The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines.
The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines.
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DOI：
10.1093/ijnp/pyw109
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发表时间：
2017-02-01
期刊：
影响因子：
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通讯作者：
Moeller HJ
中科院分区：
文献类型：
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作者：
Fountoulakis KN;Grunze H;Vieta E;Young A;Yatham L;Blier P;Kasper S;Moeller HJ
本文介绍了实际的国际神经精神药理学学院治疗双相情感障碍的临床指南。目前的临床指南是基于循证数据的，但它们也打算在临床上有用，而一个严格的算法是在确凿证据的基础上制定的。单药治疗优先于联合治疗。双相情感障碍的每个主要阶段都有单独的建议，以5步算法表示。目前国际神经精神药理学学院关于双相情感障碍治疗的临床指南是最新的指南，并尽可能以证据为基础。它们还包括关于使用心理治疗干预措施的建议，同样是根据现有证据提出的。工作组以临床为导向的方式坚持证据，有助于阐明特定抗抑郁药和传统药物（如锂、丙戊酸盐或卡马西平）的作用。额外关注特定的临床特征，包括主要极性，混合特征和快速循环，也是一种新颖的方法。许多问题需要进一步研究，数据稀少和不充分，许多问题仍未得到解答。最重要且尚未满足的需求是将所有涉及疾病不同阶段的指南合并为一个指南，并以这种方式将双相障碍视为单一的统一疾病，这是现实世界的事实。然而，迄今为止的研究数据不允许这样一个统一的方法。
The current paper introduces the actual International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder. The current clinical guidelines are based on evidence-based data, but they also intend to be clinically useful, while a rigid algorithm was developed on the basis of firm evidence alone. Monotherapy was prioritized over combination therapy. There are separate recommendations for each of the major phases of bipolar disorder expressed as a 5-step algorithm. The current International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder are the most up-to-date guidance and are as evidence based as possible. They also include recommendations concerning the use of psychotherapeutic interventions, again on the basis of available evidence. This adherence of the workgroup to the evidence in a clinically oriented way helped to clarify the role of specific antidepressants and traditional agents like lithium, valproate, or carbamazepine. The additional focus on specific clinical characteristics, including predominant polarity, mixed features, and rapid cycling, is also a novel approach. Many issues need further studies, data are sparse and insufficient, and many questions remain unanswered. The most important and still unmet need is to merge all the guidelines that concern different phases of the illness into a single one and in this way consider BD as a single unified disorder, which is the real world fact. However, to date the research data do not permit such a unified approach.