Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review.
Psychological interventions for bipolar disorder in low- and middle-income countries: systematic review.
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低收入国家和中等收入国家对躁郁症的心理干预措施：系统评价。
DOI：
10.1192/bjo.2018.46
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发表时间：
2018-09
期刊：
影响因子：
5.4
通讯作者：
Fekadu A
中科院分区：
文献类型：
--
作者：
Demissie M;Hanlon C;Birhane R;Ng L;Medhin G;Fekadu A
与单独的药物治疗相比，双相情感障碍的辅助心理干预在预防或延迟复发和改善预后方面表现出更好的疗效。评估中低收入国家双相情感障碍心理干预的效果。采用PubMed、PsycINFO、Medline、EMBASE、Cochrane系统评价数据库、Cochrane中央对照试验注册库、拉丁美洲和加勒比卫生科学文献中心和非洲期刊在线数据库进行系统评价，不受语言和发表年份的限制。研究的方法学异质性排除了meta分析。共纳入18项辅助研究：心理教育（n = 14）、家庭干预（n = 1）、群体认知行为疗法（CBT） （n = 2）和群体正念认知疗法（MBCT） （n = 1）。总共18项研究中有16项来自中高收入国家，没有一项来自低收入国家。所有人都使用心理健康专家或经验丰富的治疗师进行干预。大多数研究有中等偏倚风险。心理教育改善了治疗依从性、对双相情感障碍的认识和态度以及生活质量，并导致复发率和住院率下降。家庭心理教育预防复发，减少住院率，提高药物依从性。CBT减轻了抑郁和躁狂症状。MBCT减少了情绪失调。辅助心理干预与药物治疗似乎可以改善中等收入国家双相情感障碍患者的临床结果和生活质量。需要进一步的研究来调查环境适应和非专业人员在提供心理干预措施方面的作用，以确保这些干预措施在低收入国家环境中的可扩展性和有效性。没有。
Adjunctive psychological interventions for bipolar disorder have demonstrated better efficacy in preventing or delaying relapse and improving outcomes compared with pharmacotherapy alone. To evaluate the efficacy of psychological interventions for bipolar disorder in low- and middle-income countries. A systematic review was conducted using PubMed, PsycINFO, Medline, EMBASE, Cochrane database for systematic review, Cochrane central register of controlled trials, Latin America and Caribbean Center on Health Science Literature and African Journals Online databases with no restriction of language or year of publication. Methodological heterogeneity of studies precluded meta-analysis. A total of 18 adjunctive studies were identified: psychoeducation (n = 14), family intervention (n = 1), group cognitive–behavioural therapy (CBT) (n = 2) and group mindfulness-based cognitive therapy (MBCT) (n = 1). In total, 16 of the 18 studies were from upper-middle-income countries and none from low-income countries. All used mental health specialists or experienced therapists to deliver the intervention. Most of the studies have moderately high risk of bias. Psychoeducation improved treatment adherence, knowledge of and attitudes towards bipolar disorder and quality of life, and led to decreased relapse rates and hospital admissions. Family psychoeducation prevented relapse, decreased hospital admissions and improved medication adherence. CBT reduced both depressive and manic symptoms. MBCT reduced emotional dysregulation. Adjunctive psychological interventions alongside pharmacotherapy appear to improve the clinical outcome and quality of life of people with bipolar disorder in middle-income countries. Further studies are required to investigate contextual adaptation and the role of non-specialists in the provision of psychological interventions to ensure scalability and the efficacy of these interventions in low-income country settings. None.
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影响因子：
15.8
作者：
Dua T;Barbui C;Clark N;Fleischmann A;Poznyak V;van Ommeren M;Yasamy MT;Ayuso-Mateos JL;Birbeck GL;Drummond C;Freeman M;Giannakopoulos P;Levav I;Obot IS;Omigbodun O;Patel V;Phillips M;Prince M;Rahimi-Movaghar A;Rahman A;Sander JW;Saunders JB;Servili C;Rangaswamy T;Unützer J;Ventevogel P;Vijayakumar L;Thornicroft G;Saxena S
通讯作者：
Saxena S
影响因子：
2.3
作者：
Cuhadar, Dondu;Cam, M. Olcay
通讯作者：
Cam, M. Olcay
影响因子：
6.7
作者：
de Barros Pellegrinelli, K.;Costa, L. F. de O.;Moreno, R. A.
通讯作者：
Moreno, R. A.
影响因子：
22.8
作者：
Gomes, B. C.;Abreu, L. N.;Lafer, B.
通讯作者：
Lafer, B.
影响因子：
10.5
作者：
Fekadu, Abebaw;Medhin, Girmay;Shibre, Teshome
通讯作者：
Shibre, Teshome