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양극성 장애 심리사회적 개입에서 최근 발전현황의 탐색적 고찰

An exploratory review on recent advances in psychosocial intervention for bipolar disorder

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참고문헌

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주제분류심리과학

초록

양극성 장애는 재발성의 만성적 정신장애로 성공적인 관리를 위해 약물치료에 보조적인 심리사회적 개입이 추가될 때 재발 방지와 환자의 삶의 질 증진의 측면에서 치료적 이점이 있는 것으로 알려져 있다. 본고에서는 2년 전 양극성 장애의 근거기반 심리치료에 관한 최초의 개관 이후로 추가적인 발전 동향을 개관함으로써, 어떠한 심리사회적 개입이 양극성 장애 치료에 근거를 가진 것으로 권고되는지에 관한 최신 지견을 제공하고자 한다. 여전히 4가지 심리사회적 개입(심리교육, 가족중심치료, 인지행동치료, 대인관계 및 사회적 리듬 치료)이 강한 경험적 근거를 가진다는 점에서는 변함이 없었으며, 2020년 Royal Australian and New Zealand College of Psychiatrists 가이드라인을 비롯하여 양극성 장애 치료의 근거기반 가이드라인에서도 이러한 4가지 개입을 권고하고 있었다. 한편 사회적 리듬 및 대인관계 치료 연구가 증가하였고, 북미 외 타 지역에서 수렴적 증거가 축적되고 있으며, 치료효과 유무를 넘어 치료효과의 기제와 조절변인 등의 다음 단계 연구 문제들이 탐색되기 시작하였다는 차이가 있었다.

Abstract

Bipolar disorder is a recurrent, chronic mental disorder, for which adjunctive psychosocial intervention in addition to pharmacotherapy can contribute to a more successful long-term management in terms of recurrence prevention and improved quality of life. This article aimed to provide an up-to-date review of evidence-based psychosocial interventions for bipolar disorder by examining recent development occurred within this area after the previous review in 2019. Four psychosocial interventions (i.e., psychoeducation, family-focused therapy, cognitive behavioral therapy, and interpersonal and social rhythm therapy) were still reported to be evidence-based interventions with strong level of empirical evidence and being recommended by clinical guidelines of the 2020 Royal Australian and New Zealand College of Psychiatrists. Meanwhile, there was an increasing number of IPSRT studies and converging evidence collected from other regions outside North America. Moreover, studies began to further explore the research questions of treatment mechanism and moderator beyond mere presence or absence of treatment effect.

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