Psychotherapeutic and Psychosocial Approaches in Bipolar Disorder: A Systematic Literature Review
Psychotherapeutic and Psychosocial Approaches in Bipolar Disorder: A Systematic Literature Review
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DOI：
10.5080/u6157
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发表时间：
2010-06-01
影响因子：
0.9
通讯作者：
Ozerdem, Ayseguel
中科院分区：
文献类型：
--
作者：
Cakir, Sibel;Ozerdem, Ayseguel
目的：本系统评价的目的是关键介绍的心理社会方法在双相情感障碍方面的基本面和影响的临床过程和结果的illustration.Method：PubMed，Medline，PsycINFO和土耳其数据库之间的1980年和2009年进行了搜索，使用关键词“双相情感障碍”和“心理治疗”，“心理社会方法”，“心理干预”。随机对照试验，审查和meta analysis was included. Results：50项研究符合纳入标准，其中四种类型的干预措施-心理教育，家庭为重点，认知行为和人际心理社会节律治疗-进行了研究。24篇原始研究论文中，22篇为随机对照试验，23篇为综述，3篇为荟萃分析。在几乎所有的研究中，心理治疗方法被用作药物治疗的替代品。团体心理教育在预防躁狂复发方面更有效，而认知行为和以家庭为中心的治疗在预防抑郁发作方面更有效。报告了次要结局的其他获益，如药物依从性、住院次数和持续时间、复发时间。对功能和生活质量的影响很少进行评估，但据报道是有益的。文化适应的研究是稀缺的，需要探索。结论：在双相情感障碍的药物治疗的心理社会干预似乎是有效的预防复发。开始治疗的疾病阶段和预防的目标发作在干预措施之间各不相同。未来的研究需要加强心理社会干预在治疗指南中的地位，并有助于缩小药物治疗有效性和功能改善之间的差距。
Objective: Aim of this systematic review was critical presentation of psychosocial approaches in bipolar disorders with regard to their fundamentals and impact on the clinical course and outcome of the illness.Method: PubMed, Medline, PsycINFO and Turkish databases between 1980 and 2009 were searched by using keywords "bipolar disorder" and "psychotherapy", "psychosocial approaches", "psychological intervention". Randomized controlled trials, reviews and meta analysis were included.Results: Fifty studies met the inclusion criteria where four types of interventions -psychoeducation, family focused, cognitive behavioral and interpersonal psychosocial rhythm therapy- were studied. Twenty two of 24 original research papers were randomized controlled trials, 23 were reviews and 3 were meta analysis. In almost all studies psychotherapeutic approach was applied as adjunctive to pharmacotherapy. Group psychoeducation was more effective in preventing manic relapses, whereas cognitive behavioral and family focused therapies showed efficacy in preventing depressive episodes. Additional benefits on such secondary outcomes as medication compliance, number and duration of hospitalizations, time to recurrence were reported. Effects on functionality and quality of life were assessed rarely, but reported to be beneficial. Cultural adaptation studies are scarce and needs exploration.Conclusion: Psychosocial interventions adjunctive to pharmacotherapy in bipolar disorder seem to be effective in relapse prevention. Stage of illness where the therapy is initiated and the targeted episode for prevention varies between interventions. Future studies are needed to strengthen the place of psychosocial interventions in treatment guidelines and would contribute to narrow the gap between effectiveness of pharmacotherapy and functional improvement.