Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
J Affect Disord. 2020 Jan 1;260:263-271. doi: 10.1016/j.jad.2019.09.014. Epub 2019 Sep 3.
The working alliance plays an essential role in the treatment of patients with different diseases. However, this variable has received little attention in patients with bipolar disorder. Therefore, this systematic review aimed to examine the working alliance's influence on these patients' treatment outcomes, analyze its role in the adherence to pharmacotherapy, and identify the variables that are related to a good working alliance.
PubMed, PsycINFO, and Web of Science databases were searched until January 5, 2018 using a predetermined search strategy. Then, a formal process of study selection and data extraction was conducted.
Seven articles fulfilled the inclusion criteria and they included a total of 3,985 patients with bipolar disorder type I and II. Although the working alliance's ability to predict the duration and presence of manic and depressive symptoms is unclear, a good working alliance facilitates the adherence to pharmacological treatment. In addition, good social support for patients is associated with a strong working alliance.
The selected studies used different definitions and measures of the working alliance and adherence, and most used self-reports to assess the working alliance. Furthermore, the relationships found among the variables were correlational.
The working alliance can play an important role in adjunctive psychological therapies and in pharmacological and somatic treatments for patients with bipolar disorder. However, the number of studies on working alliance in bipolar disorder is rather limited and there is methodological heterogeneity between the studies.
工作联盟在治疗不同疾病的患者中起着至关重要的作用。然而，这一变量在双相情感障碍患者中却很少受到关注。因此，本系统综述旨在考察工作联盟对这些患者治疗结果的影响，分析其在药物治疗依从性中的作用，并确定与良好工作联盟相关的变量。
我们使用预定的搜索策略，在 2018 年 1 月 5 日之前检索了 PubMed、PsycINFO 和 Web of Science 数据库。然后，我们进行了正式的研究选择和数据提取过程。
符合纳入标准的有 7 篇文章，共纳入了 3985 例 I 型和 II 型双相情感障碍患者。尽管工作联盟预测躁狂和抑郁症状的持续时间和存在的能力尚不清楚，但良好的工作联盟有助于药物治疗的依从性。此外，患者良好的社会支持与较强的工作联盟相关。
入选的研究使用了不同的工作联盟和依从性的定义和测量方法，且大多数研究使用自我报告来评估工作联盟。此外，所发现的变量之间的关系是相关的。
工作联盟可以在双相情感障碍患者的辅助心理治疗以及药物和躯体治疗中发挥重要作用。然而，关于双相情感障碍中工作联盟的研究数量相当有限，并且研究之间存在方法学的异质性。
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