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Comorbidity in bipolar disorder: a framework for rational treatment selection.

机译：在双相情感障碍共病:一个框架理性的治疗选择。

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摘要

Bipolar disorders are heterogeneous disorders often requiring multimodality treatment. The expanding pharmacopeia for bipolar disorders invites the need for a treatment framework that both recognizes and anticipates the multidimensionality and comorbidity of the illness. No available neurotherapeutic agent is singularly efficacious for the complete melange of bipolar symptomatology. An apparent paradox has emerged in the management of bipolar disorder; whilst results from rigorous controlled monotherapy trials suggest that a disparate assortment of neurotherapeutic agents are efficacious in distinct phases of bipolar disorder, the majority of tertiary-treated bipolar patients receive polypharmacotherapeutic regimens. The evidentiary base for polypharmacotherapy is sparse and has recently become an area of active research focus. In the interim, clinicians are encouraged to invoke an organizational schema for the treatment of bipolar disorder that considers the spectrum of effectiveness of putative and established mood stabilizers. This schema should be further informed by the treatment data for comorbid and accessory conditions. The authors propose a schema to provide the impetus for further work in the area. Copyright 2004 John Wiley & Sons, Ltd.
机译：双相情感障碍是异构的障碍通常需要多峰性治疗。扩大药典对双相情感障碍邀请治疗框架的必要性识别和预测多重空间和合并症疾病。非常有效的完成混色双相情感障碍的症状。在双相的管理出现了吗障碍;单一疗法试验表明,不同的各式各样的neurotherapeutic代理有效的双相的不同的阶段障碍,大多数tertiary-treated双相患者接受polypharmacotherapeutic方案。polypharmacotherapy稀疏,最近成为一个活跃的研究领域的焦点。期间,鼓励临床医生来调用一个组织模式的治疗双相情感障碍,认为的光谱假定,建立了情绪的有效性稳定剂。共病的治疗数据和通知辅助条件。模式为进一步的工作提供动力该地区。

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