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难治性心境障碍

Treatment-Resistant Mood Disorders.

作者信息

Naeem Nadia, Farooqi Rabia

机构信息

Nadia Naeem, Department of Psychology, University of Central Punjab, Lahore, Pakistan.

Rabia Farooqi, PhD. Associate Professor, Department of Psychology, University of Central Punjab, Lahore, Pakistan.

出版信息

Pak J Med Sci. 2024 Oct;40(9):2141-2148. doi: 10.12669/pjms.40.9.8245.

Abstract

OBJECTIVE

The objective of the study was to explore the presentation of symptoms in patients suffering from treatment-resistant mood disorder (TRMD), and associated clinical features, including age, gender, and comorbid conditions, that lead towards the development of treatment-resistant mood disorder. Furthermore, the study analyses the available psychotherapeutic treatment modalities and evidence-based non-medical treatment approaches for TRMD.

METHOD

The current study utilized a systematic review approach where 37 articles were studied and three articles were theoretically sampled to authenticate and signify the findings. PRISMA guidelines were followed and the review was conducted by searching social sciences databases and electronic libraries including Google Scholar, Sage Journal, and Science Direct (1990-2020).

RESULTS

The results suggested that psychotherapeutic interventions including cognitive behavior therapy, mindful-based cognitive therapy; and interpersonal and social rhythm therapeutic interventions are efficacious modalities for treatment when in augmentation with psychopharmacological treatment. Bipolar diathesis and comorbid conditions of anxiety and personality disorders are possible causal factors in developing the condition of treatment resistance in mood disorders. The prevalence rate of TRMD is more common in females and in late adulthood. The analysis also suggests that there are numerous risk factors contributing to making a mood disorder treatment-resistant over a period of time; the most observed conditions were physical and psychological comorbidity, inaccurate diagnosis, lack of proper medical treatment, illness severity, and late age diagnosis. In evidence-based non-medical treatment approaches aerobics demonstrated promising results in improving the condition of complex mood disorders.

CONCLUSION

It was concluded that psychotherapeutic interventions in augmentation with pharmacological modalities enhance the efficacy of treatment.

摘要

目的

本研究的目的是探讨难治性心境障碍(TRMD)患者的症状表现,以及导致难治性心境障碍发生的相关临床特征,包括年龄、性别和共病情况。此外,本研究还分析了现有的心理治疗方法以及针对TRMD的循证非药物治疗方法。

方法

本研究采用系统评价方法,研究了37篇文章,并从理论上抽取了3篇文章以验证和说明研究结果。遵循PRISMA指南,通过检索社会科学数据库和电子图书馆进行综述,包括谷歌学术、Sage期刊和科学Direct(1990 - 2020年)。

结果

结果表明,心理治疗干预措施,包括认知行为疗法、正念认知疗法;以及人际和社会节律治疗干预措施,在与心理药物治疗联合使用时是有效的治疗方式。双相素质以及焦虑和人格障碍的共病情况可能是导致心境障碍出现治疗抵抗状态的因果因素。TRMD的患病率在女性和成年晚期更为常见。分析还表明,随着时间的推移,有许多风险因素导致心境障碍产生治疗抵抗;最常见的情况是身体和心理共病、诊断不准确、缺乏适当的药物治疗、疾病严重程度以及诊断年龄较晚。在循证非药物治疗方法中,有氧运动在改善复杂心境障碍状况方面显示出有希望的结果。

结论

得出的结论是,心理治疗干预与药物治疗相结合可提高治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5252/11476141/fd2cb3819afa/PJMS-40-2141-g001.jpg

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