González Sara, Artal Jesús, Gómez Elsa, Caballero Patricia, Mayoral Jacqueline, Moreno Teresa, Alvarez-Jiménez Mario, Gook Sarah, Villacorta María C, Higuera Alfonso, Vázquez-Barquero José Luis
Hospital Universitario Marqués de Valdecilla, Santander, España.
Actas Esp Psiquiatr. 2012 Mar-Apr;40(2):51-6. Epub 2012 Mar 1.
In order to improve relapse and recurrence prevention in bipolar disorder, the purposes of this paper are: (i) to summarize the evidence published on treatments for this disorder, particularly on psychological interventions in its early phases; (ii) to provide a description of the Jano Intervention and Research Program on the Early Phases of Bipolar Disorder, which is being developed at Valdecilla Hospital (Santander, Spain). Firstly, we review the data from randomized controlled trials and systematic reviews regarding four psychotherapies proven to be effective in the treatment of bipolar disorder: psychoeducation, cognitive-behavioral therapy, family therapy and interpersonal and social rhythm therapy. Secondly, we display a systematic review on the effectiveness of psychological therapies during the early stage of bipolar disorder. Out of 456 studies, all were excluded due to not meeting the inclusion criteria. Finally, we outline the Jano Program, which provides psychiatric management, psychoeducation, psychotherapy and family therapy for patients in the early stage of bipolar disorder. Several standardized clinical, social and neuropsychological tests are administered to the patients at the beginning of the program, and also at 2, 4, 6 and 8 weeks, 3 and 6 months, 1, 2, 3 and 5 years later.
It's necessary to enlarge the sample and finish our data collection in order to determine the effectiveness and efficiency of this kind of program, and specially of its psychological components. Early intervention for bipolar disorder may need to be adapted in some way from usual treatments to better reach our goals.
为改善双相情感障碍的复发预防情况，本文目的如下：（i）总结已发表的关于该疾病治疗方法的证据，尤其是早期阶段的心理干预措施；（ii）介绍正在西班牙桑坦德市瓦尔迪西利亚医院开展的双相情感障碍早期阶段的哈诺干预与研究项目。首先，我们回顾了来自随机对照试验和系统评价的数据，这些数据涉及四种已被证明对双相情感障碍治疗有效的心理疗法：心理教育、认知行为疗法、家庭疗法以及人际与社会节律疗法。其次，我们展示了一项关于双相情感障碍早期阶段心理疗法有效性的系统评价。在456项研究中，所有研究均因不符合纳入标准而被排除。最后，我们概述了哈诺项目，该项目为双相情感障碍早期阶段的患者提供精神科管理、心理教育、心理治疗和家庭治疗。在项目开始时，以及在2周、4周、6周和8周、3个月和6个月、1年、2年、3年和5年后，对患者进行多项标准化的临床、社会和神经心理学测试。
有必要扩大样本并完成数据收集，以确定此类项目，特别是其心理组成部分的有效性和效率。双相情感障碍的早期干预可能需要在某些方面对常规治疗方法进行调整，以更好地实现我们的目标。
