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№ 4 (2023)

ПРАКТИКА

Диагностика, скрининг и возможности фармакотерапии биполярного аффективного расстройства II типа

https://doi.org/10.21265/PSYPH.2023.13.45.004

Опубликован 2023-12-30

  • Е.Г. Костюкова

Е.Г. Костюкова
Московский НИИ психиатрии — филиал ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации

Аннотация

Настоящая статья является нарративным обзором литературы, целью которого было проанализировать имеющиеся данные о современных подходах к диагностике и терапии биполярного расстройства (БАР) II типа. БАР II имеет большую распространенность и поражает чаще всего молодых, физически здоровых людей, социальная адаптация которых напрямую зависит от частоты, тяжести и длительности развивающихся у них фаз, что определяет актуальность темы. БАР II остается малоизученным заболеванием с точки зрения как методов диагностики, так и подходов к терапии. Его выявляемость остается до настоящего времени крайне низка, в связи с чем пациенты не получают адекватной помощи на протяжении десятилетий. При этом известно, что только раннее начало терапии позволяет обеспечить максимальный контроль над симптоматикой и сохранение социальной адаптации пациента.
В последнее десятилетие исследуются возможности новаторских методов диагностики и мониторинга состояния пациента в период терапии с использованием цифровых биомаркеров, существенно расширился арсенал средств для лечения БАР и изменились подходы к терапии заболевания, прежде всего депрессивных фаз. Однако доказательные исследования эффективности лекарственных средств касаются в основном БАР I типа, в то время как для БАР II типа они практически отсутствуют.
Вывод. необходимо проведение дополнительных исследований и внедрение новых методов диагностики и терапии биполярного расстройства II типа с целью обеспечить максимально раннее начало терапии. В их числе внедрение в повседневную практику скрининговых инструментов мобильных мониторирующих устройств типа актиметрии.

Ключевые слова

биполярное аффективное расстройство II типа, депрессия, гипомания, диагностика, выявляемость, терапия, цифровые биомаркеры

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