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科学现状:情绪障碍跨诊断治疗的统一方案。

State of the Science: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders.

机构信息

Center for Anxiety and Related Disorders, Boston University.

Center for Anxiety and Related Disorders, Boston University.

出版信息

Behav Ther. 2024 Nov;55(6):1189-1204. doi: 10.1016/j.beth.2024.04.007. Epub 2024 Apr 29.

Abstract

Before the development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), evidence-based treatment options for commonly co-occurring anxiety, mood, and related disorders consisted of numerous single-disorder protocols that shared many similarities, reflecting the overlap among these disorders themselves. The UP distilled common elements of cognitive behavioral protocols into a unified intervention directly targeting core temperamental features underlying these disorders of emotion, namely neuroticism and associated emotion dysregulation. The UP has since become a leading "transdiagnostic" treatment for emotional disorders, which is now available in several formats (e.g., individual, group, digital) and has accumulated a strong evidence base, leading to international implementation. There is now also research evidence that the UP can be flexibly applied to a range of clinical presentations, including borderline personality disorder, trauma- and stressor-related disorders, eating disorders, alcohol use disorder, and comorbid chronic physical health conditions. Yet additional research is needed to evaluate the UP in routine clinical settings, with more heterogeneous patient populations, and under circumstances that mirror actual clinical practice. Thus, we must also continue to explore the benefits of large-scale UP training initiatives and implementation in major healthcare systems.

摘要

在发展情绪障碍的跨诊断统一治疗方案(UP)之前,针对常见共病的焦虑、情绪和相关障碍的循证治疗选择包括许多单一疾病的方案,这些方案有许多相似之处,反映了这些疾病本身的重叠。UP 将认知行为方案的共同要素提炼为一种直接针对情绪障碍核心气质特征的统一干预措施,即神经质和相关的情绪失调。UP 现已成为情绪障碍的主要“跨诊断”治疗方法,目前有多种形式(例如个体、团体、数字),并积累了强大的证据基础,导致国际实施。现在也有研究证据表明,UP 可以灵活应用于各种临床表现,包括边缘型人格障碍、创伤和应激相关障碍、饮食障碍、酒精使用障碍以及合并的慢性身体健康状况。然而,需要更多的研究来评估 UP 在常规临床环境中的应用,包括更具异质性的患者人群,以及在反映实际临床实践的情况下。因此,我们还必须继续探索在大型医疗保健系统中开展 UP 大规模培训计划和实施的好处。

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