Instituto Peruano para el Estudio y Abordaje Integral de la Personalidad, Lima, Peru; Servicio de Psiquiatría, Hospital de Emergencias Villa El Salvador, Lima, Peru.
Rev Colomb Psiquiatr (Engl Ed). 2023 Jul-Sep;52(3):213-224. doi: 10.1016/j.rcpeng.2021.05.009. Epub 2023 Oct 20.
Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%-1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases. Although it has harmacological and psychotherapeutic treatment, cognitive behavioural therapy (CBT) has shown beneficial effects, but there is not enough clinical information in the current literature.
The main aim was to determine the efficacy of CBT alone or as an adjunct to pharmacological treatment for BD. A systematic review of 17 articles was carried out. The inclusion criteria were: quantitative or qualitative research aimed at examining the efficacy of CBT in BD patients with/without medication; publications in English language; and) being 18-65 years of age. The exclusion criteria were: review and meta-analysis articles; articles that included patients with other diagnoses in addition to BD and that did not separate the results based on such diagnoses; and studies with patients who did not meet the DSM or ICD criteria for BD. The PubMed, PsycINFO and Web of Science databases were searched up to 5 January 2020. The search strategy was: "Bipolar Disorder" AND "Cognitive Behavioral Therapy".
A total of 1531 patients both sexes were included. The weighted mean age was 40.703 years. The number of sessions ranged from 8 to 30, with a total duration of 45-120 min. All the studies show variable results in improving the level of depression and the severity of mania, improving functionality, reducing relapses and recurrences, and reducing anxiety levels and the severity of insomnia.
The use of CBT alone or adjunctive therapy in BD patients is considered to show promising results after treatment and during follow-up. Benefits include reduced levels of depression and mania, fewer relapses and recurrences, and higher levels of psychosocial functioning. More studies are needed.
双相情感障碍（BD）是一种严重的精神疾病，具有慢性病程和显著的发病率和死亡率。BD 的终身患病率为 1%-1.5%，其特征是反复发作的躁狂和抑郁，或两者混合。尽管有药理学和心理治疗，但认知行为疗法（CBT）已显示出有益的效果，但目前文献中没有足够的临床信息。
主要目的是确定单独使用 CBT 或作为药物治疗的辅助治疗对 BD 的疗效。对 17 篇文章进行了系统评价。纳入标准为：旨在检查 CBT 在有/无药物治疗的 BD 患者中的疗效的定量或定性研究；以英语发表的出版物；年龄在 18-65 岁之间。排除标准为：综述和荟萃分析文章；包括除 BD 以外还有其他诊断的患者的文章，并且没有根据这些诊断来分离结果的文章；以及不符合 DSM 或 ICD 双相情感障碍标准的患者的研究。检索了 PubMed、PsycINFO 和 Web of Science 数据库，截至 2020 年 1 月 5 日。搜索策略为：“双相情感障碍”和“认知行为疗法”。
共纳入 1531 名男女患者。加权平均年龄为 40.703 岁。治疗次数从 8 次到 30 次不等，总治疗时间为 45-120 分钟。所有研究均显示出改善抑郁程度和躁狂严重程度、改善功能、减少复发和再发、降低焦虑水平和失眠严重程度等方面的可变结果。
在 BD 患者中单独使用 CBT 或辅助治疗被认为在治疗后和随访期间显示出有希望的结果。益处包括降低抑郁和躁狂程度、减少复发和再发、提高心理社会功能水平。需要更多的研究。
