双相情感障碍防治指南第二版【参考】.ppt

双相障碍预防目标：降低双相障碍的发病率、患病率、复发率，减少症状存在时间，减少罹患双相障碍的危险因素，制止或延缓疾病复发，减少其对本人、家庭和社会的危害。 二、双相障碍的精神科管理 （一）建立治疗联盟 1.良好的医患沟通 2.以患者为中心的医疗护理 3.向患者及家属讲解疾病的特点及注意事项 （二）个案管理 个案管理用于精神卫生领域是20世纪60年代，当时精神卫生服务的主流是将住院机构大量关闭，发展以社区为基础的服务模式。 个案管理包括以下7个环节：现场评估、问题明确、目标确立、指标制定、策略选择、责任明确、进度检查。 （三）护理管理 1.整体护理 2.分级护理 （四）服药管理 （五）家庭管理 （六)疾病教育 1.积极参与自身治疗的重要性； 2.双相障碍的本质和病程； 3.治疗的潜在获益和可能的不良反应； 4.识别复发的早期症状； 5.行为干预可降低复发的风险，包括珍惜观察睡眠规律和避免物质滥用。 双相情感障碍的治疗目标 双相情感障碍是终身疾病；治疗的关键是维持治疗 治疗方案应当由患者和医生共同制定 急性期治疗的目标是痊愈 维持治疗的目标是有效地防止复发 同时应当最大限度恢复患者功能，减少亚临床症状和药物副反应 Summary of DSM-IV-TR Classification of Bipolar Disorders According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-TR), bipolar disorder can be divided into four classifications: Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder, and Bipolar Disorder Not Otherwise Specified. Bipolar I Disorder is characterized by one or more manic or mixed episodes usually accompanied by major depressive episodes. Bipolar II Disorder focuses on one or more major depressive episodes accompanied by at least one hypomanic episode. A diagnosis of Cyclothymic Disorder is made when a patient experiences at least 2 years of numerous periods of hypomanic symptoms that do not meet the criteria for a manic episode and numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode. Bipolar Disorder Not Otherwise Specified is characterized by bipolar features that do not meet the criteria for any of the specific bipolar disorders described above or for bipolar symptoms about which there is inadequate or contradictory information. Each classification of bipolar disorder is further defined by the presence (or history) of manic episodes, mixed episodes, or hypomanic episodes, usually accompanied by the presence (or history) of major depressive episodes. First, ed. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Rev. Washington, DC: American Psychiatri