El-Sayed Mona Metwally, Elhay Eman Sameh Abd, Taha Samah Mohamed, Khedr Mahmoud Abdelwahab, Mansour Feby Saad Attalla, El-Ashry Ayman Mohamed
Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Psychiatric and Mental Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
BMC Nurs. 2023 Aug 17;22(1):271. doi: 10.1186/s12912-023-01443-1.
Among people with bipolar disorders, there are high rates of impulsivity and suicide attempts. Efforts to reduce suicide are hindered by the lack of conclusive evidence on interventional programs for those at risk. Thus, this work evaluated the efficacy of acceptance and commitment therapy on impulsivity and suicidality among bipolar clients.
In a randomized controlled trial, 30 eligible clients with bipolar disorders were given Acceptance and Commitment Therapy, and 30 eligible clients for the control group were chosen randomly at a 1:1 ratio using Research Randomizer version 4.0. Clients completed the Acceptance and Action Questionnaire II, the Short Arabic Version of the Impulsivity Behavior Scale, and the Arabic Version of the Beck Scale for Suicide Ideation.
It can be observed that there was a statistically significant decrement in the mean scores of psychological inflexibility among the study group between baseline value (T0), posttest measurement (T1), and post-two-month follow-up (T2), from 32.91 SD (6.03) to 23.06 SD (6.22) post and 26.83 SD (3.49) post-two months, with an effect size of 0.846 (P < 0.001), compared to the control group, which revealed an increase in the mean score. The overall impulsivity among the study group between T0, T1, and T2 was 61.27 SD (4.57) to 46.83 SD (4.47) post- and 43.0 SD (5.30) post-two months, with an effect size of 0.906 (P < 0.001). Compared to the control group, which revealed a relative increase in the mean impulsivity score at the post- and post-two-month intervals, the Arabic Versions of the Beck Scale for Suicide Ideation Scale mean score before the intervention was 16.33 SD (6.08), then the post was 7.23 SD (4.72), and the post-two-month mean was 10.13 SD (5.49) with an effect size of 0.878 (P < 0.001) among the study group. On the other hand, mean scores of "suicide ideation" among clients in the control group increased posttest and nearly returned to the same value after two months.
For bipolar clients suffering from suicidal thoughts and impulsive behaviors, acceptance and commitment therapy, an emerging third-wave behavior therapy, is an effective intervention.
The study was registered retrospectively with reference number NCT05693389 on 23/1/2023, available at: https://clinicaltrials.gov/ct2/show/NCT05693389 .
在双相情感障碍患者中，冲动性和自杀企图的发生率很高。由于缺乏针对高危人群干预项目的确凿证据，减少自杀的努力受到阻碍。因此，本研究评估了接受与承诺疗法对双相情感障碍患者冲动性和自杀倾向的疗效。
在一项随机对照试验中，30名符合条件的双相情感障碍患者接受了接受与承诺疗法，使用Research Randomizer 4.0版本以1:1的比例随机选择30名符合条件的患者作为对照组。患者完成了接受与行动问卷II、冲动行为量表阿拉伯语简版和自杀观念贝克量表阿拉伯语版。
可以观察到，研究组在基线值（T0）、测试后测量（T1）和两个月后随访（T2）之间，心理灵活性的平均得分有统计学意义的下降，从32.91标准差（6.03）降至测试后的23.06标准差（6.22）和两个月后的26.83标准差（3.49），效应大小为0.84（P < 0.001），而对照组的平均得分有所增加。研究组在T0、T1和T2之间的总体冲动性从61.27标准差（4.57）降至测试后的46.83标准差（4.47）和两个月后的43.0标准差（5.30），效应大小为0.906（P < 0.001）。与对照组相比，对照组在测试后和两个月后的平均冲动性得分相对增加，自杀观念贝克量表阿拉伯语版干预前的平均得分是16.33标准差（6.08），测试后为7.23标准差（4.72）, 研究组两个月后的平均分为10.13标准差（5.49），效应大小为0.878（P < 0.001）。另一方面，对照组患者的“自杀观念”平均得分在测试后增加，两个月后几乎恢复到相同水平。
对于患有自杀念头和冲动行为的双相情感障碍患者，接受与承诺疗法这种新兴的第三波行为疗法是一种有效的干预措施。
该研究于2023年1月23日进行回顾性注册，注册号为NCT05693389，可在https://clinicaltrials.gov/ct2/show/NCT05693389查询。
