RESUMO
UNLABELLED: In order to improve relapse and recurrence prevention in bipolar disorder, the purposes of this paper are: (i) to summarize the evidence published on treatments for this disorder, particularly on psychological interventions in its early phases; (ii) to provide a description of the Jano Intervention and Research Program on the Early Phases of Bipolar Disorder, which is being developed at Valdecilla Hospital (Santander, Spain). Firstly, we review the data from randomized controlled trials and systematic reviews regarding four psychotherapies proven to be effective in the treatment of bipolar disorder: psychoeducation, cognitive-behavioral therapy, family therapy and interpersonal and social rhythm therapy. Secondly, we display a systematic review on the effectiveness of psychological therapies during the early stage of bipolar disorder. Out of 456 studies, all were excluded due to not meeting the inclusion criteria. Finally, we outline the Jano Program, which provides psychiatric management, psychoeducation, psychotherapy and family therapy for patients in the early stage of bipolar disorder. Several standardized clinical, social and neuropsychological tests are administered to the patients at the beginning of the program, and also at 2, 4, 6 and 8 weeks, 3 and 6 months, 1, 2, 3 and 5 years later. CONCLUSIONS: It's necessary to enlarge the sample and finish our data collection in order to determine the effectiveness and efficiency of this kind of program, and specially of its psychological components. Early intervention for bipolar disorder may need to be adapted in some way from usual treatments to better reach our goals.
Assuntos
Transtorno Bipolar/terapia , Intervenção Médica Precoce , Medicina Baseada em Evidências , Hospitais Universitários , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , EspanhaRESUMO
Con el fin de mejorar la prevención de recaídas y recurrencias en el trastorno bipolar, los objetivos de este trabajo son: (i) resumir la evidencia disponible en la literatura sobre los tratamientos para este trastorno, en particular las intervenciones psicológicas para fases tempranas; (ii) describir el Programa Jano de Intervención e Investigación en Fases Tempranas del Trastorno Bipolar, que se desarrolla actualmente en el Hospital Valdecilla (Santander, España).Primero revisamos los datos extraídos de estudios aleatorizados y revisiones sistemáticas relativos a cuatro psicoterapias de eficacia probada en el tratamiento del trastorno bipolar: psicoeducación, terapia cognitivo-conductual, terapia familiar y psicoterapia interpersonal del ritmo social. En segundo lugar, exponemos una revisión sistemática sobre la eficacia de los tratamientos psicológicos en fases tempranas de este trastorno. De 456 estudios, todos hubieron de ser excluidos por no cumplir los criterios de inclusión. Finalmente, describimos el Programa Jano, que ofrece consultas psiquiátricas, psicoeducación, psicoterapia y terapia familiar para pacientes en fases iniciales del trastorno bipolar. Se les administran además varios tests estandarizados clínicos, sociales y neuropsicológicos, al inicio del programa, a las 2, 4, 6 y 8semanas, 3 y 6 meses, y 1, 2, 3 y 5 años después del inicio. Conclusiones. Es necesario ampliar nuestra muestra actual y finalizar la recogida de datos para determinar la eficacia y eficiencia de este tipo de programas, y en especial de sus componentes psicológicos. La intervención precoz para el trastorno bipolar podría requerir algún tipo de adaptación desde los tratamientos existentes al uso para lograr nuestros objetivos (AU)
In order to improve relapse and recurrence prevention in bipolar disorder, the purposes of this paper are: (i) to summarize the evidence published on treatments for this disorder, particularly on psychological interventions in its early phases; (ii) to provide a description of the Jano Intervention and Research Program on the Early Phases of Bipolar Disorder, which is being developed at Valdecilla Hospital (Santander, Spain).Firstly, we review the data from randomized controlled trials and systematic reviews regarding four psychotherapies proven to be effective in the treatment of bipolar disorder: psychoeducation, cognitive-behavioral therapy, family therapy and interpersonal and social rhythm therapy. Secondly, we display a systematic review on the effectiveness of psychological therapies during the early stage of bipolar disorder. Out of 456 studies, all were excluded due to not meeting the inclusion criteria. Finally, we outline the Jano Program, which provides psychiatric management, psychoeducation, psychotherapy and family therapy for patients in the early stage of bipolar disorder. Several standardized clinical, social and neuropsychological tests are administered to the patients at the beginning of the program, and also at 2, 4, 6 and 8 weeks, 3 and 6 months, 1, 2, 3 and5 years later. Conclusions. Its necessary to enlarge the sample andfinish our data collection in order to determine the effectiveness and efficiency of this kind of program, and specially of its psychological components. Early intervention for bipolar disorder may need to be adapted in some way from usual treatments to better reach our goals (AU)
