The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment.
The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment.
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DOI：
10.1016/j.jad.2016.11.021
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发表时间：
2017-03
影响因子：
6.6
通讯作者：
Miklowitz DJ
中科院分区：
文献类型：
--
作者：
Gitlin MJ;Miklowitz DJ
大多数双相情感障碍的纵向或治疗研究都使用症状或综合征状态作为主要结果变量。最近，心理社会功能被强调为结果的关键领域。双相情感障碍患者似乎在所有功能领域都受损，尽管导致受损的因素尚未明确指出。本文回顾了双相情感障碍功能障碍及其与症状、神经认知、人格和压力变量关系的横断面和纵向研究；以及这些关系对于确定治疗目标的影响。通过综合 MEDLINE、SCOPUS 和 Web of Science 搜索找到了 93 篇文章。情绪发作后的功能恢复始终落后于症状和综合症的恢复。躁狂/轻躁狂发作次数只能部分解释长期功能障碍。抑郁（包括亚综合征状态）和持续性神经认知障碍是双相情感障碍功能障碍的最强相关因素，而人格和社会心理压力源则发挥次要作用。可能的治疗选择包括：对阈下抑郁状态进行更积极的治疗、针对认知的药物治疗（例如兴奋剂）以及包括认知补救在内的辅助心理治疗。
Most longitudinal or treatment studies in bipolar disorder have used symptomatic or syndromal status as the primary outcome variable. More recently, psychosocial functioning has been highlighted as a key domain of outcome. Patients with bipolar disorder appear to be impaired in all functional domains, although the factors that cause impairment have not been clearly specified. This paper reviews cross-sectional and longitudinal studies on functional impairment and its relationship to symptomatic, neurocognitive, personality, and stress variables in bipolar disorder; and the implications of these relationships for defining treatment targets. 93 articles were located through comprehensive MEDLINE, SCOPUS and Web of Science searches. Functional recovery following a mood episode consistently lags behind symptomatic and syndromal recovery. Longer term functional impairment is only partly explained by the number of manic/hypomanic episodes. Depression (including subsyndromal states) and persistent neurocognitive impairment are the strongest correlates of functional impairment in bipolar disorder, with personality and psychosocial stressors playing secondary roles. Possible treatment options include: more aggressive treatment of subthreshold depressive states, pharmacotherapies that target cognition (e.g., stimulants), and adjunctive psychotherapies including cognitive remediation.
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影响因子：
5.4
作者：
Depp CA;Mausbach BT;Harvey PD;Bowie CR;Wolyniec PS;Thornquist MH;Luke JR;McGrath JA;Pulver AE;Patterson TL
通讯作者：
Patterson TL
影响因子：
5.3
作者：
Burdick, Katherine E.;Braga, Raphael J.;Malhotra, Anil K.
通讯作者：
Malhotra, Anil K.
影响因子：
4
作者：
Daglas R;Yücel M;Cotton S;Allott K;Hetrick S;Berk M
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Berk M
影响因子：
10.5
作者：
Bonnin, C. M.;Torrent, C.;Martinez-Aran, A.
通讯作者：
Martinez-Aran, A.
影响因子：
6.1
作者：
EYSENCK, SBG;EYSENCK, HJ
通讯作者：
EYSENCK, HJ