A systematic review of interventions in the early course of bipolar disorder I or II: a report of the International Society for Bipolar Disorders Taskforce on early intervention.
A systematic review of interventions in the early course of bipolar disorder I or II: a report of the International Society for Bipolar Disorders Taskforce on early intervention.
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DOI：
10.1186/s40345-022-00275-3
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发表时间：
2023-01-03
影响因子：
4
通讯作者：
Marwaha, S.
中科院分区：
文献类型：
--
作者：
Ratheesh, A.;Hett, D.;Ramain, J.;Wong, E.;Berk, L.;Conus, P.;Fristad, M. A.;Goldstein, T.;Hillegers, M.;Jauhar, S.;Kessing, L., V;Miklowitz, D. J.;Murray, G.;Scott, J.;Tohen, M.;Yatham, L. N.;Young, A. H.;Berk, M.;Marwaha, S.
关键词：
鉴于双相情感障碍(BD)进展性疾病的可能性，了解在病程早期实施干预的益处和风险是很重要的。我们对BD I或II早期干预措施的有效性进行了系统评价。从1979年1月1日至2022年9月14日，我们完成了MEDLINE、eecINFO、EMBASE、Cochrane中央对照试验注册中心、CINAHL和Google Scholar的系统检索。我们纳入了对照试验，考察干预对BD I或II患者的症状、病程、功能和耐受性结果的影响。我们将患者归类为早期患者，如果他们(A)是第一次为躁狂发作寻求帮助，(B)一生中有多达3次躁狂发作，或(C)有至多6次一生情绪发作。证据质量采用等级法进行评估。从4135份独特的出版物中，我们纳入了25份报告，分别代表16项随机研究中的2212名参与者，以及9项非随机研究中的17,714名参与者。现有证据表明，在早期病程中，与其他情绪稳定剂相比，锂的使用与较低的复发风险有关。与中期使用抗精神病药物相比，情绪稳定剂也与更好的全球功能有关。虽然关于心理治疗的总结性发现受到异质性的限制，但以家庭为重点的认知行为干预与降低复发风险或改善症状结果相关。有一些证据表明，同样的药物干预在预防复发方面更有效，如果在病程较早的时候使用，而不是在疾病的后期使用。虽然已经有了有希望的初步发现，但仍需要进行更有力的试验，以检验干预措施在青少年和成人早期疾病病程中的有效性和耐受性。具体地说，迫切需要比较锂与其他药理药物在预防复发方面的相对益处。除了症状结果外，还应更多地关注功能影响和耐受性。应向BD早期患者提供有效的药物和心理干预，利用共同的决策方法平衡潜在风险。网上版载有补充材料，可在10.1186/s40345-022-00275-3查阅。
Given the likelihood of progressive illness in bipolar disorder (BD), it is important to understand the benefits and risks of interventions administered early in illness course. We conducted a systematic review of the effectiveness of interventions in the early course of BD I or II. We completed a systematic search on MEDLINE, PsycINFO, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL and Google Scholar from 1/1/1979 till 14/9/2022. We included controlled trials examining intervention effects on symptomatic, course, functional and tolerability outcomes of patients in the ‘early course’ of BD I or II. We classified patients to be in early course if they (a) were seeking help for the first time for a manic episode, (b) had a lifetime history of up to 3 manic episodes, or (c) had up to 6 lifetime mood episodes. Evidence quality was assessed using the GRADE approach. From 4135 unique publications we included 25 reports representing 2212 participants in 16 randomized studies, and 17,714 participants from nine non-randomized studies. Available evidence suggested that in early illness course, lithium use was associated with lower recurrence risk compared with other mood stabilizers. Mood stabilizers were also associated with better global functioning, compared with the use of antipsychotics in the medium term. While summative findings regarding psychological therapies were limited by heterogeneity, family-focused and cognitive-behavioral interventions were associated with reduced recurrence risk or improved symptomatic outcomes. There was some evidence that the same pharmacological interventions were more efficacious in preventing recurrences when utilized in earlier rather than later illness course. While there are promising initial findings, there is a need for more adequately powered trials to examine the efficacy and tolerability of interventions in youth and adults in early illness course. Specifically, there is a compelling need to compare the relative benefits of lithium with other pharmacological agents in preventing recurrences. In addition to symptomatic outcomes, there should be a greater focus on functional impact and tolerability. Effective pharmacological and psychological interventions should be offered to those in early course of BD, balancing potential risks using shared decision-making approaches. The online version contains supplementary material available at 10.1186/s40345-022-00275-3.
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影响因子：
5.4
作者：
Goldstein BI;Birmaher B;Carlson GA;DelBello MP;Findling RL;Fristad M;Kowatch RA;Miklowitz DJ;Nery FG;Perez-Algorta G;Van Meter A;Zeni CP;Correll CU;Kim HW;Wozniak J;Chang KD;Hillegers M;Youngstrom EA
通讯作者：
Youngstrom EA
DOI：
10.1016/j.jaac.2019.06.013
发表时间：
2020-10-01
影响因子：
13.3
作者：
Hafeman, Danella M.;Rooks, Brian;Birmaher, Boris
通讯作者：
Birmaher, Boris
影响因子：
5.4
作者：
Craig, TJ;Grossman, S;Bromet, EJ
通讯作者：
Bromet, EJ
影响因子：
5.4
作者：
Berk, Michael;Brnabic, Alan;McGorry, Patrick D.
通讯作者：
McGorry, Patrick D.
影响因子：
5.4
作者：
Bolton S;Warner J;Harriss E;Geddes J;Saunders KEA
通讯作者：
Saunders KEA