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Defining and improving response to treatment in patients with bipolar disorder.

机译:定义和改善躁郁症患者对治疗的反应。

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Functional outcomes are more meaningful measures of response to treatment for bipolar disorder than are scores on various psychiatric rating scales (all of which have limitations) used to gauge improvement in symptoms. With the former approach, patients are considered to be in remission if they achieve normal or near-normal levels of functioning in occupational, family, and social settings. Sleep patterns are reliable indicators of whether a patient with bipolar disorder is likely to relapse or sustain remission in the near term. Regularly scheduled nightly sleep periods may help prevent rapid cycling in patients with mania, while perturbations in circadian rhythms may be early markers of impending relapse. Medications used to attain response and/or remission in maintenance therapy include lithium and valproate. The choice of mood stabilizer depends on the patient's symptoms, prior response to a mood stabilizer, and tolerance of the drug. For patients requiring additional therapy, combination regimens with mood stabilizers and atypical antipsychotics appear effective. Psychoeducation for patients and families and interpersonal psychotherapy also can help prolong remission.
机译:功能性结局比对用于评估症状改善的各种精神病学评分量表(所有这些都具有局限性)的评分更有意义,是对躁郁症治疗的反应。使用前一种方法,如果患者在职业,家庭和社交环境中达到正常或接近正常的功能水平,则认为他们已经缓解。睡眠方式是双相情感障碍患者近期是否可能复发或维持缓解的可靠指标。定期安排的夜间睡眠时间可能有助于防止躁狂症患者快速循环,而昼夜节律的紊乱可能是即将复发的早期标志。维持疗法中用于获得缓解和/或缓解的药物包括锂和丙戊酸盐。情绪稳定剂的选择取决于患者的症状,对情绪稳定剂的先前反应以及药物的耐受性。对于需要额外治疗的患者,结合使用情绪稳定剂和非典型抗精神病药的方案似乎有效。对患者和家属的心理教育以及人际心理治疗也可以帮助延长缓解时间。

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