Miklowitz David J
Department of Psychology, Muenzinger Building, University of Colorado, Boulder, CO 80309-0345, USA.
Curr Psychiatry Rep. 2006 Dec;8(6):498-503. doi: 10.1007/s11920-006-0057-4.
Recent studies have examined the value of combining structured forms of psychotherapy with medication maintenance for patients with bipolar disorder. These studies have been influenced by the growing body of literature on stress in the elicitation of manic and depressive episodes. Randomized trials published within the past 5 years indicate positive benefits of cognitive-behavioral therapy, interpersonal and social rhythm therapy, family-focused therapy, and group psychoeducation as adjuncts to mood stabilizers in delaying recurrences, stabilizing symptoms, and improving medication adherence. Open trials of family interventions for pediatric-onset bipolar patients also have yielded promising results. Questions remain about the relative advantages of one psychosocial approach over the others, whether there are subgroups of patients who respond to each type of intervention, the impact of psychotherapy on role functioning, mediators of treatment effects, and the potential utility of early intervention as a means of delaying the onset and/or severity of the disorder.
最近的研究探讨了将结构化心理治疗形式与双相情感障碍患者的药物维持治疗相结合的价值。这些研究受到了关于压力在引发躁狂和抑郁发作方面的文献不断增多的影响。过去5年发表的随机试验表明，认知行为疗法、人际和社会节律疗法、家庭聚焦疗法以及团体心理教育作为情绪稳定剂的辅助手段，在延迟复发、稳定症状和提高药物依从性方面具有积极益处。针对儿童期起病的双相情感障碍患者的家庭干预开放试验也取得了有希望的结果。关于一种心理社会方法相对于其他方法的相对优势、是否存在对每种干预类型有反应的患者亚组、心理治疗对角色功能的影响、治疗效果的调节因素以及早期干预作为延迟疾病发作和/或严重程度的手段的潜在效用等问题仍然存在。
