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首页> 外文期刊>The journal of clinical psychiatry >Sequential treatment of mood and anxiety disorders.
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Sequential treatment of mood and anxiety disorders.

机译：依次治疗情绪和焦虑症。

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OBJECTIVE: Administration of treatments in a sequential order is a common practice in clinical medicine, but has received insufficient attention in psychiatry. The aim of this review was to survey the literature concerned with a sequential use of pharmacotherapy and psychotherapy in mood and anxiety disturbances. DATA SOURCES AND STUDY SELECTION: A review of the clinical trials in which treatment components were used in a sequential order (i.e., pharmacotherapy followed by psychotherapy, psychotherapy followed by pharmacotherapy, one drug treatment following another, or one psychotherapeutic technique following another) was performed. Studies were identified by using MEDLINE (English language articles published from 1967 to March 2005; keywords: sequential treatment, drugs and psychotherapy, combined treatment related to depressive disorder, bipolar disorder, depression, mania, anxiety disorders, panic disorder, social phobia, obsessive-compulsive disorder, generalized anxiety disorder, and posttraumatic stress disorder) and a manual search of the literature and Index Medicus for the years 1960 to 2005. DATA SYNTHESIS: In unipolar recurrent depression, the sequential use of pharmacotherapy was found to reduce relapse rate. In bipolar disorder, the use of psychotherapeutic strategies in patients who were already undergoing treatment with mood stabilizers was also found to yield clinical benefits. In anxiety disorders, the sequential use of pharmacotherapy and psychotherapy was not found to improve long-term outcome. CONCLUSION: The sequential treatment of mood and anxiety disorders does not fall within the realm of maintenance strategies. It is an intensive, 2-stage approach, which is based on the fact that one course of treatment with a specific treatment (whether pharmacotherapy or psychotherapy) is unlikely to entail solution to the complex array of symptoms of patients with mood and anxiety disorders. The sequential model introduces a conceptual shift in current assessment methods.
机译：目的：按顺序给予治疗是临床医学中的一种常见做法，但在精神病学方面并未引起足够的重视。这篇综述的目的是调查有关在情绪和焦虑症中相继使用药物治疗和心理治疗的文献。数据来源和研究选择：对按顺序使用治疗成分的临床试验进行了回顾（即先进行药物治疗，然后进行心理治疗，先进行心理治疗，然后进行药物治疗，再进行另一种药物治疗，再采用一种心理治疗技术） 。通过使用MEDLINE（1967年至2005年3月出版的英语文章;关键词：序贯治疗，药物和心理治疗，与抑郁症，双相情感障碍，抑郁症，躁狂症，焦虑症，恐慌症，社交恐惧症，强迫症有关的联合治疗）来鉴定研究-强迫症，广泛性焦虑症和创伤后应激障碍）以及1960至2005年间手动检索文献和Index Medicus。数据综合：在单相复发性抑郁症中，发现序贯使用药物疗法可降低复发率。在双相情感障碍中，还发现在已经接受情绪稳定剂治疗的患者中使用心理治疗策略可产生临床益处。在焦虑症中，未发现先后使用药物治疗和心理治疗可改善长期预后。结论：情绪和焦虑症的序贯治疗不属于维持策略的范围。这是一种密集的两阶段方法，其基于以下事实：采用一种特定疗法（无论是药物疗法还是心理疗法）的一个疗程不可能解决患有情绪和焦虑症患者的一系列复杂症状。顺序模型在当前评估方法中引入了概念上的转变。

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