Downey Jennifer I
Columbia University College of Physicians & Surgeons, New York State Psychiatric Institute, New York, NY 10128, USA.
J Am Acad Psychoanal Dyn Psychiatry. 2011 Spring;39(1):77-92. doi: 10.1521/jaap.2011.39.1.77.
Recent psychiatric attention to the bipolar spectrum conditions (Bipolar I, Bipolar II, and Bipolar NOS Disorders in the DSM-IV-TR) has revealed that many more individuals are affected by bipolar disorder (BD) than was earlier appreciated. Increased sexual thoughts, impulses, and risk-taking sexual behavior are recognized symptoms of the bipolar conditions when individuals are manic or hypomanic. There is little scientific information on the prevalence of symptoms of driven sexuality in individuals with the less severe forms of BD as well as those individuals with severer forms of the disorder who are recovering or have recovered from an episode of mania or hypomania. This article discusses the use of developmentally oriented psychotherapy for an individual with a bipolar spectrum condition whose symptoms were well controlled on medications except for her driven sexuality. Current concepts in psychodynamic psychotherapy offer a way to understand and treat sexual symptoms in many individuals with less severe or partially treated BD.
近期精神病学对双相谱系障碍（《精神疾病诊断与统计手册》第四版修订版中的双相I型、双相II型和未特定的双相障碍）的关注表明，受双相情感障碍（BD）影响的个体比之前认为的要多得多。当个体处于躁狂或轻躁狂状态时，性想法、冲动及冒险性行为增加是双相障碍的公认症状。对于症状较轻的双相障碍患者以及那些从躁狂或轻躁狂发作中恢复或已康复的症状较重的双相障碍患者，关于强迫性性行为症状的患病率几乎没有科学信息。本文讨论了对一名双相谱系障碍患者使用以发展为导向的心理治疗，该患者除了强迫性性行为外，其症状在药物治疗下得到了很好的控制。心理动力心理治疗的当前概念为理解和治疗许多症状较轻或部分治疗的双相障碍患者的性症状提供了一种方法。
