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双極性障害の治療 双極性障害の治療
John R Geddes1, David J Miklowitz1
1Department of Psychiatry, University of Oxford, Oxford, UK (Prof J R Geddes MD, Prof D J Miklowitz PhD); and Division of Child and Adolescent Psychiatry, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, CA, USA (Prof D J Miklowitz PhD).
Lancet (London, England)
|May 14, 2013
まとめ
双極性障害の治療における進歩は,薬剤での控えめな利益を示しているが,心理社会的介入では有望である. 将来のイノベーションには,パーソナライズされたケアのための統合された神経生物学的および心理社会的アプローチが必要です.
科学分野:
- 精神科医は精神病を患っている.
- 薬理学 薬理学とは
- 心理療法 心理療法とは
背景:
- 双極性障害の治療の進歩は,特に薬剤療法では,依然として控えめです.
- 抗精神病薬は,急性マニアの治療に有効であり,うつ病の治療にはさまざまな結果が出ています.
- 双極性うつ病の抗うつ剤の使用は依然として論争の的であり,リチウムは再発の予防に最適です.
研究 の 目的:
- 急性および長期的な双極性障害の治療における最近の進展をレビューする.
- 将来の治療革新のための有望な道を特定する.
- 薬理学的および心理社会的介入の統合を探求する.
主な方法:
- 双極性障害の治療における最近の進展に関する文献レビュー.
- 薬剤の有効性に関する証拠の分析 (抗精神病薬,抗うつ薬,抗薬).
- 補助的な心理社会的介入と,薬剤療法との組み合わせの評価.
主要な成果:
- 抗精神病薬は急性マニアに有効であり,クエチアピンは双極性うつ病の最も明確な証拠を示しています.
- リチウムは,最強の長期的な再発予防の証拠を示しています.
- 薬物と組み合わせた心理社会的介入は,長期的な維持と急性うつ病の安定化を促進します.
結論:
- 将来の双極性障害の治療には,神経生物学的および心理社会的メカニズムを統合する必要があります.
- 薬物療法と心理療法による治療の組み合わせを最適化することは極めて重要です.
- 睡眠と昼間のリズムに対する治療効果を理解することで,ケアをパーソナライズすることができます;心理療法には効率の向上が必要です.
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