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通过心理教育提高双相情感障碍的治疗依从性。

Improving treatment adherence in bipolar disorder through psychoeducation.

作者信息

Vieta Eduard

机构信息

Bipolar Disorders Program, Hospital Clinic IDIBAPS, University of Barcelona, Barcelona, Spain.

出版信息

J Clin Psychiatry. 2005;66 Suppl 1:24-9.

Abstract

The chronicity and cyclical nature of bipolar disorder combined with the irrationality typical during bipolar mood episodes often encourage pharmacologic treatment nonadherence, which heightens the severity of the illness. Although clinicians acknowledge treatment nonadherence to be a major issue among bipolar patients, assessing nonadherence is difficult, and improving treatment adherence is a complicated and delicate matter. Treatment adherence can be improved among patients with bipolar disorder through psychoeducation about the nature of their disorder and the vital importance of treatment adherence. Founded on a biopsychosocial, medical model of mental disorders, psychoeducation empowers the patient by providing a practical and theoretical approach to understanding and dealing with the symptoms and consequences of bipolar disorder. Psychoeducation identifies bipolar disorder as a biological abnormality that requires regular pharmacologic treatment and teaches patients to cope with symptoms and maintain regularity in daily social and occupational functioning. Psychoeducated patients show improvements in treatment adherence and in other clinical outcomes, including reduced number of mood episodes and hospitalizations and increased time between episodes. As an adjunct to pharmacotherapy of bipolar disorder, psychoeducation is a promising management component that increases treatment adherence and quality of life for patients.

摘要

双相情感障碍的慢性和周期性特点,再加上双相情感发作期间典型的非理性行为,常常导致药物治疗依从性差,进而加重病情的严重程度。尽管临床医生承认治疗依从性差是双相情感障碍患者中的一个主要问题,但评估依从性很困难,而提高治疗依从性是一件复杂而微妙的事情。通过对双相情感障碍患者进行关于其疾病本质以及治疗依从性至关重要性的心理教育,可以提高他们的治疗依从性。基于生物心理社会的精神障碍医学模型,心理教育通过提供一种理解和应对双相情感障碍症状及后果的实用理论方法,增强患者的能力。心理教育将双相情感障碍识别为一种需要定期药物治疗的生物学异常情况,并教导患者应对症状,在日常社交和职业功能中保持规律。接受过心理教育的患者在治疗依从性以及其他临床结果方面都有改善,包括情绪发作次数和住院次数减少,发作间隔时间延长。作为双相情感障碍药物治疗的辅助手段,心理教育是一个很有前景的管理组成部分,可提高患者的治疗依从性和生活质量。

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