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首页> 外文期刊>The journal of clinical psychiatry >Response, remission, and recovery in bipolar disorders: what are the realistic treatment goals?
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Response, remission, and recovery in bipolar disorders: what are the realistic treatment goals?

机译：躁郁症的反应，缓解和恢复：实际的治疗目标是什么？

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摘要

Bipolar disorder presents particular challenges with regard to assessing response to therapy. Criteria for determining remission and recovery have been suggested for mood disorders, but the clinical usefulness of these terms in bipolar disorder is elusive. Formal psychological rating scales may be impractical in a routine medical practice setting. As an alternative, clinicians might probe for information about particular signal events, fluctuations. The ultimate goal of bipolar management should be complete and sustained remission, whenever possible, although most patients will not achieve this status for any significant length of time. Furthermore, overaggressive management might entail pushing medication doses to intolerable levels. Individual treatment goals should always take into account patient acceptance of side effect burden, allowing for trade-offs between treatment effect and quality of life. Noncompliance with therapy, notoriously common among patients suffering from bipolar disorder, can stem from drug side effects, treatment ineffectiveness, or even treatment success if the patient misses the manic symptoms. Despite effective treatment, relapse is common. Realistic treatment goals should strive for sustained symptom abatement while maximizing patient quality of life from visit to visit.
机译：躁郁症在评估对治疗的反应方面提出了特殊的挑战。已经提出了用于情绪障碍的确定缓解和恢复的标准，但是这些术语在双相情感障碍中的临床实用性难以捉摸。正式的心理评估量表在常规医疗实践中可能不切实际。作为替代方案，临床医生可能会探查有关特定信号事件，波动的信息。双极性治疗的最终目标是在可能的情况下实现完全持续的缓解，尽管大多数患者在相当长的时间内都不会达到这种状态。此外，过度激进的管理可能需要将药物剂量推高到无法忍受的水平。个体治疗目标应始终考虑患者对副作用负担的接受程度，以在治疗效果和生活质量之间进行权衡。众所周知，双相情感障碍患者普遍不遵守疗法，可能是由于药物副作用，治疗无效或什至错过了躁狂症状而导致的治疗成功。尽管有有效的治疗方法，复发还是很常见的。现实的治疗目标应努力实现持续的症状减轻，同时最大程度地提高患者每次就诊的生活质量。

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