Jones Brett D M, Umer Madeha, Kittur Mary E, Finkelstein Ofer, Xue Siqi, Dimick Mikaela K, Ortiz Abigail, Goldstein Benjamin I, Mulsant Benoit H, Husain Muhammad I
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Centre for Addiction and Mental Health, Toronto, Canada.
Int J Bipolar Disord. 2023 Feb 5;11(1):6. doi: 10.1186/s40345-023-00288-6.
Evidence-based psychotherapies available to treat patients with bipolar disorders (BD) are limited. Dialectical behavior therapy (DBT) may target several common symptoms of BD. We conducted a systematic review on the efficacy of DBT for mood symptoms in patients with BD. The systematic search used key words related to DBT and BD in Medline, Embase, PsycInfo, CINAHL, and Cochrane Library databases from 1980 to April 1st, 2022. We included studies that enrolled patients with a BD I or II diagnosis (DSM or ICD), age 12 and older who received a DBT-based intervention. Studies reviewed were clinical trials including observational studies that reported at least one outcome related to BD mood symptoms or severity. We did not exclude based upon psychiatric or physical co-morbidity.
We screened 848 abstracts and reviewed 28 full texts; 10 publications with 11 studies met our pre-determined eligibility criteria. All but one were feasibility pilot studies and most included participants in all mood states except for mania. The studies provided preliminary evidence suggesting these interventions may be effective for improving several core symptoms of BD. Overall, all the studies consistently supported that DBT-based interventions are feasible and acceptable for patients with BD.
DBT may be an effective treatment for BD; however, the confidence in this conclusion is limited by the small sample sizes, heterogeneity, and high risk of bias in all published trials. Larger well-designed RCTs are now required to establish the effectiveness of DBT in BD.
可用于治疗双相情感障碍（BD）患者的循证心理疗法有限。辩证行为疗法（DBT）可能针对BD的几种常见症状。我们对DBT治疗BD患者情绪症状的疗效进行了系统评价。系统检索在1980年至2022年4月1日期间使用Medline、Embase、PsycInfo、CINAHL和Cochrane图书馆数据库中与DBT和BD相关的关键词。我们纳入了诊断为I型或II型双相情感障碍（DSM或ICD）、年龄在12岁及以上且接受基于DBT干预的患者的研究。所综述的研究为临床试验，包括观察性研究，这些研究报告了至少一项与BD情绪症状或严重程度相关的结果。我们没有基于精神或身体共病进行排除。
我们筛选了848篇摘要并审阅了28篇全文；10篇出版物中的11项研究符合我们预先确定的纳入标准。除一项外，其余均为可行性试点研究，且大多数研究纳入了除躁狂症外所有情绪状态的参与者。这些研究提供了初步证据，表明这些干预措施可能对改善BD的几种核心症状有效。总体而言，所有研究一致支持基于DBT的干预措施对BD患者是可行且可接受的。
DBT可能是治疗BD的有效方法；然而，由于所有已发表试验的样本量小、异质性高和偏倚风险高，对这一结论的信心有限。现在需要更大规模、设计良好的随机对照试验来确定DBT在BD中的有效性。
