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抗精神病薬の継続または中止の意思決定過程を形作る要因:最初のエピソードの精神病から寛解した12人の調査的定性研究
Laurent Béchard1,2,3,4, Elizabeth Anderson5,4, Olivier Corbeil2,3,4
1Faculty of Nursing, Université Laval, Quebec, Canada.
BJPsych open
|September 4, 2025
まとめ
最初のエピソードの精神病 (FEP) から回復している患者は,個人的な回復目標と副作用の懸念によって,しばしば抗精神病薬の停止に関する決定を促します. 共同で意思決定を行うためには 積極的な臨床的議論が必要である.
科学分野:
- 精神科
- 臨床心理学
- 神経科学
背景:
- 最初のエピソードサイコシス (FEP) の治療の継続/中止は複雑です.
- 治療を中止すると再発するリスクがあり,長期的な副作用 (代謝,エクストラピラミッド) が懸念される.
- ガイドラインでは1~5年間の治療と共同意思決定 (SDM) を提案しています.
研究 の 目的:
- FEPにおける抗精神病治療の意思決定過程を探求する.
- 治療中止または継続決定に影響を与える患者による要因を特定する.
- 寛解後の治療管理に関する患者の見解を理解する.
主な方法:
- 記述的な質的研究
- カナダのケベック州でFEPを治した 12人の参加者
- オンラインの半構造面接とテーマ分析
主要な成果:
- 病気/治療の認識,汚名,社会的関係によって影響される意思決定.
- 福祉と社会貢献に関連する意思決定の動機付け
- ほとんどの参加者は,臨床医が中止の議論を開始しなかったと感じました.
結論:
- 患者の回復の動機は,抗精神病治療の決定に大きく影響する.
- 臨床医と患者との対話を 積極的に行う必要があります
- SDMを支援するために,FEP集団に合わせた意思決定支援の開発が推奨されています.
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