Sanchez-Moreno Jose, Bonnín Caterina, González-Pinto Ana, Amann Benedikt L, Solé Brisa, Balanzá-Martínez Vicent, Arango Celso, Jimenez Esther, Tabarés-Seisdedos Rafael, Garcia-Portilla M Paz, Ibáñez Angela, Crespo Jose Manuel, Ayuso-Mateos Jose Luis, Vieta Eduard, Martinez-Aran Anabel, Torrent Carla
Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Álava University Hospital, CIBERSAM, University of the Basque Country, BIOARABA, Vitoria, Spain.
Eur Neuropsychopharmacol. 2017 Apr;27(4):350-359. doi: 10.1016/j.euroneuro.2017.01.010. Epub 2017 Jan 23.
We analyzed the efficacy of functional remediation, in a sample of patients with bipolar disorder who presented with subsyndromal symptoms. From a total sample of 239 patients with bipolar I and II disorder, according to DSM-IV-TR diagnostic criteria, entering a randomized clinical trial, those patients who presented with subsyndromal symptoms were selected based on a method already described by Berk and colleagues was applied. It consists of using the Clinical Global Impression-Bipolar version (CGI-BP) to establish the scores of the Hamilton Depression Rating Scale (HAM-D) and of the Young Mania Rating Scale (YMRS) that correspond with 1 in the CGI-BP. Functional outcome and mood symptoms were assessed at 6 and at 12-month follow-up. A total of 99 patients were selected for this post-hoc analysis, allocated as follows: functional remediation (n=33); psychoeducation (n=37) and treatment as usual (TAU,n=29). The repeated-measures analyses at 12-month follow-up revealed a significant group x time interaction in favour of the patients who received functional remediation when compared to psychoeducation and TAU (F=2.93; p=0.02) at improving psychosocial functioning. Finally, mood symptoms did not significantly change in any of the three groups at any time of follow-up, as shown by the non-significant group x time interaction effect in HAM-D scores (F=1.57; p=0.18) and YMRS scores (F=1.51; p=0.20). Bipolar patients with subsyndromal symptoms improve their functional outcome when exposed to functional remediation regardless of the persistence of mood symptomatology.
我们分析了功能康复疗法对一组患有双相情感障碍且有亚综合征症状患者的疗效。在239例根据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）诊断标准进入随机临床试验的双相I型和II型障碍患者总样本中，按照伯克及其同事已描述的方法，挑选出有亚综合征症状的患者。该方法是使用临床总体印象-双相版（CGI-BP）来确定汉密尔顿抑郁量表（HAM-D）和杨氏躁狂量表（YMRS）中与CGI-BP评分为1相对应的分数。在6个月和12个月随访时评估功能结局和情绪症状。共有99例患者被选入此次事后分析，分配如下：功能康复疗法组（n = 33）；心理教育组（n = 37）和常规治疗组（TAU，n = 29）。12个月随访时的重复测量分析显示，与心理教育组和常规治疗组相比，接受功能康复疗法的患者在改善社会心理功能方面存在显著的组×时间交互作用（F = 2.93；p = 0.02）。最后，随访的任何时间，三组中任何一组的情绪症状均未发生显著变化，这在HAM-D评分（F = 1.57；p = 0.18）和YMRS评分（F = 1.51；p = 0.20）的组×时间交互作用效应不显著中得到体现。有亚综合征症状的双相情感障碍患者，无论情绪症状是否持续存在，接受功能康复疗法后其功能结局均会得到改善。
