Patelis-Siotis I
Mood Disorders Program, Hamilton Psychiatric Hospital, Ont, Canada.
Bipolar Disord. 2001 Feb;3(1):1-10. doi: 10.1034/j.1399-5618.2001.030101.x.
This paper reviews cognitive-behavioral therapy (CBT) for bipolar disorder (BD). Data on the poor outcome of about 50% of patients diagnosed with BD supports the addition of a psychosocial intervention for the treatment of this recurring disorder. The psychoeducational nature of CBT, the effectiveness of CBT in increasing compliance to pharmacological treatment, and the ability of CBT to prevent relapse in unipolar depression (UD) are well suited to the treatment of BD.
Psychosocial interventions for BD will be briefly reviewed. Individual and group CBT interventions (published and unpublished) will also be reviewed. The significance of comorbid anxiety disorders regarding response to treatment will also be discussed. A review of the treatment protocol with the specific cognitive-behavioral interventions as applied to BD will be presented. Finally, a case example will be presented to illustrate the application of CBT to BD.
Preliminary results indicate that CBT may be an effective adjunctive, intervention for the treatment of BD. Specifically CBT may be helpful in increasing compliance, improving quality of life and functioning, help early symptom recognition, decrease relapse and decrease depressive symptomatology.
Preliminary data on CBT for BD are promising but more rigorous randomized clinical trials are needed to confirm the efficacy of CBT for BD. An other area of research should be to pursue the understanding of cognitive processes in BD which would allow us to refine and develop CBT interventions unique to this disorder.
本文综述了用于双相情感障碍（BD）的认知行为疗法（CBT）。约50%被诊断为BD的患者预后不佳的数据支持增加一种心理社会干预措施来治疗这种复发性疾病。CBT的心理教育性质、CBT在提高药物治疗依从性方面的有效性以及CBT预防单相抑郁症（UD）复发的能力非常适合BD的治疗。
将简要综述针对BD的心理社会干预措施。还将综述个体和团体CBT干预措施（已发表和未发表的）。还将讨论共病焦虑症对治疗反应的意义。将介绍应用于BD的具体认知行为干预措施的治疗方案综述。最后，将给出一个病例示例来说明CBT在BD中的应用。
初步结果表明，CBT可能是治疗BD的一种有效辅助干预措施。具体而言，CBT可能有助于提高依从性、改善生活质量和功能、帮助早期症状识别、减少复发以及减轻抑郁症状。
关于BD的CBT的初步数据很有前景，但需要更严格的随机临床试验来证实CBT对BD的疗效。另一个研究领域应该是深入了解BD中的认知过程，这将使我们能够完善和开发针对这种疾病的独特CBT干预措施。
