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Psicoeducación: mejorar la evolución en el trastorno bipolar

Published online by Cambridge University Press:  12 May 2020

Francesc Colom  and
Dominic Lam
Francesc Colom
Affiliation:
Programa de Trastomos Bipolares, IDIBAPS, Centro de Investigatión Médica Stanley de Barcelona, Barcelona, España
Dominic Lam
Affiliation:
Henry Wellcome Building (P077), Departamento de Psicología, Instituto de Psiquiatría, De Crespigny Park, LondresSE5 8AF, Reino Unido
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Resumen

Antecedentes

Hace algunos años se initió un cambio significativo de paradigma en el tratamiento del trastorno bipolar; hallazgos cruciales sobre la utilidad de las intervenciones psicológicas apoyan claramente el cambio de un enfoque terapéutico exclusivamente farmacológico a un modelo combinado pero jerárquico en el que la farmacoterapia desempeña un papel central pero las intervenciones psicológicas pueden ayudar a salvar la separación que existe entre la eftcacia teórica y la eficacia en el “mundo real”. En el presente trabajo revisamos la eficacia de varias psicoterapias accesorias en el tratamiento de mantenimiento de los pacientes bipolares.

Metodos

Se realizó una revisión sistemática de las publicaciones sobre la cuestión utilizando las bases de datos Medline y Current Contents. Se introdujo como palabras clave: “bipolar”, “psicoterapia”, “psicoeducación”, “cognitivo-conductual” y “prevención de recaídas”.

Resultados

Los tratamientos psicológicos diseñados específicamente para la prevención de recaídas en el trastorno afectivo bipolar son herramientas útiles en conjunción con los estabilizadores del estado de ánimo. La mayoría de estudios de psicoterapia publicados recientemente comunica resultados positivos en el mantenimiento como tratamiento complementario y eficacia en el tratamiento de los episodios depresivos. Resulta interesante que varios grupos de todo el mundo hayan comunicado resultados positivos similares y alcanzado conclusiones muy similares; casi todas las intervenciones examinadas contienen elementos psicoeducativos importantes que incluyen la mejora del cumplimiento y además la identificatión temprana de los signos prodrómicos -haciendo hincapié en la importancia de la regularidad del estilo de vida- y exploran las creencias de salud y la conciencia de la enfermedad de los pacientes.

Conclusiones

La utilidad de la psicoterapia para mejorar el cumplimiento del tratamiento y la evolutión clínica de los pacientes bipolares es incuestionable en la actualidad, y las directrices de tratamiento futuras deben promover su uso regular entre los profesionales clínicos. Como profesionales clmicos, nuestro deber principal es ofrecer el mejor tratamiento disponible a nuestros pacientes y esto incluye tanto los programas psicoeducativos basados en la evidencia como los nuevos agentes psicofarmacológicos.

Keywords

Trastorno bipolarPsicoeducaciónCogniciónPsicoterapia
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 13 , Issue 1 , February 2006 , pp. 24 - 30
Copyright
Copyright © European Psychiatric Association 2006

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Footnotes

Colom F, Lam D. Psychoeducation: improving outcomes in bipolar disorder. Eur Psychiatry 2005;20:359-364.

References

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