Vieta Eduard
Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain.
J Clin Psychiatry. 2005;66 Suppl 5:34-9.
Although pharmacotherapy is the mainstay of the comprehensive program of medical care for the management of patients with bipolar disorder, the additional benefits of psychosocial interventions for the patient, family, and caregivers are now being recognized and increasingly adopted. Several facets of bipolar disorder can be addressed more effectively by instituting adjunctive psychosocial interventions. Recent clinical evidence indicates that combining pharmacotherapy with psychosocial interventions, which are tailored to patients' individual needs, may decrease the risk of relapse, improve patient adherence, and decrease the number and length of hospitalizations. A multidisciplinary approach may also enhance long-term patient outcomes such as mood stability, enhanced occupational and/or social functioning, and overall quality of life. Psychoeducation helps individuals become active and informed participants in the management of their illness, promoting a collaborative relationship between patients and their caregivers. However, psychosocial interventions are not useful for all patients with bipolar illness and may be more useful in addressing some problems than others. Evidence would suggest that psychosocial interventions, with continuing pharmacotherapy, are best used as prophylaxis and during periods of remission to prevent further episodes. Further randomized, clinical trials will help to define which components of psychosocial intervention are most effective in patients with bipolar disorder.
虽然药物治疗是双相情感障碍患者综合医疗护理方案的主要支柱，但现在人们已经认识到心理社会干预对患者、家庭和护理人员的额外益处，并越来越多地采用这种干预措施。通过实施辅助性心理社会干预，可以更有效地解决双相情感障碍的几个方面问题。最近的临床证据表明，将药物治疗与根据患者个体需求量身定制的心理社会干预相结合，可能会降低复发风险、提高患者依从性，并减少住院次数和住院时间。多学科方法还可能改善患者的长期预后，如情绪稳定性、增强职业和/或社会功能以及整体生活质量。心理教育有助于个人成为疾病管理的积极参与者并了解相关信息，促进患者与其护理人员之间的合作关系。然而，心理社会干预并非对所有双相情感障碍患者都有用，在解决某些问题方面可能比其他问题更有用。有证据表明，心理社会干预与持续的药物治疗相结合，最适合用作预防措施以及在缓解期预防进一步发作。进一步的随机临床试验将有助于确定心理社会干预的哪些组成部分对双相情感障碍患者最有效。
