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首页> 外文期刊>The journal of clinical psychiatry >Treating nonspecific anxiety and anxiety disorders in patients with bipolar disorder: a review.
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Treating nonspecific anxiety and anxiety disorders in patients with bipolar disorder: a review.

机译：治疗双相情感障碍患者的非特异性焦虑症和焦虑症：综述。

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OBJECTIVE: To review the evidence for treating anxiety in patients with bipolar disorder. DATA SOURCES: A literature search from 1950 to week 1 of August 2009 was conducted via OVID and the National Institutes of Health's clinical trials online databases. Search terms included anxiety, anxiety disorders, bipolar disorder, panic disorder, generalized anxiety disorder, social phobia, social anxiety, obsessive compulsive disorder, specific phobia, posttraumatic stress disorder, and treatment. Reference lists of identified articles were also searched. STUDY SELECTION: Fourteen treatment studies that included patients with bipolar disorder with either a syndrome-defined anxiety disorder or nonspecific anxiety were selected. DATA EXTRACTION: Sample size, bipolar disorder subtype, comorbid anxiety disorders, baseline anxiety, treatment interventions, and outcome measurements were extracted. RESULTS: The majority of studies focus on treating anxiety disorders and nonspecific anxiety occurring during bipolar mood episodes. Studies of syndrome-defined anxiety disorders reveal that risperidone monotherapy did not separate from placebo and that olanzapine was superior to lamotrigine when used to augment lithium treatment. A study using open-label divalproex sodium and an uncontrolled study of group cognitive-behavioral therapy both suggest some benefit from these treatments in patients with bipolar disorder with panic disorder. Studies of nonspecific anxiety reveal some benefit for divalproex, quetiapine, olanzapine, and olanzapine-fluoxetine combination. Weaker evidence supports the use of Mindfulness-Based Cognitive Therapy, and observational studies suggest potential efficacy for gabapentin and valproate. CONCLUSIONS: Nonspecific anxiety symptoms occurring during a mood episode improve with treatment of the mood disturbance, though divalproex may be the mood stabilizer of choice for anxious patients with bipolar disorder. Given their reduced risk for manic induction and episode cycling, psychotherapy, benzodiazepines, and certain atypical antipsychotics are recommended for treatment of anxiety disorders present in patients with bipolar disorder not currently experiencing an acute mood episode.
机译：目的：综述双相情感障碍患者治疗焦虑症的证据。数据来源：通过OVID和美国国立卫生研究院的临床试验在线数据库对1950年至2009年8月1日进行的文献检索。搜索词包括焦虑症，焦虑症，躁郁症，恐慌症，广泛性焦虑症，社交恐惧症，社交焦虑症，强迫症，特定恐惧症，创伤后应激障碍和治疗。还搜索了已识别文章的参考列表。研究选择：选择14项治疗研究，包括患有躁郁症，综合征定义的焦虑症或非特异性焦虑症的患者。数据提取：提取样本量，双相情感障碍亚型，合并症，焦虑症，基线焦虑症，治疗干预措施和结果测量。结果：大多数研究集中于治疗躁郁症期间发生的焦虑症和非特异性焦虑。对综合征定义的焦虑症的研究表明，利培酮单药治疗不能与安慰剂分开，并且奥氮平在用于增强锂治疗时优于拉莫三嗪。一项使用公开标签的双丙戊酸钠的研究和一项非对照的团体认知行为疗法研究均表明，这些疗法对患有躁郁症的躁郁症患者有一定的益处。对非特异性焦虑的研究表明，双丙戊酸钠，喹硫平，奥氮平和奥氮平-氟西汀的组合具有一定的益处。较弱的证据支持基于正念的认知疗法，观察研究表明加巴喷丁和丙戊酸盐具有潜在疗效。结论：情绪障碍发作期间发生的非特异性焦虑症状可通过情绪障碍的治疗得到改善，尽管双丙戊酸钠可能是躁郁症双相情感障碍患者选择的情绪稳定剂。鉴于它们降低了躁狂发作和发作的风险，因此，心理治疗，苯二氮卓类药物和某些非典型抗精神病药被推荐用于治疗目前尚无急性情绪发作的双相情感障碍患者的焦虑症。

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