Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
Mary Lou Chatterton, PharmD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria; Emily Stockings, PhD, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; Michael Berk, PhD, Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, and Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, and Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria; Jan J. Barendregt, PhD, Epigear International Pty Ltd, Sunrise Beach, and School of Public Health, University of Queensland, Brisbane, Queensland; Rob Carter, PhD, Cathrine Mihalopoulos, PhD, Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.
Br J Psychiatry. 2017 May;210(5):333-341. doi: 10.1192/bjp.bp.116.195321. Epub 2017 Feb 16.
Few trials have compared psychosocial therapies for people with bipolar affective disorder, and conventional meta-analyses provided limited comparisons between therapies.To combine evidence for the efficacy of psychosocial interventions used as adjunctive treatment of bipolar disorder in adults, using network meta-analysis (NMA).Systematic review identified studies and NMA was used to pool data on relapse to mania or depression, medication adherence, and symptom scales for mania, depression and Global Assessment of Functioning (GAF).Carer-focused interventions significantly reduced the risk of depressive or manic relapse. Psychoeducation alone and in combination with cognitive-behavioural therapy (CBT) significantly reduced medication non-adherence. Psychoeducation plus CBT significantly reduced manic symptoms and increased GAF. No intervention was associated with a significant reduction in depression symptom scale scores.Only interventions for family members affected relapse rates. Psychoeducation plus CBT reduced medication non-adherence, improved mania symptoms and GAF. Novel methods for addressing depressive symptoms are required.
很少有试验比较过双相情感障碍患者的心理社会治疗，传统的荟萃分析也只能对不同治疗方法进行有限的比较。为了结合网络荟萃分析（NMA）评估成人双相障碍辅助心理社会干预的疗效证据，我们对相关研究进行了系统综述。研究通过系统综述进行了识别，采用 NMA 汇总了关于躁狂或抑郁复发、药物依从性以及躁狂、抑郁和总体功能评估量表（GAF）的症状量表的数据。以照顾者为中心的干预措施可显著降低躁狂或抑郁复发的风险。单纯的心理教育以及与认知行为疗法（CBT）相结合可显著降低药物不依从性。心理教育加 CBT 可显著降低躁狂症状并提高 GAF。没有干预措施与抑郁症状量表评分的显著降低相关。只有针对家庭成员的干预措施会影响复发率。心理教育加 CBT 可降低药物不依从性，改善躁狂症状和 GAF。需要新的方法来解决抑郁症状。
