Mental Health Therapist at Southlake Regional Health Centre, Newmarket, ON, Canada.
J Affect Disord. 2013 Mar 5;145(3):386-93. doi: 10.1016/j.jad.2012.05.054. Epub 2012 Aug 1.
Bipolar disorder (BD) is a chronic and disabling psychiatric disorder characterized by recurrent episodes of mania/hypomania and depression. Dialectical behavior therapy (DBT) techniques have been shown to effectively treat borderline personality disorder, a condition also marked by prominent affective disturbances. The utility of DBT techniques in treating BD has been largely unexplored. The purpose of this research was to conduct a pilot study of a DBT-based psychoeducational group (BDG) in treating euthymic, depressed, or hypomanic Bipolar I or II patients.
In this experiment, 26 adults with bipolar I or II were randomized to intervention or wait-list control groups and completed the Beck depression inventory II, mindfulness-based self-efficacy scale, and affective control scale at baseline and 12 weeks. The BDG intervention consisted of 12 weekly 90-min sessions which taught DBT skills, mindfulness techniques, and general BD psychoeducation.
Using RM-ANOVA, subjects in BDG demonstrated a trend toward reduced depressive symptoms, and significant improvement in several MSES subscales indicating greater mindful awareness, and less fear toward and more control of emotional states (ACS). These findings were supported with a larger sample of patients who completed the BDG. Furthermore, group attendees had reduced emergency room visits and mental health related admissions in the six months following BDG.
The small sample size in RCT affects power to detect between group differences. How well improvements after the12-week BDG were maintained is unknown.
There is preliminary evidence that DBT skills reduce depressive symptoms, improve affective control, and improve mindfulness self-efficacy in BD. Its application warrants further evaluation in larger studies.
双相情感障碍（BD）是一种慢性且致残的精神疾病，其特征为反复发作的躁狂/轻躁狂和抑郁。辩证行为疗法（DBT）技术已被证明可有效治疗边缘型人格障碍，这种疾病也以明显的情感障碍为特征。DBT 技术在治疗 BD 中的应用尚未得到广泛探索。本研究的目的是对基于 DBT 的心理教育团体（BDG）治疗轻躁狂、抑郁或轻躁狂的双相 I 或 II 型患者进行初步研究。
在这项实验中，26 名双相 I 或 II 型成年人被随机分配到干预组或候补名单对照组，并在基线和 12 周时完成贝克抑郁量表 II、基于正念的自我效能感量表和情感控制量表。BDG 干预包括 12 次每周 90 分钟的课程，教授 DBT 技能、正念技术和一般 BD 心理教育。
使用 RM-ANOVA，BDG 组的受试者抑郁症状呈下降趋势，MSES 几个子量表的评分显著提高，表明正念意识增强，对情绪状态的恐惧减少，控制能力增强（ACS）。这些发现得到了完成 BDG 的更大样本患者的支持。此外，在 BDG 之后的六个月内，团体参与者的急诊就诊次数和与心理健康相关的入院次数减少。
RCT 中的小样本量影响了检测组间差异的能力。BDG 后 12 周的改善能维持多久尚不清楚。
有初步证据表明，DBT 技能可降低 BD 的抑郁症状，改善情感控制，提高正念自我效能感。其应用需要在更大的研究中进一步评估。
