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老年双相情感障碍:指导临床实践的新证据

Bipolar Disorder Among Older Adults: Newer Evidence to Guide Clinical Practice.

作者信息

Dols Annemiek, Sekhon Harmehr, Rej Soham, Klaus Federica, Bodenstein Katie, Sajatovic Martha

机构信息

Department of Psychiatry, University Medical Centre Utrecht, Utrecht, the Netherlands (Dols); Department of Psychiatry, Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, Quebec, Canada (Sekhon, Rej, Bodenstein); McLean Hospital (Harvard Medical School Affiliate), Belmont, Massachusetts (Sekhon); Department of Psychiatry, University of California, San Diego, La Jolla, California (Klaus); Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio (Sajatovic).

出版信息

Focus (Am Psychiatr Publ). 2023 Oct;21(4):370-379. doi: 10.1176/appi.focus.20230010. Epub 2023 Oct 15.

Abstract

The term (OABD) refers to patients with bipolar disorder who are ages 50 and older. Research findings suggest important differences, including the attenuation of manic symptoms with age and the occurrence of multiple somatic comorbid conditions. Although the pharmacological treatment of OABD is fairly similar, adverse effects, somatic comorbidity, and drug-drug interactions are more common. Lithium is effective in treating OABD and may have the potential to be neuroprotective. Anticonvulsants and second-generation antipsychotics have a growing evidence supporting their use in treating OABD. Behavioral intervention can be a helpful adjunct to pharmacological treatment. Clinicians and health care systems need to be prepared to provide care and services to individuals with bipolar disorder throughout the life span. Although older adults have typically been excluded from bipolar disorder RCTs, emerging efforts organized by global advocates and harnessing teams of clinicians and scientists have the potential to advance care.

摘要

术语“老年双相情感障碍(OABD)”指的是年龄在50岁及以上的双相情感障碍患者。研究结果表明存在重要差异,包括躁狂症状随年龄减轻以及多种躯体合并症的发生。尽管OABD的药物治疗相当相似,但不良反应、躯体合并症和药物相互作用更为常见。锂盐对治疗OABD有效,并且可能具有神经保护作用。抗惊厥药和第二代抗精神病药越来越多地有证据支持其用于治疗OABD。行为干预可以作为药物治疗的有益辅助。临床医生和医疗保健系统需要做好准备,为双相情感障碍患者提供贯穿其一生的护理和服务。尽管老年人通常被排除在双相情感障碍随机对照试验之外,但全球倡导者组织的新努力以及临床医生和科学家团队的合作有潜力推动护理工作的进展。

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