An evidence map of psychosocial interventions for the earliest stages of bipolar disorder.
An evidence map of psychosocial interventions for the earliest stages of bipolar disorder.
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DOI：
10.1016/s2215-0366(15)00156-x
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Scott J
中科院分区：
文献类型：
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作者：
Vallarino M;Henry C;Etain B;Gehue LJ;Macneil C;Scott EM;Barbato A;Conus P;Hlastala SA;Fristad M;Miklowitz DJ;Scott J
抑郁症、精神分裂症和双相情感障碍是25岁以下人群最严重的四个问题中的三个。在精神病和抑郁症中，对于首发或早发疾病的高危患者来说，心理干预是有效、低风险和高收益的方法。我们回顾了心理干预在15-25岁患者早期双相情感障碍中的应用。由于之前的系统评价难以确定关于这一新兴研究领域的信息，我们使用证据图谱来帮助我们确定证据的范围、分布和方法质量，因为黄金标准方法只提供了轻微的信息或适当的信息。这一策略确定了三个目标组的29项研究：10项针对双相情感障碍高危人群的研究，5项针对首发患者的研究，14项针对早发性双相情感障碍患者的研究。在20项已完成的研究中，有8项研究是随机试验，但只有两项研究的样本量超过100人。使用的主要干预方法是家庭疗法、认知行为疗法和人际疗法。只有行为家庭疗法在我们的所有三个目标群体中进行了测试。虽然现有的干预措施很好地适应了年轻人的成熟水平和社会环境，但很少有干预措施针对特定的发展心理或生理过程(例如，沉思反应方式或睡眠延迟)，或提供管理物质使用或身体健康的详细战略。
Depression, schizophrenia, and bipolar disorder are three of the four most burdensome problems in people aged under 25 years. In psychosis and depression, psychological interventions are effective, low-risk, and high-benefit approaches for patients at high risk of first-episode or early-onset disorders. We review the use of psychological interventions for early-stage bipolar disorder in patients aged 15–25 years. Because previous systematic reviews had struggled to identify information about this emerging sphere of research, we used evidence mapping to help us identify the extent, distribution, and methodological quality of evidence because the gold standard approaches were only slightly informative or appropriate. This strategy identified 29 studies in three target groups: ten studies in populations at high risk for bipolar disorder, five studies in patients with a first episode, and 14 studies in patients with early-onset bipolar disorder. Of the 20 completed studies, eight studies were randomised trials, but only two had sample sizes of more than 100 individuals. The main interventions used were family, cognitive behavioural, and interpersonal therapies. Only behavioural family therapies were tested across all of our three target groups. Although the available interventions were well adapted to the level of maturity and social environment of young people, few interventions target specific developmental psychological or physiological processes (eg, ruminative response style or delayed sleep phase), or offer detailed strategies for the management of substance use or physical health.