Revisión Sistemática del Tratamiento del Trastorno Bipolar con Características Mixtas

Q3 Medicine

Revista Colombiana de Psiquiatria Pub Date : 2024-07-01 DOI:10.1016/j.rcp.2022.06.003

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Abstract

Introduction

The mixed states of bipolar disorder (BD) are typified as a subtype of mania or depression. Mixed episodes respond worse to monotherapy treatment, imply a higher risk of relapse, a chronicity of 15% at five years and an associated suicide risk similar to that of patients with depression.

Objective

To evaluate and compare the different therapeutic strategies for BD with mixed characteristics.

Methods

A systematic bibliographic review was carried out. Those studies carried out in patients with bipolar disorder with mixed characteristics and who were receiving treatment were selected.

Results

The initial search showed a total of 228 articles, of which 28 met the inclusion criteria. We included 19 randomised clinical trials (RCTs) comparing an antipsychotic with placebo.

Discussion

According to the data evaluated, antipsychotics —especially second-generation ones— represent a first-line tool for the treatment of manic symptoms with mixed characteristics. ECT should be considered as a secondary intervention strategy in the case of acute mania when an adequate response has not been obtained after the administration of first-line drugs.

Conclusions

The review found that the therapeutic recommendations for bipolar disorder with mixed characteristics are limited.

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混合特征双相情感障碍治疗的系统评价

导言双相情感障碍（BD）的混合状态是躁狂或抑郁的一种亚型。混合发作对单一疗法的反应较差，意味着复发的风险较高，五年内的慢性化率为 15%，相关的自杀风险与抑郁症患者相似。结果初步检索显示共有 228 篇文章，其中 28 篇符合纳入标准。讨论根据评估数据，抗精神病药物（尤其是第二代抗精神病药物）是治疗具有混合特征的躁狂症状的一线工具。结论综述发现，针对混合型双相情感障碍的治疗建议是有限的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Colombiana de Psiquiatria Medicine-Psychiatry and Mental Health

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Revista Colombiana de Psiquiatría (RCP) is a quarterly official publication of Colombian Psychiatry Association (March, June, September and December) and its purpose is to spread different the knowledge models that currently constitute the theoretical and practical body of our specialty. Psychiatrists, psychiatric residents, non psychiatric physicians, psychologists, philosophers or other health professionals or persons interested in this area can take part in the magazine. This journal publishes original works, revision or updating articles, case reports of all psychiatry and mental health areas, epistemology, mind philosophy, bioethics and also articles about methodology of investigation and critical reading.