Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK; Centre of Resilience for Social Justice, School of Sport and Health Sciences, University of Brighton, Brighton, UK.
Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK.
J Affect Disord. 2022 Jul 15;309:375-392. doi: 10.1016/j.jad.2022.04.075. Epub 2022 Apr 22.
Outcome measurement in bipolar disorder (BD) traditionally focused on clinical improvement without considering other domains. Improvement trajectories in clinical and social-functional domains are different and can simultaneously appear in one while not in other domains. Measuring personal recovery (PR) has become a priority internationally. This review explored the shift in research investigating operational recovery definitions and underpinning factors of recovery in BD over the past four decades.
Studies defining recovery domains (other than clinical recovery) in BD were systematically reviewed; operational recovery definitions and factors assessed in association with recovery were thematically categorised and integrated in a narrative synthesis.
Thirty-three studies, comprising 3638 participants from 19 countries were included. Identified operational recovery definition themes included i) PR ii) social-functional (SFR), and iii) occupational-residential (ORR) recovery. Examined factors were grouped as demographic, clinical and psychosocial factors. Predominantly demographic factors were linked to ORR and clinical factors to SFR. Depressive symptomatology was the only clinical factor associated with PR. Research investigating psychosocial factors in PR is emerging and has showed that resilience and appraisals of mood seem to be associated with PR.
Studies not available in English or examining functioning without defining recovery were excluded.
Earlier operational recovery definitions of ORR and SFR were often arbitrary and inconsistent, and predominantly focused on clinical and demographic underpinning factors. While research attempts to follow the significant policy shifts towards personalised care by measuring what matters to individuals and exploring broader underpinning psychosocial factors, it is still lagging behind.
双相情感障碍（BD）的传统疗效评估侧重于临床改善，而没有考虑其他领域。临床和社会功能领域的改善轨迹不同，可能同时出现在一个领域，而不在其他领域出现。衡量个人康复（PR）已成为国际优先事项。本综述探讨了过去四十年中，研究在 BD 中调查操作性康复定义和康复支持因素方面的转变。
系统综述了定义 BD 中其他康复领域（临床康复以外）的研究；对与康复相关的操作性康复定义和评估因素进行了主题分类，并以叙述性综合的方式进行了整合。
共纳入来自 19 个国家的 33 项研究，共 3638 名参与者。确定的操作性康复定义主题包括：i）个人康复（PR）、ii）社会功能（SFR）和 iii）职业-居住（ORR）康复。研究考察的因素分为人口统计学、临床和心理社会因素。主要的人口统计学因素与 ORR 相关，而临床因素与 SFR 相关。抑郁症状是唯一与 PR 相关的临床因素。研究表明，心理社会因素在 PR 中发挥作用，韧性和情绪评估似乎与 PR 相关。
排除了未以英文发表或未定义康复而仅检查功能的研究。
早期的 ORR 和 SFR 操作性康复定义通常是任意和不一致的，且主要侧重于临床和人口统计学基础因素。尽管研究试图通过衡量对个人重要的事物和探索更广泛的潜在心理社会因素来顺应重大的个性化治疗政策转变，但仍落后于政策。
