Keck Paul E
Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
J Clin Psychiatry. 2006 Dec;67(12):e17.
Predictors of poor functional outcome in patients with bipolar disorder include psychiatric and medical comorbidity, interepisode subsyndromal symptoms, psychosis during manic or mixed episode, and low premorbid functioning. Cognitive dysfunction may also contribute to functional impairment. Psychosocial intervention has shown success in improving syndromal outcomes for people with bipolar disorder. Lithium, lamotrigine, olanzapine, and aripiprazole have all shown substantial improvements in relapse rates compared with placebo. Combination therapy with antipsychotics and antidepressants has also been shown to produce improvement in symptoms in people with bipolar disorder. However, limited evidence is available for the effects of these treatments on cognitive outcomes. This review discusses treatment strategies for the long-term management of bipolar disorder and functional outcome measures associated with these treatments.
双相情感障碍患者功能预后不良的预测因素包括精神和躯体共病、发作间期亚综合征症状、躁狂或混合发作时的精神病性症状以及病前功能低下。认知功能障碍也可能导致功能损害。心理社会干预已被证明在改善双相情感障碍患者的综合征结局方面取得了成功。与安慰剂相比，锂盐、拉莫三嗪、奥氮平和阿立哌唑均显示出复发率有显著改善。抗精神病药和抗抑郁药联合治疗也已被证明可改善双相情感障碍患者的症状。然而，关于这些治疗对认知结局的影响，现有证据有限。本综述讨论了双相情感障碍长期管理的治疗策略以及与这些治疗相关的功能预后指标。
