Department of Clinical and Developmental Psychology, Institute of Psychology, Eberhard Karls Universität Tübingen, Germany.
Psychol Med. 2012 Jul;42(7):1429-39. doi: 10.1017/S0033291711002522. Epub 2011 Nov 21.
The efficacy of adjunctive psychosocial interventions such as cognitive behaviour therapy (CBT) for bipolar disorder (BD) has been demonstrated in several uncontrolled and controlled studies. However, these studies compared CBT to either a waiting list control group, brief psycho-education or treatment as usual (TAU). Our primary aim was to determine whether CBT is superior to supportive therapy (ST) of equal intensity and frequency in preventing relapse and improving outcome at post-treatment. A secondary aim was to look at predictors of survival time.
We conducted a randomized controlled trial (RCT) at the Department of Psychology, University of Tübingen, Germany (n=76 patients with BD). Both CBT and ST consisted of 20 sessions over 9 months. Patients were followed up for a further 24 months.
Although changes over time were observed in some variables, they were not differentially associated with CBT or ST. CBT showed a non-significant trend for preventing any affective, specifically depressive episode during the time of therapy. Kaplan-Meier survival analyses revealed that 64.5% of patients experienced a relapse during the 33 months. The number of prior episodes, the number of therapy sessions and the type of BD predicted survival time.
No differences in relapse rates between treatment conditions were observed, suggesting that certain shared characteristics (e.g. information, systematic mood monitoring) might explain the effects of psychosocial treatment for BD. Our results also suggest that a higher number of prior episodes, a lower number of therapy sessions and a diagnosis of bipolar II disorder are associated with a shorter time before relapse.
认知行为疗法（CBT）等辅助心理社会干预措施对双相情感障碍（BD）的疗效已在多项非对照和对照研究中得到证实。然而，这些研究将 CBT 与等待名单对照组、简短心理教育或常规治疗（TAU）进行了比较。我们的主要目的是确定 CBT 是否优于同等强度和频率的支持性治疗（ST），以预防复发和改善治疗后结局。次要目的是观察生存时间的预测因素。
我们在德国图宾根大学心理学系进行了一项随机对照试验（RCT）（n=76 名 BD 患者）。CBT 和 ST 均包含 9 个月内的 20 次治疗。患者随访 24 个月。
尽管一些变量随时间发生了变化，但它们与 CBT 或 ST 没有差异相关。CBT 显示出在治疗期间预防任何情感、特别是抑郁发作的非显著趋势。Kaplan-Meier 生存分析显示，33 个月期间 64.5%的患者出现复发。既往发作次数、治疗次数和 BD 类型预测生存时间。
治疗条件之间未观察到复发率的差异，这表明某些共同特征（例如信息、系统情绪监测）可能解释了针对 BD 的心理社会治疗的效果。我们的结果还表明，既往发作次数较多、治疗次数较少以及双相 II 型障碍的诊断与复发前时间较短相关。
