Bipolar Disorder (BD) optimal care involves pharmacotherapy in conjunction with psychosocial interventions. Both treatment modalities require the establishment of a therapeutic alliance (TA), a cornerstone necessary for the successful treatment of any chronic illness regardless of the psychotherapeutic model¹. In mental disorders, TA has been considered a mediator of adherence and treatment success in a number of conditions, including but not being restricted to schizophrenia spectrum disorders; major depressive disorders, personality disorders; addictions, and also BD. It is well known that there are several obstacles to the establishment of a TA with individuals with BD, including those related to patient’s characteristics (e.g. history of childhood maltreatment, comorbidities with personality disorders or substance abuse), to their illness (e.g. severity of symptoms, poor insight), patient characteristics, level of expertise and experience of the health care professional, and systemic factors (e.g. time available to provide care, models of remuneration, possibility to provide both pharmacological and psychotherapeutic care)¹. However, for psychiatrists and health professionals involved in the care of individuals with BD, countertransference (CT) factors could be especially challenging.

中文翻译：

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双相情感障碍急性期个体临床护理中反移情的重要性

双相情感障碍 (BD) 的最佳护理包括药物疗法和社会心理干预。两种治疗方式都需要建立治疗联盟 (TA)，这是成功治疗任何慢性疾病所必需的基石，无论心理治疗模式如何¹. 在精神障碍中，TA 被认为是在许多情况下依从性和治疗成功的媒介，包括但不限于精神分裂症谱系障碍；重度抑郁症、人格障碍；成瘾，还有BD。众所周知，与 BD 患者建立 TA 存在一些障碍，包括与患者特征（例如童年虐待史、人格障碍合并症或药物滥用）、疾病（例如症状严重程度）相关的障碍。 , 洞察力差), 患者特征, 医疗保健专业人员的专业水平和经验, 以及系统性因素 (例如提供护理的时间、报酬模式、提供药物和心理治疗护理的可能性)¹ . 然而，对于参与照顾 BD 患者的精神科医生和卫生专业人员来说，反移情 (CT) 因素可能尤其具有挑战性。