雙相情緒障礙症病患之照護

Care of Individuals With Bipolar Disorders

雙相情緒障礙症（簡稱雙相症）為具有慢性化、高度復發性及不穩定性，及高自殺率之嚴重精神疾病。實證研究支持遺傳及基因因素、神經發炎反應與社會節奏失衡，彼此之間惡性循環為其重要病因。因此，雙相症的急性期照護應以藥物治療為主，後續維持期則需合併藥物治療及心理社會治療，方能有效協助該族群病患規則服藥及處理情緒起伏症狀，促進其疾病自我管理及社會功能， 終而降低復發及再住院，並達到較佳穩定狀態。本文首先介紹雙相症之疾病特性、病因假說、實證照護模式與成效，再以「盪鞦韆團體」為例，簡介國人雙相症實證照護模式的初步發展。期藉由這些實證照護知識的統整與分享，做為臨床工作者照護此族群病患的參考，更且，由於目前探討國人雙相症心理社會相關因素之研究仍十分欠缺， 發展該族群病患合適的心理社會治療模式亦刻不容緩，盼望藉由本文拋磚引玉，以引發相關決策單位與健康照護者對於此臨床問題的關切。

Bipolar disorder (BD) is a severe mental illness that is characterized by chronicity, pervasive instability, and relatively high rates of recurrence and suicide. Current evidence supports that adverse circles among hereditary and genetic factors, neuroinflamation, and social rhythm constitute a crucial etiology. Pharmacological treatment is the first priority for BD patients during the acute stage. Pharmacological and psychosocial treatments should be combined during the maintenance stage in order to help patients self-manage medication, effectively control mood swings, enhance disease self-management and social functions, decrease the risks of relapse and re-hospitalization, and stabilize overall health. The present article firstly introduces the characteristics and etiological assumptions related to BD, the related evidence-based care models and their effects, and the early development of an evidence-based care model, the BalancingMySwing group, for BD patients in Taiwan. This article provides updated information to clinicians who are involved in caring for this population. Moreover, the existing data related to biological and psychosocial factors for BD in Taiwan is insufficient and developing individual-tailored psychosocial intervention is urgently needed. The authors hope that this article will elicit greater concern for this issue from policy decision-makers and healthcare providers.