Conroy Susan, Francis Michael, Hulvershorn Leslie A
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Curr Treat Options Psychiatry. 2018 Mar;5(1):113-128. doi: 10.1007/s40501-018-0138-0. Epub 2018 Jan 22.
The goal of this paper is to review recent research on the identification and treatment of prodromal periods that precede bipolar and psychotic disorders. We also sought to provide information about current best clinical practices for prodromal youth.
Research in the areas of identifying prodromal periods has rapidly advanced. Calculators that can predict risk are now available for use during both bipolar and psychotic disorder prodromes. Cognitive behavior therapies have emerged as the gold standard psychosocial interventions for the psychosis prodrome, while several other types of therapies hold promise for treatment during the bipolar prodrome. Due to safety and efficacy concerns, pharmacologic treatments are not currently recommended during either prodromal period.
While additional research is needed to develop useful clinical tools to screen and diagnose during prodromal phases, existing literature has identified constellations of symptoms that can be reliably identified in research settings. Specialized psychotherapies are currently recommended to treat prodromal symptoms in clinical settings. They may also be useful to curtail future episodes, although further research is needed.
本文旨在回顾近期关于双相情感障碍和精神障碍前驱期识别与治疗的研究。我们还试图提供有关前驱期青少年当前最佳临床实践的信息。
识别前驱期领域的研究进展迅速。现在有可用于双相情感障碍和精神障碍前驱期预测风险的计算器。认知行为疗法已成为精神病前驱期的金标准心理社会干预措施，而其他几种疗法有望用于双相情感障碍前驱期的治疗。由于安全性和有效性问题，目前在前驱期均不推荐药物治疗。
虽然需要更多研究来开发在前驱期进行筛查和诊断的有用临床工具，但现有文献已确定了在研究环境中可可靠识别的症状群。目前建议在临床环境中采用专门的心理治疗来治疗前驱期症状。它们可能也有助于减少未来发作，不过还需要进一步研究。
