Evidence-based psychosocial treatments for child and adolescent bipolar spectrum disorders.
Evidence-based psychosocial treatments for child and adolescent bipolar spectrum disorders.
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DOI：
10.1080/15374416.2013.822309
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
MacPherson HA
中科院分区：
文献类型：
--
作者：
Fristad MA;MacPherson HA
儿童双相谱系障碍（BPSD）是与发病率和死亡率相关的严重疾病。虽然大多数治疗研究检查了儿科BPSD的药物治疗，但越来越多的文献表明，心理社会干预也很重要：为家庭提供对BPSD症状，病程和治疗的理解;教导青少年和父母应对症状的方法（例如，解决问题，沟通，认知行为技能）;并防止复发。通过全面的文献检索确定了13项针对儿童BPSD的心理社会干预试验，并根据心理程序促进和传播工作组指南进行了评价。所有干预措施均在药物治疗和/或常规治疗（TAU）后进行检查。未确定有效性良好或可疑的治疗。家庭心理教育加上技能建设可能是有效的（即，多家庭心理教育心理治疗，以家庭为中心的治疗）;认知行为治疗（CBT）可能有效。实验采用辩证行为疗法（DBT）和人际与社会节律疗法（IPSRT）。有限的研究排除了按格式和年龄细分治疗。只有一个和多个家庭的心理教育加上技能建设和CBT与儿童进行了评估。只有单一的家庭心理教育加上技能建设和DBT，和个人（通常与有限的家庭参与）的CBT和IPSRT与青少年进行了评估。涉及家庭，心理教育和技能建设的心理社会干预可能会为药物治疗和/或其他TAU提供额外的好处。目前研究的局限性包括很少的结果研究，小样本，以及未能使用严格的控制条件或随机化。评论的结论与调解人和主持人的讨论，最佳实践的建议，并为未来的研究提出建议。
Pediatric bipolar spectrum disorders (BPSDs) are serious conditions associated with morbidity and mortality. Although most treatment research examined pharmacotherapy for pediatric BPSDs, growing literature suggests that psychosocial interventions are also important to: provide families with an understanding of symptoms, course, and treatment of BPSDs; teach youth and parents methods for coping with symptoms (e.g., problem-solving, communication, cognitive-behavioral skills); and prevent relapse. Thirteen psychosocial intervention trials for pediatric BPSDs were identified via a comprehensive literature search and evaluated according to the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines. All interventions were examined adjunctive to pharmacotherapy and/or treatment as usual (TAU). No well-established or questionably efficacious treatments were identified. Family psychoeducation plus skill building was probably efficacious (i.e., Multi-Family Psychoeducational Psychotherapy, Family-Focused Treatment); cognitive-behavioral therapy (CBT) was possibly efficacious. Dialectical behavior therapy (DBT) and interpersonal and social rhythm therapy (IPSRT) were experimental. Limited research precluded subdivision of treatments by format and age. Only single- and multiple-family psychoeducation plus skill building and CBT were evaluated with children. Only single-family psychoeducation plus skill building and DBT, and individual (commonly with limited familial involvement) CBT and IPSRT were evaluated with adolescents. Psychosocial interventions that involve families, psychoeducation, and skill building may offer added benefit to pharmacotherapy and/or other TAU. Limitations of current research include few outcome studies, small samples, and failure to use stringent control conditions or randomization. The review concludes with a discussion of mediators and moderators, recommendations for best practice, and suggestions for future research.
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