Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.
J Affect Disord. 2010 Jul;124(1-2):76-84. doi: 10.1016/j.jad.2009.11.004. Epub 2009 Dec 6.
Little is known about how patients successfully manage their bipolar disorder (BD). This is a remarkable gap in the BD literature, given that current treatments are inadequate and information about beneficial self-management strategies could have clinical and theoretical implications. Here, we present results from a study of self-management strategies used by a sample of high-functioning individuals with BD.
The objectively rated Multidimensional Scale of Independent Functioning (MSIF) was used to confirm high functioning status (score <3) amongst a sample of individuals self-described as functioning well with BD type I or II (N=32). Participants completed quantitative scales to assess psychiatric history, current symptoms, functioning and quality of life, and underwent either an individual interview or focus group to answer open questions about the self-management strategies they used to maintain or regain wellness.
Wellness strategies fell into the following themes: 1) Sleep, rest, exercise and diet; 2) Ongoing monitoring; 3) Enacting a plan; 4) Reflective and meditative practices; 5) Understanding BD and educating others; 6) Connecting with others.
The wellness strategies described by the current sample have substantial overlap with those identified in the sole comparable qualitative study. They are also broadly consistent with, and serve to elaborate on proposed mechanisms of therapeutic action in adjunctive psychosocial interventions for BD. The findings constitute hopeful stories for people affected by the disorder and suggest further research to confirm and refine mechanisms of beneficial effect in BD.
关于患者如何成功管理双相情感障碍(BD),我们知之甚少。鉴于目前的治疗方法并不完善,了解有益的自我管理策略可能具有临床和理论意义,而这在 BD 文献中是一个显著的空白。在此,我们介绍了一项对具有 BD 一型或二型的高功能个体使用的自我管理策略进行研究的结果。
使用客观评定的多维独立功能评定量表(MSIF),确认自我描述为具有良好 BD 一型或二型功能的个体的高功能状态(得分<3)(N=32)。参与者完成了定量量表评估,以评估精神病史、当前症状、功能和生活质量,并接受了个体访谈或焦点小组,以回答他们用于维持或恢复健康的自我管理策略的开放性问题。
健康策略分为以下主题:1)睡眠、休息、锻炼和饮食;2)持续监测;3)实施计划;4)反思和冥想实践;5)了解 BD 并教育他人;6)与他人联系。
当前样本描述的健康策略与唯一一项可比定性研究中确定的策略有很大重叠。它们也与 BD 辅助心理社会干预中提出的治疗作用机制基本一致,并对其进行了阐述。这些发现为受该疾病影响的人们带来了希望,并建议进一步研究以确认和完善 BD 中有益效果的机制。