Intensive Psychotherapy More Effective Than Brief Therapy for TBD
作者: Colleen Labbe / 6988次阅读 时间: 2009年8月23日
来源: NIMH Press Office 301-443-4536 标签: TBD 密集家庭治疗
www.psychspace.com心理学空间网Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar Depression心理学空间9qSG0T0J~4e+G

{G%Z Z5?})hNL:U0Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar DepressionPatients taking medications to treat bipolar disorder are more likely to get well faster and stay well if they receive intensive psychotherapy, according to results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). The results are published in the April 2007 issue of the Archives of General Psychiatry.
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}A}!qvd3lI|0 Bipolar disorder is a debilitating illness marked by severe mood swings between depression and mania that affects 2.6 percent of Americans in any given year. "We know that medication is an important component in the treatment of bipolar illness. These new results suggest that adding specific, targeted psychotherapy to medication may help give patients a better shot at lasting recovery," said NIH Director Dr. Elias A. Zerhouni.心理学空间0?Zk%H/R,xW2M-f
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"STEP-BD is helping us identify the best tools—both medications and psychosocial treatments—that patients and their clinicians can use to battle the symptoms of this illness," said NIMH Director Thomas R. Insel, M.D.心理学空间)c%m$_B w

)ss |9\-_0 Psychotherapy is routinely employed as a means to treat bipolar illness in conjunction with medication, but the extent to which psychotherapy is effective has been unclear. In addition, most psychotherapeutic studies have been limited to a single site and compared only one type of treatment to routine care. Thus, in addition to examining the role of medication, STEP-BD set out to compare several types of psychotherapy and pinpoint the most effective treatments and treatment combinations.
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] HM2H%d0 With 293 participants, David Miklowitz, Ph.D., of the University of Colorado and colleagues set out to test the effectiveness of three types of standardized, intensive, nine-month-long psychotherapy compared to a control group that received a three-session, psychoeducational program called collaborative care. The intensive therapies were
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family-focused therapy, which required the participation and input of patients' family members and focused on enhancing family coping, communication and problem-solving;
-s}K iiX0 cognitive behavioral therapy, which focused on helping the patient understand distortions in thinking and activity, and learn new ways of coping with the illness; and 心理学空间!w6ci w-R%T
interpersonal and social rhythm therapy, which focused on helping the patient stabilize his or her daily routines and sleep/wake cycles, and solve key relationship problems. 心理学空间*?3_+Ow;[$z.qe
All participants were already taking medication for their bipolar disorder, and most were also enrolled in a STEP-BD medication study reported in the New England Journal of Medicine on March 28, 2007. The researchers compared patients' time to recovery and their stability over one year.
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Over the course of the year, 64 percent of those in the intensive psychotherapy groups had become well, compared with 52 percent of those in collaborative care therapy. Patients in intensive psychotherapy also became well an average of 110 days faster than those in collaborative care. In addition, patients who received intensive psychotherapy were one and a half times more likely to be clinically well during any month out of the study year than those who received collaborative care. Discontinuation rates among the groups were similar—36 percent of those in the intensive programs discontinued and 31 percent of those in collaborative care discontinued. None of the three intensive psychotherapies appeared to be significantly more effective than the others, although rates of recovery were higher among those in family-focused therapy compared to the other groups.心理学空间 {1`u`R
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"Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person's chances for recovering from depression and staying healthy over the long term," said Dr. Miklowitz. "It should be considered a vital part of the effort to treat bipolar illness."
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The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website, http://www.nimh.nih.gov..
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The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.心理学空间.S\K$E"i,~5@

x$l)Z:A4K0 Miklowitz D. et al. Psychosocial Treatments for Bipolar Depression. Archives of General Psychiatry. Apr 2007; 164.www.psychspace.com心理学空间网
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