Nierenberg Andrew A, Ostacher Michael J, Borrelli David J, Iosifescu Dan V, Perlis Roy H, Desrosiers Astrid, Armistead Molly S, Calkins Amanda W, Sachs Gary S
Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, MA 02114, USA.
J Clin Psychiatry. 2006;67 Suppl 11:3-7.
Patients with bipolar disorder are among the most challenging to treat. These patients frequently present with complex mood and other symptoms that change over time, complex psychiatric and medical comorbid conditions, and multiple medications. Clinicians rarely systematically assess or measure all of these factors and instead rely on memory and general impressions. It is imperative that clinicians systematically track and monitor these relevant variables to ensure treatment decisions are based on precise clinical data. By integrating measurement and management, clinicians and patients can collaborate to assess the effectiveness of treatments and to make joint decisions about critical points at which to adjust treatment. This method was shown to be successful in the National Institute of Mental Health (NIMH) Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).
双相情感障碍患者是最难治疗的群体之一。这些患者经常表现出复杂的情绪及其他随时间变化的症状、复杂的精神和医学共病状况，以及多种药物治疗情况。临床医生很少系统地评估或衡量所有这些因素，而是依赖记忆和总体印象。临床医生必须系统地跟踪和监测这些相关变量，以确保治疗决策基于精确的临床数据。通过整合测量与管理，临床医生和患者可以共同评估治疗效果，并就是否调整治疗的关键点做出共同决策。美国国立精神卫生研究所（NIMH）的双相情感障碍系统治疗强化项目（STEP-BD）表明这种方法是成功的。
