Depp Colin A, Moore David J, Patterson Thomas L, Lebowitz Barry D, Jeste Dilip V
Sam and Rose Stein Institute for Research on Aging, Department of Psychiatry, University of California, San Gilman Drive, 0664 La Jolla, CA 92093-0664, USA.
Dialogues Clin Neurosci. 2008;10(2):239-50. doi: 10.31887/DCNS.2008.10.2/cadepp.
Recent research has indicated that psychosocial interventions can have a valuable role in reducing the substantial psychosocial disability associated with bipolar disorder. Randomized controlled trials of these interventions indicate that improvements are seen in symptoms, psychosocial functioning, and treatment adherence. These interventions, systematically presented in the form of standardized treatment manuals, vary in format, duration, and theoretical basis. All are meant to augment pharmacotherapy, which represents the standard of treatment in the field. Modalities that have gathered the most empirical support include cognitive-behavioral therapy, family-focused therapy, interpersonal and social rhythms therapy, and psychoeducation. The enhancement of adherence to pharmacotherapy is a common therapeutic target, due to the association of nonadherence with higher relapse rates, hospitalization, and health care costs among people with bipolar disorder. Given the complexity of nonadherence behavior, multicomponent interventions are often required. In this review, we provide an overview of the rationale, evidence base, and major psychotherapeutic approaches in bipolar disorder, focusing on the assessment and enhancement of medication adherence.
近期研究表明，心理社会干预在减轻与双相情感障碍相关的严重心理社会功能障碍方面可发挥重要作用。这些干预措施的随机对照试验表明，症状、心理社会功能及治疗依从性均有改善。这些干预措施以标准化治疗手册的形式系统呈现，在形式、时长和理论基础上各有不同。所有这些干预措施旨在辅助药物治疗，而药物治疗是该领域的标准治疗方法。获得最多实证支持的治疗方式包括认知行为疗法、家庭聚焦疗法、人际与社会节律疗法以及心理教育。提高药物治疗的依从性是一个常见的治疗目标，因为双相情感障碍患者不依从治疗与更高的复发率、住院率及医疗费用相关。鉴于不依从行为的复杂性，通常需要多成分干预措施。在本综述中，我们概述了相关理论依据、证据基础及主要心理治疗方法，重点关注药物治疗依从性的评估与提高。
