Maczka Grzegorz, Grabski Bartosz, Gierowski Józef Krzysztof, Dudek Dominika
Oddział Kliniczny Kliniki Psychiatrii, Doroslych Szpitala Uniwersyteckiego UJ CM w Krakowie.
Psychiatr Pol. 2010 Jan-Feb;44(1):89-100.
To share our experience in introducing an original, structured group psychoeducational programme entitled "Familiarizing bipolar disorder" into the integrated complex treatment of bipolar disorder (BP).
The programme is partially based on the Barcelona Bipolar Disorders Program format and represents our proposal of a short, easily applied group psychoeducation. It consists of 8 meetings, conducted by a psychiatrist and a psychologist who are both trained in cognitive-behavioural therapy. Two groups of patients accomplished the programme so far. We would like to present our conclusions and qualitative observations.
The patients noticed a change in a philosophical view on the bipolar disorder treatment (access to information, partnership between a doctor and a patient, appreciation of psychological aspects of bipolar illness), which is embodied by the psychoeducational approach. They welcomed our programme with enthusiasm and interest. Many questions were asked about different aspects of bipolar disorder, especially concerning pharmacotherapy, genetic and legal issues. Our participants assessed the number of sessions as optimal, but some of them insisted on devoting one more meeting to interactively discuss pharmacotherapy of BP. The programme revealed many other relevant issues concerning patients' attitudes toward bipolar disorder like: common presence of dysfunctional beliefs patients hold regarding their illness, unawareness of importance of mood stabilizer serum level examination, insufficient knowledge on hypomania or--in some cases--ignorance of a hypomania phenomenon. Moreover, patients appreciated the fact that the psychoeducational programme helped them to diminish the sense of stigma, shame, and the feeling of being different or worse. Finally we are amazingly impressed by the unsatisfied need existing in bipolar patients to share their fears, emotions and to be fully informed.
Our observations support the statement, that the psychoeducational approach to BD is a crucial element of a complex treatment. It surely satisfies patients needs for information and may help to reformulate beliefs about their illness and its treatment. Further studies on the effectiveness and mechanisms of psychoeducational interventions are needed.
分享我们将原创的结构化团体心理教育项目“认识双相情感障碍”引入双相情感障碍(BP)综合治疗的经验。
该项目部分基于巴塞罗那双相情感障碍项目的形式,是我们提出的一种简短、易于实施的团体心理教育方案。它由8次会议组成,由一位接受过认知行为疗法培训的精神科医生和一位心理学家主持。到目前为止,两组患者完成了该项目。我们希望展示我们的结论和定性观察结果。
患者注意到双相情感障碍治疗的哲学观点发生了变化(获取信息、医患伙伴关系、对双相情感障碍心理方面的认识),这体现在心理教育方法中。他们热情且感兴趣地欢迎我们的项目。关于双相情感障碍的不同方面提出了许多问题,尤其是关于药物治疗、遗传和法律问题。我们的参与者认为会议次数是最佳的,但他们中的一些人坚持要再增加一次会议来互动讨论双相情感障碍的药物治疗。该项目揭示了许多其他与患者对双相情感障碍态度相关的问题,比如:患者对自身疾病存在功能失调信念的普遍情况、未意识到心境稳定剂血清水平检查的重要性、对轻躁狂的了解不足或在某些情况下对轻躁狂现象的无知。此外,患者赞赏心理教育项目帮助他们减少了耻辱感、羞耻感以及与众不同或低人一等的感觉。最后,双相情感障碍患者对分享恐惧、情感以及充分了解信息的未被满足的需求给我们留下了惊人的印象。
我们的观察结果支持这样的观点,即双相情感障碍的心理教育方法是综合治疗的关键要素。它肯定满足了患者对信息的需求,并可能有助于重新构建他们对疾病及其治疗的信念。需要对心理教育干预的有效性和机制进行进一步研究。