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老年双相情感障碍的心理治疗:当前证据、实践与未来方向。

Psychological therapies for bipolar disorder in later life: Current evidence, practice and future directions.

作者信息

Tyler Elizabeth, Warner Aaron

机构信息

Division of Psychology and Mental Health, University of Manchester, Manchester, UK.

Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.

出版信息

Psychol Psychother. 2025 Sep;98(3):821-831. doi: 10.1111/papt.12593. Epub 2025 Apr 4.

Abstract

PURPOSE

Bipolar disorder (BD) is a severe and enduring mental health condition that persists into older adulthood. The number of people living with BD into later life is set to increase as our population ages and awareness of the condition increases. BD in later life may present with additional challenges, such as increased physical health comorbidities and poorer cognitive function. Despite these additional challenges, there has been a paucity of research focused specifically on the treatment needs of older people with BD, highlighted by several review papers. In comparison, the last 30 years have witnessed a rapid development of psychological treatments for younger people with BD.

METHODS

The authors completed a literature review of peer-reviewed journal articles reporting on psychological therapies developed specifically for older adults with BD. The authors also considered adaptations to psychological therapies that may benefit this population.

RESULTS

This review highlighted that there is limited available research investigating the efficacy of psychological treatments for older adults with BD, despite their unique care needs. The available evidence demonstrated the importance of adapting psychological interventions to meet this client group's needs and outlined potentially beneficial adaptations, such as increasing the flexibility of treatment, taking into account health-related and symptom changes, and developing treatments in consultation with older adults with BD.

CONCLUSIONS

Improved attention and awareness of the challenges faced by older adults with BD is warranted. The development of tailored psychological treatments for this group may help reduce the significant inequalities they currenty face.

摘要

目的

双相情感障碍(BD)是一种严重且持久的心理健康状况,会持续到老年期。随着人口老龄化以及对该疾病认识的提高,老年期患有双相情感障碍的人数将会增加。老年期的双相情感障碍可能会带来额外的挑战,比如身体健康合并症增多以及认知功能较差。尽管存在这些额外挑战,但正如几篇综述文章所强调的,专门针对老年双相情感障碍患者治疗需求的研究却很少。相比之下,在过去30年里,针对年轻双相情感障碍患者的心理治疗发展迅速。

方法

作者对同行评审期刊文章进行了文献综述,这些文章报道了专门为老年双相情感障碍患者开发的心理治疗方法。作者还考虑了可能使该人群受益的心理治疗方法的调整。

结果

该综述强调,尽管老年双相情感障碍患者有独特的护理需求,但研究其心理治疗效果的现有研究有限。现有证据表明了调整心理干预以满足该客户群体需求的重要性,并概述了可能有益的调整方法,比如增加治疗的灵活性,考虑与健康相关的因素和症状变化,以及在与老年双相情感障碍患者协商的情况下开发治疗方法。

结论

有必要提高对老年双相情感障碍患者所面临挑战的关注和认识。为该群体开发量身定制的心理治疗方法可能有助于减少他们目前面临的显著不平等现象。

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