Colom F, Vieta E, Sánchez-Moreno J, Goikolea J M, Popova E, Bonnin C M, Scott J
Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
J Affect Disord. 2009 Jan;112(1-3):30-5. doi: 10.1016/j.jad.2008.03.023. Epub 2008 May 16.
Bipolar II represents a significant subgroup of bipolar patients. However, there is limited evidence regarding the efficacy of pharmacological and/or psychosocial therapies.
Post-hoc analyses were undertaken using data on 20 (out of 120) patients who fulfilled DSM-IV criteria for BP II who had participated in a single-blind randomized controlled treatment trial (RCT) exploring the acute and long-term efficacy of group psychoeducation plus standard pharmacological treatment as compared with unstructured support groups plus standard pharmacological treatment. Eight BP II subjects had been randomized to a psychoeducation group and 12 to an unstructured support group.
Psychoeducated, as compared to control group bipolar II patients, had significantly better 5-year outcomes, with lower mean number of BP episodes (p<.02), hypomanic episodes (p<.03) and depressive episodes (p<.03), fewer days spent in mood episodes (p=.004) and higher mean levels of functioning (p<.05).
Although these findings should be treated with caution, it appears that psychoeducation plus medication can benefit bipolar II subjects. Dedicated treatment trials will need to clarify whether these therapies require modifications in duration and/or content to meet the needs of bipolar II patients.
双相II型障碍是双相情感障碍患者中的一个重要亚组。然而,关于药物治疗和/或心理社会治疗疗效的证据有限。
对参与一项单盲随机对照治疗试验(RCT)的120例符合DSM-IV双相II型障碍标准的患者中的20例患者的数据进行事后分析,该试验探讨了团体心理教育加标准药物治疗与非结构化支持小组加标准药物治疗相比的急性和长期疗效。8例双相II型障碍受试者被随机分配到心理教育组,12例被分配到非结构化支持组。
与对照组双相II型障碍患者相比,接受心理教育的患者5年结局显著更好,平均双相发作次数(p<0.02)、轻躁狂发作次数(p<0.03)和抑郁发作次数(p<0.03)更低,情绪发作天数更少(p = 0.004),平均功能水平更高(p<0.05)。
尽管这些发现应谨慎对待,但心理教育加药物治疗似乎对双相II型障碍患者有益。专门的治疗试验需要阐明这些治疗是否需要在持续时间和/或内容上进行调整,以满足双相II型障碍患者的需求。