Intensive psychosocial intervention enhances functioning in patients with bipolar depression: Results from a 9-month Randomized controlled trial
Intensive psychosocial intervention enhances functioning in patients with bipolar depression: Results from a 9-month Randomized controlled trial
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DOI：
10.1176/appi.ajp.2007.07020311
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发表时间：
2007-09-01
影响因子：
17.7
通讯作者：
Wisniewski, Stephen R.
中科院分区：
文献类型：
--
作者：
Miklowitz, David J.;Otto, Michael W.;Wisniewski, Stephen R.
目的：心理社会干预在延缓双相情感障碍复发方面是药物治疗的有效替代品;然而，迄今为止，它们对生活功能的影响很少受到关注。在一项随机试验中，作者研究的影响，密集的心理社会治疗加药物治疗的功能结果的双相情感障碍患者在9个月后抑郁epission.Method：参与者是152名抑郁症门诊患者与双相I型或双相11障碍的多站点系统治疗增强计划双相情感障碍（STEP-BD）的研究。所有患者均接受药物治疗。84例患者被随机分配到强化心理社会干预（30个疗程，为期9个月，包括人际和社会节奏治疗、认知行为治疗[CBT]或以家庭为中心的治疗），68例患者被随机分配到协作护理（3个疗程的心理教育治疗）。独立评估者对纵向间隔随访评估-功能受损范围工具的四个分量表进行评分（生命裂缝）（关系，活动满意度，工作/角色功能，和娱乐活动）通过结构化访谈在基线和每3个月在9个月的时间。结果：接受强化心理治疗的患者在9个月内的总体功能、关系功能和生活满意度评分均优于接受协作护理的患者，即使在预处理后，功能和并发抑郁评分也是共变的。在这9个月的periods.Conclusions：密集的心理社会治疗增强双相情感障碍患者的关系功能和生活满意度的工作/角色功能或娱乐scores的心理社会干预没有效果。针对双相情感障碍患者特定认知缺陷的替代干预措施可能是必要的，以增强抑郁发作后的职业功能。
Objective: Psychosocial interventions are effective adjuncts to pharmacotherapy in delaying recurrences of bipolar disorder; however, to date their effects on life functioning have been given little attention. In a randomized trial, the authors examined the impact of intensive psychosocial treatment plus pharmacotherapy on the functional outcomes of patients with bipolar disorder over the 9 months following a depressive episode.Method: Participants were 152 depressed outpatients with bipolar I or bipolar 11 disorder in the multisite Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. All patients received pharmacotherapy. Eightyfour patients were randomly assigned to intensive psychosocial intervention (30 sessions over 9 months of interpersonal and social rhythm therapy, cognitive behavior therapy [CBT], or family-focused therapy), and 68 patients were randomly assigned to collaborative care (a 3-session psychoeducational treatment). Independent evaluators rated the four subscales of the Longitudinal Interval Follow-Up Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT) (relationships, satisfaction with activities, work/role functioning, and recreational activities) through structured interviews given at baseline and every 3 months over a 9-month period.Results: Patients in intensive psychotherapy had better total functioning, relationship functioning, and life satisfaction scores over 9 months than patients in collaborative care, even after pretreatment functioning and concurrent depression scores were covaried. No effects of psychosocial intervention were observed on work/role functioning or recreation scores during this 9-month period.Conclusions: Intensive psychosocial treatment enhances relationship functioning and life satisfaction among patients with bipolar disorder. Alternate interventions focused on the specific cognitive deficits of individuals with bipolar disorder may be necessary to enhance vocational functioning after a depressive episode.