Integration of Patient, Provider, and Systems Treatment Approaches in Bipolar Disorder: Where Evidence Meets Practice Reality

Integration of Patient, Provider, and Systems Treatment Approaches in Bipolar Disorder: Where Evidence Meets Practice Reality
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双相情感障碍患者、提供者和系统治疗方法的整合:证据与实践的结合

DOI:
10.1002/9780470696385.ch13
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发表时间:
2008
期刊:
American Journal of Psychiatric Rehabilitation
影响因子:
--
通讯作者:
S. Kennedy
S. Kennedy
中科院分区:
--
文献类型:
--
作者:
S. Parikh;S. Kennedy

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双相情感障碍通常以夸大为躁狂的主要症状,但从另一个角度来看,夸大也可能是该疾病的特征:几乎没有其他精神障碍在其过多的临床表现中如此夸张(Goldberg & Harrow, 1999; Goodwin & Jamison, 1990)。抑郁、躁狂和混合状态都需要本质上不同的生物、心理和社会干预,即使是同一事件,两个生物精神病学家或两个心理治疗师也可以非常不同地处理(Prien & Potter, 1990; Prien & Rush, 1996)。医生如何在众多治疗途径中进行选择?医学科学确定了每一种特定途径的疗效,但只有医学艺术——用临床判断和综合方法权衡个人情况的能力——才能实现真正有效的治疗。本章探讨了几种主要的治疗方法,每一种方法在本书中都有详细的讨论,但它试图为编织治疗挂毯提供一个模型。
Bipolar disorder is often characterized by grandiosity as a cardinal symptom of mania, but grandiosity may also characterize the illness from another perspective: virtually no other psychiatric disorder is as grand in its plethora of clinical presentations (Goldberg & Harrow, 1999; Goodwin & Jamison, 1990). Depression, mania, and mixed states each require substantially different biological, psychological, and social interventions, and even the same episode can be approached very differently by two biological psychiatrists or two psychotherapists (Prien & Potter, 1990; Prien & Rush, 1996). How is a practitioner to choose among the many pathways to treatment? The science of medicine identifies the efficacy of each particular path, but only the art of medicine—the weighing of individual circumstances with clinical judgement and the capacity to integrate approaches—allows for truly effective treatment. This chapter explores several dominant approaches to treatment, each of which has been discussed in detail in this book—but it then attempts to provide a model for weaving a therapeutic tapestry.
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