Ostacher Michael J, Miller Christopher J, Edwards-Stewart Amanda, Cazares Paulette T, Owen Richard R, Fuller Matthew A, Osser David, Abrams Thad E, Mangal Jed P, Katz Ira, Ballard-Hernandez Jennifer M, Davis-Arnold Sarah D, Alvarez Isabella, Sall James L
Department of Veterans Affairs, Washington, DC.
School of Medicine, Stanford University, Stanford, California.
J Clin Psychiatry. 2025 Jan 13;86(1):24cs15546. doi: 10.4088/JCP.24cs15546.
The US Department of Veterans Affairs (VA) and Department of Defense (DOD) Work Group revised the 2013 VA/DOD Clinical Practice Guideline (CPG) for the Management of Bipolar Disorder (BD). This paper reviews the 2023 CPG and its development process, including how recommendations were made for evidence-based treatment in BD. Subject experts and key stakeholders developed 20 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Recommendations were based on quality and strength of evidence and informed by other factors, including feasibility, patient perspectives, and the unique needs of people with BD. Peer review by an external group of experts then resulted in completion of the CPG. While the scope of the CPG is broad, this synopsis focuses on clinically relevant recommendations related to the identification and management of BD, including the acute and maintenance phases of illness.
美国退伍军人事务部（VA）和国防部（DOD）工作组修订了2013年VA/DOD双相情感障碍（BD）管理临床实践指南（CPG）。本文回顾了2023年CPG及其制定过程，包括BD循证治疗建议的制定方式。主题专家和关键利益相关者提出了20个关键问题，并在使用PICOTS（人群、干预措施、对照、结局、结局测量时间和环境）方法进行系统检索后，对已发表的文献进行了回顾。然后使用推荐分级评估、制定和评价（GRADE）方法对证据进行评估。建议基于证据的质量和强度，并参考其他因素，包括可行性、患者观点以及BD患者的独特需求。随后，由外部专家小组进行同行评审，最终完成了CPG。虽然CPG的范围很广，但本概述重点关注与BD识别和管理相关的临床相关建议，包括疾病的急性期和维持期。
