Reilly-Harrington Noreen A, Deckersbach Thilo, Knauz Robert, Wu Yelena, Tran Tanya, Eidelman Polina, Lund Hannah G, Sachs Gary, Nierenberg Andrew A
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
J Psychiatr Pract. 2007 Sep;13(5):291-7. doi: 10.1097/01.pra.0000290667.02484.3d.
Bipolar disorder is characterized by depressive and/or manic episodes that interfere with daily functioning. Between 10%-24% of bipolar patients experience a rapid-cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood stabilizing medications, patients with rapid-cycling bipolar disorder are particularly in need of effective, adjunctive treatments. Adjunctive cognitive-behavioral therapy (CBT) has been shown to improve adherence to medication and reduce relapse rates in patients with bipolar disorder. However, no published trials to date have examined the application of CBT to the treatment of patients with a rapid-cycling course of illness, with only a single case study published in the literature. We recently developed a CBT protocol that addresses the specific needs of bipolar patients with rapid cycling. The present study was designed to investigate outcomes with this CBT protocol. Study participants were 10 patients with rapid-cycling bipolar disorder, 6 of whom completed the study. Completers showed significant decreases in depressive mood, and improvements remained stable during the 2-month follow-up. This suggests that CBT for rapid cycling may have beneficial effects.
双相情感障碍的特征是出现干扰日常功能的抑郁和/或躁狂发作。10%至24%的双相情感障碍患者经历快速循环病程，即每年出现4次或更多次情绪发作。快速循环型双相情感障碍患者对标准心境稳定剂药物无反应，尤其需要有效的辅助治疗。辅助性认知行为疗法（CBT）已被证明可提高双相情感障碍患者的药物依从性并降低复发率。然而，迄今为止尚无已发表的试验研究CBT在快速循环病程患者治疗中的应用，文献中仅发表过一项个案研究。我们最近制定了一种针对快速循环型双相情感障碍患者特定需求的CBT方案。本研究旨在调查该CBT方案的治疗效果。研究参与者为10名快速循环型双相情感障碍患者，其中6人完成了研究。完成研究的患者抑郁情绪显著降低，且在2个月的随访期间改善情况保持稳定。这表明针对快速循环的CBT可能具有有益效果。
