The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders: Bipolar disorder summary

被引：103

作者：

Malhi, Gin S. ^{[1
,2
,3
]}

Bell, Erica ^{[1
,2
,3
]}

Boyce, Philip ^{[4
,5
,6
]}

Bassett, Darryl

Berk, Michael ^{[7
,8
,9
]}

Bryant, Richard ^{[10
]}

Gitlin, Michael ^{[11
]}

Hamilton, Amber ^{[1
,2
,3
]}

Hazell, Philip ^{[6
]}

Hopwood, Malcolm ^{[12
,13
]}

Lyndon, Bill ^{[1
]}

McIntyre, Roger S. ^{[14
]}

Morris, Grace ^{[1
,2
,3
]}

Mulder, Roger ^{[15
]}

Porter, Richard ^{[15
]}

Singh, Ajeet B. ^{[16
]}

Yatham, Lakshmi N. ^{[17
]}

Young, Allan ^{[18
,19
]}

Murray, Greg ^{[20
]}

机构：

[1] Univ Sydney, Fac Med & Hlth, Northern Clin Sch, Dept Psychiat, Sydney, NSW, Australia

[2] Royal North Shore Hosp, Acad Dept Psychiat, Northern Sydney Local Hlth Dist, St Leonards, NSW, Australia

[3] Royal North Shore Hosp, Northern Sydney Local Hlth Dist, CADE Clin, St Leonards, NSW, Australia

[4] Westmead Hosp, Dept Psychiat, Wentworthville, NSW, Australia

[5] Westmead Clin Sch, Wentworthville, NSW, Australia

[6] Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Discipline Psychiat, Sydney, NSW, Australia

[7] Deakin Univ, Sch Med, IMPACT Inst Mental & Phys Hlth & Clin Translat, Barwon Hlth, Geelong, Vic, Australia

[8] Univ Melbourne, Florey Inst, Orygen, Parkville, Vic, Australia

[9] Univ Melbourne, Dept Psychiat, Parkville, Vic, Australia

[10] Univ New South Wales, Sch Psychol, Sydney, NSW, Australia

[11] Univ Calif Los Angeles, Dept Psychiat, Geffen Sch Med, Los Angeles, CA USA

[12] Univ Melbourne, Dept Psychiat, Melbourne, Vic, Australia

[13] Albert Rd Clin, Professorial Psychiat Unit, Melbourne, Vic, Australia

[14] Univ Hlth Network, Mood Disorders Psychopharmacol Unit, Toronto, ON, Canada

[15] Univ Otago, Dept Psychol Med, Christchurch, New Zealand

[16] Deakin Univ, Sch Med, IMPACT Inst Mental & Phys Hlth & Clin Translat, Geelong Clin Healthscope, Geelong, Vic, Australia

[17] Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada

[18] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, London, England

[19] Bethlem Royal & Maudsley Hosp, South London & Maudsley NHS Fdn Trust, Beckenham, Kent, England

[20] Swinburne Univ Technol, Ctr Mental Hlth, Hawthorn, Vic, Australia

来源：

BIPOLAR DISORDERS | 2020年 / 22卷 / 08期

基金：

英国医学研究理事会;

关键词：

bipolar disorder; guideline; mood disorders; treatment; ELECTROCONVULSIVE-THERAPY; 12-MONTH PREVALENCE; II DISORDER; MIXED-STATE; PREDICTORS; DEPRESSION; OUTCOMES;

D O I：

10.1111/bdi.13036

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objectives To provide a succinct, clinically useful summary of the management of bipolar disorder, based on the 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (MDcpg(2020)). Methods To develop the MDcpg(2020), the mood disorders committee conducted an extensive review of the available literature to develop evidence-based recommendations (EBR) based on National Health and Medical Research Council (NHMRC) guidelines. In the MDcpg(2020), these recommendations sit alongside consensus-based recommendations (CBR) that were derived from extensive deliberations of the mood disorders committee, drawing on their expertise and clinical experience. This guideline summary is an abridged version that focuses on bipolar disorder. In collaboration with international experts in the field, it synthesises the key recommendations made in relation to the diagnosis and management of bipolar disorder. Results The bipolar disorder summary provides a systematic approach to diagnosis, and a logical clinical framework for management. It addresses the acute phases of bipolar disorder (mania, depression and mixed states) and its longer-term management (maintenance and prophylaxis). For each phase it begins with Actions, which include important strategies that should be implemented from the outset wherever possible. These include for example, lifestyle changes, psychoeducation and psychological interventions. In each phase, the summary advocates the use of Choice medications for pharmacotherapy, which are then used in combinations along with additional Alternatives to manage acute symptoms or maintain mood stability and provide prophylaxis. The summary also recommends the use of electroconvulsive therapy (ECT) for each of the acute phases but not for maintenance therapy. Finally, it briefly considers bipolar disorder in children and its overlap in adults with borderline personality disorder. Conclusions The bipolar disorder summary provides up to date guidance regarding the management of bipolar disorder, as set out in the MDcpg(2020). The recommendations are informed by evidence and clinical expertise and experience. The summary is intended for use by psychiatrists, psychologists and primary care physicians but will be of interest to anyone involved in the management of patients with bipolar disorder.

引用

页码：805 / 821

页数：17

共 47 条

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