Читать книгу Well-Being Therapy - G.A. Fava - Страница 28
Addressing Cyclothymic Disorder
ОглавлениеUntil then we had conceptualized WBT essentially as a tool for increasing psychological well-being in people who had impaired levels. But in my clinical practice I had observed patients in whom these psychological dimensions were exaggerated or unrealistic, whose environmental mastery, for instance, led them to take too many challenges and to be under very stressful situations. Was the role of WBT simply that of a well-being enhancer or could it also serve a stabilizing function?
We thus decided to apply WBT to treatment of cyclothymic disorder, which involves mild or moderate fluctuations of mood, thought, and behavior without meeting formal diagnostic criteria for either major depressive disorder or mania [21]. It is a common and disabling condition that does not attract much research attention since no drugs have been patented for its treatment. Sixty-two patients with cyclothymic disorder were randomly assigned to the sequential combination of CBT and WBT or clinical management. An independent blind evaluator assessed the patients before treatment, after therapy, and at 1 - and 2-year followups. The CID [2] and the Mania Scale developed by Per Bech and his collaborators [22] were used to evaluate symptoms. After treatment, a significant difference was found in outcome measures, with greater improvements in the CBT/WBT group compared to clinical management. Therapeutic gains were maintained at the 1- and 2-year follow-ups [21]. The results thus indicate that WBT may address both polarities of mood swings and comorbid anxiety, and may yield significant and lasting benefits in cyclothymic disorder.