İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme

OZERDEM, AYSEGUL; CAKIR, SIBEL

İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme

Sibel ÇAKIR, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Psikiyatri Anabilim Dalı, İstanbul, Türkiye)

Ayşegül ÖZERDEM (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, İzmir, Türkiye)

Türk Psikiyatri Dergisi

3 0

Yıl: 2010 Cilt: 21 Sayı: 2 Sayfa Aralığı: 143 - 154 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme

Öz:

Amaç: İki uçlu bozuklukta psikoterapötiksağaltımların ana ilkelerini ve klinik seyir üzerine etkilerini eleştirel birgözle sergilemektir.Yöntem: 1980-2009 yılları arasındaki PubMed,Medline ve PsycINFO ve Türkçe veri tabanları, ?bipolar disorder? ve?psychotherapy?, ?psychosocial approaches?, ?psychological intervention?anahtar sözcükleri kullanılarak tarandı. Seçkisiz kontrollü araştırmalar,gözden geçirme yazıları ve meta analiz çalışmaları ele alındı.Bulgular: Psikoeğitim, aile odaklı terapi,bilişsel davranışçı terapi ve kişilerarası psikososyal ritim terapisi olarakdört modelde, 50 araştırma ölçütlere uyuyordu. Yirmi dört orijinal araştırmanın22'si seçkisiz kont- rollü desende idi, diğerlerinin 23'ü gözden geçirme ve 3'ümeta-analiz çalışması idi. Çalışmaların tümünde psikoterapiler, ilaçsağaltımına eklenmiştir. Araştırmalarda grup psikoeğitimi özellikle manidönemi, bilişsel davranışçı terapi ve aile odaklı terapi ise depresif dönemyinelemelerini önlemede etkili bulunmuştur. Psikososyal sağaltımların bazıçalışmalarda ilaç uyumu, hastane yatış sayı ve süresi, yinelemeye kadar geçen süreüzerine, az sayıda çalışmada işlevsellik ve yaşam kalitesi üzerine olumluetkileri gösterilmiştir. Psikososyal sağaltımların kültürel uyum çalışmalarıyok ya da yetersiz düzeydedir.Sonuç: İki uçlu bozuklukta ilaç sağaltımınaeklenen psikososyal yaklaşımlar yinelemeleri önlemede etkilidir. Terapilerinbaşlatıldığı hastalık aşaması ve etkililik gösterdiği hastalık dönemi, terapiekolleri arasında farklılık göstermektedir. İleri araştırmalar, psikososyalyaklaşımların sağaltım kılavuzlarındaki yerini güçlendirecek, ilaç sağaltımıetkinliği ve işlevsellik arasındaki boşluğun kapanmasına katkıda bulunacaktır.

Anahtar Kelime:

Konular: Psikiyatri

Psychotherapeutic and psychosocial approaches in bipolar disorder: A systematic literature review

Öz:

Objective: Aim of this systematicreview was critical presentation of psychosocial approaches in bipolardisorders with regard to their fundamentals and impact on the clinical courseand outcome of the illness. Method:PubMed,Medline, PsycINFO and Turkish databases between 1980 and 2009 were searched byusing keywords ?bipolar disorder? and ?psychotherapy?, ?psychosocialapproaches?, ?psychological intervention?. Randomized controlled trials,reviews and meta analysis were included.Results: Fifty studies met theinclusion criteria where four types of interventions -psychoeducation, familyfocused, cognitive behavioral and interpersonal psychosocial rhythm therapy-were studied. Twenty two of 24 original research papers were randomizedcontrolled trials, 23 were reviews and 3 were meta analysis. In almost allstudies psychotherapeutic approach was applied as adjunctive topharmacotherapy. Group psychoeducation was more effective in preventing manicrelapses, whereas cognitive behavioral and family focused therapies showedefficacy in preventing depressive episodes. Additional benefits on suchsecondary outcomes as medication compliance, number and duration ofhospitalizations, time to recurrence were reported. Effects on functionalityand quality of life were assessed rarely, but reported to be beneficial.Cultural adaptation studies are scarce and needs exploration.Conclusion:Psychosocialinterventions adjunctive to pharmacotherapy in bipolar disorder seem to beeffective in relapse prevention. Stage of illness where the therapy isinitiated and the targeted episode for prevention varies between interventions.Future studies are needed to strengthen the place of psychosocial interventionsin treatment guidelines and would contribute to narrow the gap betweeneffectiveness of pharmacotherapy and functional improvement.

Anahtar Kelime:

Konular: Psikiyatri

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	CAKIR S, OZERDEM A (2010). İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. , 143 - 154.
Chicago	CAKIR SIBEL,OZERDEM AYSEGUL İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. (2010): 143 - 154.
MLA	CAKIR SIBEL,OZERDEM AYSEGUL İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. , 2010, ss.143 - 154.
AMA	CAKIR S,OZERDEM A İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. . 2010; 143 - 154.
Vancouver	CAKIR S,OZERDEM A İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. . 2010; 143 - 154.
IEEE	CAKIR S,OZERDEM A "İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme." , ss.143 - 154, 2010.
ISNAD	CAKIR, SIBEL - OZERDEM, AYSEGUL. "İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme". (2010), 143-154.

APA	CAKIR S, OZERDEM A (2010). İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Türk Psikiyatri Dergisi, 21(2), 143 - 154.
Chicago	CAKIR SIBEL,OZERDEM AYSEGUL İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Türk Psikiyatri Dergisi 21, no.2 (2010): 143 - 154.
MLA	CAKIR SIBEL,OZERDEM AYSEGUL İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Türk Psikiyatri Dergisi, vol.21, no.2, 2010, ss.143 - 154.
AMA	CAKIR S,OZERDEM A İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Türk Psikiyatri Dergisi. 2010; 21(2): 143 - 154.
Vancouver	CAKIR S,OZERDEM A İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme. Türk Psikiyatri Dergisi. 2010; 21(2): 143 - 154.
IEEE	CAKIR S,OZERDEM A "İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme." Türk Psikiyatri Dergisi, 21, ss.143 - 154, 2010.
ISNAD	CAKIR, SIBEL - OZERDEM, AYSEGUL. "İki uçlu bozuklukta psikoterapötik ve psikososyal sağaltımlar: sistematik bir gözden geçirme". Türk Psikiyatri Dergisi 21/2 (2010), 143-154.