文献类型：
--
作者：
Swartz,HA;Frank,E
目的：双相情感障碍的抑郁期特别难以治疗。双相抑郁症的药物治疗策略往往不足。因此，我们回顾了关于心理治疗作为药物辅助治疗双相抑郁症的作用的文献。方法：除了一个例外，没有专门用于治疗双相抑郁症的心理治疗的描述。因此，我们回顾了已发表的双相情感障碍心理治疗的总体报告，并从这些报告中提取了有关治疗对该疾病抑郁期具体效果的相关数据或印象。 结果：描述的双相情感障碍的心理社会方法包括心理教育、团体治疗、认知行为治疗、夫妻治疗、家庭治疗和人际心理治疗。在一项专门用于治疗双相抑郁症的试点研究中，仅测试了认知行为疗法。家庭治疗以及人际和社会节律治疗的随机对照试验结果表明，相对于躁狂症，这些治疗在抑郁症的治疗和预防方面可能更有效。 结论：数量有限的精心设计的研究和大量的病例报告限制了关于心理治疗在双相抑郁症治疗中作用的明确结论。然而，一致的报告表明，认知行为疗法、家庭疗法以及人际和社会节律疗法可能对双相抑郁特别有用。我们提出了一种治疗双相情感障碍的新方法，包括使用以可变模式提供并与波动的情绪状态相关的特定阶段的顺序心理治疗。
Objectives:The depressive phase of bipolar disorder is particularly difficult to treat. Pharmacologic strategies for bipolar depression are often inadequate. We therefore review the literature on the role of psychotherapy as an adjunct to medication in the treatment of bipolar depression.Methods:With one exception, there are no descriptions of psychotherapies employed specifically for the treatment of bipolar depression. We therefore reviewed published reports of psychotherapy for bipolar disorder in general and extracted from these reports relevant data or impressions about the specific effects of the therapies on the depressive phase of the disorder.Results:Described psychosocial approaches to bipolar disorder include psychoeducation, group therapy, cognitive‐behavioral therapy, couples therapy, family therapy, and interpersonal psychotherapy. Only cognitive‐behavioral therapy has been tested in a pilot study for the treatment of bipolar depression specifically. Results from randomized controlled trials of family therapy and interpersonal and social rhythm therapy suggest that these treatments may be more efficacious in the treatment and prevention of depression relative to mania.Conclusions:A limited number of well‐designed studies and preponderance of case reports limit definitive conclusions about the role of psychotherapy in the treatment of bipolar depression. However, converging reports suggest that cognitive‐behavioral therapy, family therapy, and interpersonal and social rhythm therapy may be particularly useful for bipolar depression. We propose a novel approach to the treatment of bipolar disorder that includes the use of phase‐specific sequenced psychotherapies delivered in variable patterns and linked to fluctuating mood states.