Centre for Mental Health, Swinburne University of Technology, Hawthorn VIC, Australia.
Centre for Mental Health, Swinburne University of Technology, Hawthorn VIC, Australia.
J Affect Disord. 2021 Jun 15;289:110-116. doi: 10.1016/j.jad.2021.04.018. Epub 2021 Apr 27.
Despite its significant morbidity and mortality, very little is known about how those with lived experience of bipolar II disorder (BD-II) manage their condition. This study sought to understand unmet needs in currently available psychosocial treatments, explore self-management strategies (SMS) that individuals with BD-II currently use, and determine the potential role of digital mental health interventions in this space.
Individuals (aged 18-65) confirming they had received a diagnosis of BD-II from a mental health professional were invited to complete an online survey about treatments trialled, coping strategies used to manage their condition and perspectives on the role of digital mental interventions.
Ninety individuals commencing the survey confirmed a diagnosis of BD-II; of these, n = 35 were screened out based on self-reported hospitalisation for mania and/or experiencing a manic episode. A final sample of n = 55 was subsequently analysed. From the perspective of those with BD-II, current psychosocial treatments fall short in terms of meeting their specific needs. Tailored psychosocial interventions delivered by clinicians with BD-II expertise are sought after, however accessibility and cost are ongoing barriers. Participants were open to digital self-management interventions however uptake was limited. In terms of self-management, actively seeking external help was perceived as most helpful for stopping progression in depression, while self-care strategies were prioritised for hypomania.
The study had several limitations: (1) BD-II diagnoses were not formally verified via standardised diagnostic interview, (2) Borderline personality disorder and comorbid substance abuse disorders were not assessed; (3) the influence of current mood state on participant responses was not assessed, (4) females were over-represented, limiting generalisation of findings to males with BD-II.
Study findings highlight the need for tailored interventions paying specific attention to nuanced features of BD-II, and the potential role of digital mental health interventions for this underserved group.
尽管双相情感障碍 II 型（BD-II）具有显著的发病率和死亡率，但对于那些有双相情感障碍 II 型患病经历的人如何管理他们的病情，我们知之甚少。本研究旨在了解当前可用的心理社会治疗中未满足的需求，探索个体目前使用的自我管理策略（SMS），并确定数字心理健康干预在这方面的潜在作用。
邀请年龄在 18-65 岁之间、经心理健康专业人员确诊为 BD-II 的个体完成一项关于试用治疗、用于管理病情的应对策略以及对数字心理干预作用的看法的在线调查。
90 名开始调查的个体确认了 BD-II 的诊断；其中，根据自我报告的躁狂发作住院和/或经历躁狂发作，有 n=35 名个体被筛选掉。随后对 n=55 名最终样本进行了分析。从 BD-II 患者的角度来看，目前的心理社会治疗在满足他们的特定需求方面存在不足。他们希望得到具有 BD-II 专业知识的临床医生提供的量身定制的心理社会干预，但可及性和成本仍是持续存在的障碍。参与者对数字自我管理干预持开放态度，但参与度有限。在自我管理方面，主动寻求外部帮助被认为对阻止抑郁进展最有帮助，而自我护理策略则被优先用于轻躁狂。
该研究存在一些局限性：（1）BD-II 诊断未通过标准化诊断访谈正式验证；（2）未评估边缘型人格障碍和共病物质滥用障碍；（3）未评估当前情绪状态对参与者反应的影响；（4）女性参与者人数过多，限制了研究结果在男性 BD-II 患者中的推广。
研究结果强调了需要针对 BD-II 的细微特征制定量身定制的干预措施，以及数字心理健康干预在这一未得到充分服务的群体中的潜在作用。
