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1.
软双相情感障碍31例分析   总被引:1,自引:0,他引:1  
目的 研究以抑郁症状首发的双相情感障碍-软双相情感障碍的发病率,探究软双相情感障碍的临床特征及合理的治疗方案。方法 2002-01/12,中国医科大学心理卫生医院心理科共收冶首发抑郁症患者114例,转成双相情感障碍31例。对于软双相情感障碍患者的自然情况分析及对治疗方案进行比较分析。结果 软双相情感障占抑郁症病例27.2%。软双相情感障碍病例临床特征:男女性别比例相近,发病年龄偏低小于25岁,发病病程小于3个月,性格外向偏多。使用抗抑郁药治疗易诱发躁狂症状出现,病例转成躁狂前均使用抗抑郁药物,最短时间2周。使用非典型抗精神病药(氯氮平/奥氮平/维思通/思瑞康等)有利于软双相情感障碍治疗,使用情感稳定剂(碳酸锂/丙戊酸钠等)利于软双相情感障碍治疗并可预防疾病复发。结论 正确认识软双相情感障碍病例的临床客观存在,在临床工作中,应避免单独使用抗抑郁药物增加症状转相危险,抗抑郁药物联合情感稳定剂(碳酸锂/丙戊酸钠等)有利于软双相情感障碍治疗。  相似文献   

2.
目的研究以抑郁症状首发的双相情感障碍-软双相情感障碍的发病率,探究软双相情感障碍的临床特征及合理的治疗方案。方法2002-01/12,中国医科大学心理卫生医院心理科共收治首发抑郁症患者114例,转成双相情感障碍31例。对于软双相情感障碍患者的自然情况分析及对治疗方案进行比较分析。结果软双相情感障占抑郁症病例27.2%。软双相情感障碍病例临床特征:男女性别比例相近,发病年龄偏低小于5岁,发病病程小于3个月,性格外向偏多。使用抗抑郁药治疗易诱发躁狂症状出现,病例转成躁狂前均使用抗抑郁药物,最短时间2周。使用非典型抗精神病药(氯氮平/奥氮平/维思通/思瑞康等)有利于软双相情感障碍治疗,使用情感稳定剂(碳酸锂/丙戊酸钠等)利于软双相情感障碍治疗并可预防疾病复发。结论正确认识软双相情感障碍病例的临床客观存在,在临床工作中,应避免单独使用抗抑郁药物增加症状转相危险,抗抑郁药物联合情感稳定剂(碳酸锂/丙戊酸钠等)有利于软双相情感障碍治疗。  相似文献   

3.
本文综述了软双相性抑郁的概念及诊断标准,以及《精神疾病统计诊断手册》第5版双相障碍和抑郁障碍诊断标准变化对软双相诊断标准的影响,进而提出我国软双相性抑郁的建议性诊断标准,以期有利于双相障碍的早期识别和诊断.  相似文献   

4.
王朝辉 《中国误诊学杂志》2011,11(24):5905-5905
双相障碍(bipolar disorder)也称双相情感障碍,一般是指既有符合症状学诊断的躁狂或轻躁狂发作,又有抑郁发作的一类心境障碍<'[1]>是一种常见且易复发的严重精神疾病.对双相障碍误诊2例分析如下.  相似文献   

5.
总结1例青少年双相情感障碍患者的护理经验。具体措施为护理人员在药物及物理治疗的基础上进行了包括心理护理、康复锻炼、人性化护理、健康教育等综合护理干预措施你,提高了患者住院期间的治疗依从性,恢复了患者的社会功能和生活质量,最终顺利出院。  相似文献   

6.
睡眠障碍与昼夜节律紊乱是双相情感障碍患者常出现的临床表现。研究表明昼夜节律紊乱与双相情感障碍的关系密切。昼夜节律是控制睡眠的主要因素之一,而睡眠与情绪之间存在复杂的关系,因而提示睡眠问题与双相情感障碍之间存在着不可忽视的联系。兹阐述双相情感障碍与睡眠障碍以及昼夜节律紊乱的联系,进一步介绍部分睡眠障碍对双相情感障碍预测作用及临床意义。  相似文献   

7.
1病例资料【例1】男,15岁。因发作性嗜睡,心烦,乱发脾气10个月,加重2个月入院。嗜睡发作开始时持续5~15天,能自行缓解,后每次发作持续1~2个月。发作时除吃饭、大小便外,患者一直处于嗜睡中,曾被诊断为“脑炎、癫”。1岁时有头部外伤史,幼年发育正常,适龄上学,成绩优秀。躯体检查及神经系统检查未见异常。专科检查:意识清晰,表情茫然,接触被动,定向力准确,回答医生问题时不耐烦,易激惹,卧床多睡,每天睡眠大约15小时左右,问答切题,未引出幻觉、妄想及感知综合障碍。智力检查:计算力、判断力、理解力正常,记忆力下降,记不清早饭吃了什么,多卧床…  相似文献   

8.
正双相情感障碍是既有躁狂又有抑郁发作的心境障碍,心境障碍又称情感性精神障碍,以显著而持久的情感或心境改变为主要特征的一组疾病,一般指情感的高涨或低落,伴有相应的认知和行为改变,此病往往有复发倾向,间歇期精神状态基本正常[1]。双相情感障碍在本科住院的精神障碍患者占60%,精神障碍患者由于疾病或自身、社会等原因,长时间住院,由于长期生活在封闭的环境中,与社会交往少、社会功能减退、机体机能  相似文献   

9.
双相情感障碍患者186例分析   总被引:1,自引:0,他引:1  
目的 分析双相情感障碍住院患者药物治疗状况。方法 选择1999/2004在北京回龙观医院住院治疗双相情感障碍患者186例,回顾性调查患者的一般资料和详细用药情况。结果 186例全部进入结果分析。①186例中双相躁狂障碍94例,双相抑郁障碍82例,快速循环型10例,伴有精神病性症状42例。②双相抑郁发作时,首选抗抑郁剂治疗占95%,同时合并情感稳定剂治疗者占20%;双相躁狂发作时,首选碳酸锂治疗占84%,首选抗精神病药物治疗占95%,首选碳酸锂加抗精神病药物治疗占79%。结论 目前双相情感障碍的临床用药及治疗方案需要规范,应以“中国精神障碍防治指南”作为标准。  相似文献   

10.
本文研究了双相情感障碍男女患者间神经阻滞剂用量的差异。发现年轻男性患者用量显著高于年轻女性;老年女性患者用量高于年轻女性。并对产生这些差异的原因进行了讨论。  相似文献   

11.
Bipolar disorder (BD) is a chronic, potentially disabling illness with a lifetime morbid risk of approximately 1%. There is substantial evidence for a significant genetic etiology, but gene‐mapping efforts have been hampered by the complex mode of inheritance and the likelihood of multiple genes of small effect. In view of the complexity, it may be instructive to understand the biological bases for pathogenesis. Extensive disruption in circadian function is known to occur among patients in relapse. Therefore, it is plausible that circadian dysfunction underlies pathogenesis. Evidence for such a hypothesis is mounting and is reviewed here. If circadian dysfunction can be established as an ‘endophenotype’ for BD, this may not only enable identification of more homogenous sub‐groups, but may also facilitate genetic analyses. For example, it would be logical to investigate polymorphisms of genes encoding key proteins that mediate circadian rhythms. Association studies that analyzed circadian genes in BD have been initiated and are reviewed. Other avenues for research are also discussed.  相似文献   

12.
Psychoeducation has become a common intervention within mental health settings. It aims to increase people's ability to manage a life with a long‐term illness. For people with bipolar disorder, psychoeducation is one of a range of psychosocial interventions now considered part of contemporary mental health practice. It has taken on a ‘common sense’ status that results in little critique of psychoeducation practices. Using a published manual on psychoeducation and bipolar disorder as its data, Foucauldian discourse analysis was used in the present study for a critical perspective on psychoeducation in order to explore the taken‐for‐granted assumptions on which it is based. It identifies that the text produces three key subject positions for people with bipolar disorder. To practice self‐management, a person must: (i) accept and recognize the authority of psychiatry to know them; (ii) come to see that they can moderate themselves; and (iii) see themselves as able to undertake a reflexive process of self‐examination and change. These findings highlight the circular and discursive quality to the construct of insight that is central to how psychoeducation is practiced. Using Foucault's construct of pastoral power, it also draws attention to the asymmetrical nature of power relations between the clinician and the person with bipolar disorder. An effect of the use of medical discourse in psychoeducation is to limit its ability to work with ambivalence and contradiction. A critical approach to psychotherapy and education offers an alternate paradigm on which to basis psychoeducation practices.  相似文献   

13.
Bipolar disorder (BD) is an important factor contributing to rates of higher morbidity and mortality with serious consequences on the quality of life. There is limited literature on life experience of people living with BD in Chile. For this reason, this study examines the life experiences of Chilean clients with BD. Semi‐structured interviews were conducted, and clients aged 40‐65 years, euthymic, with a preserved judgement of reality were included. A thematic analysis was conducted, and two themes and subthemes were extracted. The first theme is the life experiences of the disease, and it comprises the subtheme information about BD, life experiences of relapses (with acute experiences of disease, professional assistance, and prodromal symptom management), accepting the disease, accepting the medication, and being bipolar as a stigma. The second theme is that of family environment, which includes the subthemes of family support, lack of family support, and family crisis resulting from BD. The findings provide evidence to support the importance of accepting the disease, the long‐term course of the disease, in addition to pharmacological treatment, which requires interventions from nurses when personal risk factors of acute episodes are identified and addressed. Besides, client and family members have to be actively involved. Future research should examine the relationship between stigma from bipolar disorder, perceptions from family members, and educational interventions from nurses and people affected by BD in Chile.  相似文献   

14.
介绍了认知功能和认知功能障碍的定义、双相情感障碍认知功能损害特点;从认知行为疗法、人际和社会节律治疗、家庭治疗、心理教育方面论述了非药物认知干预措施和效果。  相似文献   

15.
Title.  Parenting with a diagnosis bipolar disorder.
Aim.  This paper is a report of a study of the ways in which bipolar disorder is constructed in the DSM-IV and popular texts, and how parents who have been diagnosed as having a bipolar disorder construct their role as parent.
Background.  Research into parenting and mental illness has typically taken a deficit-based approach that focuses on the risks to children when a parent has a mental illness. Literature that considers parenting specifically in the context of bipolar disorder retains a focus on the increased risk to their children of psychopathology or psychosocial difficulties.
Method.  A critical discourse analysis was conducted using interviews with five parents who had received a diagnosis of bipolar disorder. These interviews were examined in relation to the text that constructs the diagnosis of bipolar disorder (DSM-IV) and the popular texts from which the parents drew their understandings of parenting.
Findings.  The need to monitor and moderate emotions was a dominant theme that emerged from the analysis. For these parents this also involved teaching moderation to their children and monitoring it in their children's development. The consequence of this for these parents was a heightened sense of the need for self-surveillance.
Conclusion.  The challenge for people working with parents who have been diagnosed with a bipolar disorder is to support them to feel confident in the management of their bipolar disorder and their ability to parent effectively.  相似文献   

16.
目的探讨血清脑源性神经营养因子(BDNF)对双相障碍的诊断价值。方法采用躁狂量表(YMRS)、功能评定表(GAF)和抑郁表(MADRS),对本院在2013年1月到2016年1月所所收治的100例双相障碍者进行评定,其中双相障碍抑郁组50例,双相障碍躁狂组50例。另外还收集单纯抑郁组50例,健康体检组50例做比较。采用酶联免疫吸附法检测血清脑源性营养因子水平。结果⑴治疗后,单项抑郁组与正常组的BDNF差异无统计学意义(P0.05);⑵治疗后,双相障碍抑郁组BDNF水平显著低于正常组,组间数据对比差异有统计学意义(P0.05);⑶治疗后,双相障碍狂躁组BDNF水平显著低于正常组,组间数据对比差异有统计学意义(P0.05)。结论双相障碍躁狂和抑郁与血清脑源性神经营养因子水平有关。  相似文献   

17.
目的 分析我院住院双相情感障碍(bipolar disorder BPD)患者药物应用现状,为临床合理用药提供参考.方法 选择住院的224例BPD患者,分析双相躁狂及双相抑郁的心境稳定剂、非典型抗精神病药、抗抑郁药物使用比例及剂量.结果 心境稳定剂应用比例为68.3%,非典型抗精神病药应用比例为77.3%.在双相躁狂(102例)及双相抑郁(122例)中,丙戊酸盐、奥氮平使用比例分别为(80.4% vs 45.1%;68.6% vs 18.0%),差异有统计学意义(P<0.05).双相躁狂与双相抑郁中丙戊酸盐、奥氮平、喹硫平的剂量分别为(0.82土0.31)g vs(0.56±0.22)g;(13.39±6.14) mg vs(7.75±4.26)mg;(380.77±278.79) mg vs (163.89±191.25) mg,差异均有统计学意义(P<0.05).双相抑郁中抗抑郁药使用频率71.3%,使用频率依次为舍曲林、艾司西肽普兰、米氮平、文拉法辛.结论 丙戊酸盐及非典型抗精神病药(奥氮平和喹硫平)已经作心境稳定剂广泛应用于临床,且双相躁狂用药比例及剂量明显大于双相抑郁.双相抑郁治疗大多临床医生选择了在心境稳定剂的基础上合并抗抑郁药.  相似文献   

18.
Māori have high rates of bipolar disorder (BD) and mental health service use. Despite the high prevalence and the impact on functioning and whānau (family), there is limited research on treatment interventions for Māori with bipolar disorder and indeed on Māori and indigenous mental health generally. A qualitative study combining individual interviews and focus groups was conducted with the aim to explore mental health clinicians’ and Māori mental health workers’ perspectives of effective treatment for Māori with BD. Sixteen participants took part in either individual interviews, focus groups or both. The study found the importance of a Māori worldview; tikanga Māori (rituals); understanding the whānau context, whakawhanaugatanga (connection), the powhiri (introduction) process, and whakarongo (listening) were key to working effectively with Māori who had BD. Both the interviews and focus groups identified similar concepts. The concept of whakawhanaungatanga (connection) captures the themes from the individual interviews and focus groups. The participants in this study identified the person and their culture rather than the psychiatric diagnosis as crucial to providing effective care to Māori with BD. Without a foundation in whakawhanaungatanga, engagement, diagnosis, treatment adherence, and the process of recovery are unlikely to be as effective for Māori with BD. It was evident from the findings that it was the person not the diagnosis that was central to therapeutic engagement.  相似文献   

19.
The life of close relatives of persons with bipolar disorder (BD) is associated with emotional distress, depression, and a high level of use of mental health care. Illness‐related changes of their life situation endanger relationships, social life, finances, and occupational functioning. Understanding of facilitating conditions for close relatives is still a neglected research area. The aim of the present study thus was to explore what makes the life of close relatives of persons with BD more liveable. A lifeworld phenomenological approach was used. The findings reveal that keeping distance, having stability in everyday life, and strengthening equality through transparent communication are conditions that enable close relatives to influence the unpredictable and its consequences and thus make life more liveable. This implies contributions from close relatives, the person with BD, and the caring services. We propose that health‐care support should not be divided in support for the patient and/or the close relatives but instead be designed as support for the ‘patient and close relatives’ as a unit. Professional caregivers need to take responsibility for creating intersubjective settings for the person with BD and their close relatives to share their needs and make joint plans for how to influence the illness‐related life issues.  相似文献   

20.
It has been reported that, at any time, over half of the people with bipolar disorder are receiving no active treatment. Despite the availability of effective medications and psychotherapies, research concludes that the care of bipolar disorder in everyday practice is often deficient. Evidence base reports the effectiveness of psychosocial interventions using many of the same ideas as the recovery approach; both attempt to place clients at the heart of service delivery. This paper reports on the development and implementation of three pilot group programmes for service users with bipolar disorder, in a community clinical setting in South East England. The group programme design and development was based upon the evidence-based psychosocial interventions advocated in national clinical guidelines and research literature. The programme incorporated the key effective psychosocial interventions and self-management mechanisms within its 12 sessions spanning over 3 months, followed by three booster sessions in 6 months' time. Twenty-three service users have to date completed the programme. Participant feedback will be discussed and reported to inform further development and research implications of such innovative evidence-based interventions for service users with bipolar disorder.  相似文献   

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