Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy
Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy
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DOI：
10.1016/s0006-3223(00)00931-8
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发表时间：
2000-09-15
影响因子：
10.6
通讯作者：
Suddath, R
中科院分区：
文献类型：
--
作者：
Miklowitz, DJ;Simoneau, TL;Suddath, R
背景：很少有研究检验心理社会治疗和药物治疗对双相情感障碍的联合作用。本研究采用随机对照设计，检验了为期9个月的以家庭为中心的心理教育治疗(FFT)方案。方法：双相情感障碍患者(N=101)在疾病发作后不久被招募，随机分配到21次FFT治疗(n=31)或包括两次家庭教育和后续危机管理的对照治疗(CM；n=70)。两种治疗方法均超过9个月；患者同时服用稳定情绪的药物。每隔3个月对患者进行一年的复发状态、症状严重程度和药物依从性评估。结果：在研究年度内，与CM组患者相比，FFT组患者的复发次数更少，复发前的延迟时间更长。快速傅立叶变换的患者在抑郁(但不是躁狂)症状方面也有更大的改善。最显著的改善是在FFT患者中，他们的家人表达了很高的情感。结论：家庭心理教育治疗是双相情感障碍药物治疗的有效辅助手段。未来的研究应该评估家庭治疗与其他形式的心理治疗在治疗师与患者接触的数量上相匹配的情况。(C)2000年生物精神病学学会。
Background: Few studies have examined the combined effects of psychosocial treatment and pharmacotherapy for bipolar disorder This study used a randomized controlled design to examine a 9-month, manual-based program of family-focused psychoeducational treatment (FFT).Methods: Bipolar patients (N = 101) were recruited shortly after an illness episode and randomly assigned to 21 sessions of FFT(n = 31) or to a comparison treatment involving two family education sessions and follow-up crisis management (CM; n = 70). Both treatments were delivered over 9 months; patients were simultaneously maintained on mood stabilizing medications. Patients were evaluated every 3 months for I year as to relapse status, symptom severity, and medication compliance.Results: Patients assigned to FFT had fewer relapses and longer delays before relapses during the study year than did patients in CM. Patients in FFT also showed greater improvements in depressive (but not manic) symptoms. The most dramatic improvements were among FFT patients whose families were high in expressed emotion. The efficacy of FFT could not be explained by differences among patients in medication regimes or compliance.Conclusions: Family-focused psychoeducational treatment appears to be an efficacious adjunct to pharmacotherapy for bipolar disorder. Future studies should evaluate family treatment against other forms of psychotherapy matched in amount of therapist-patient contact. (C) 2000 Society of Biological Psychiatry.