抗精神病药和抗抑郁药在第一次精神病性抑郁症中的使用:一项全国性的基于登记册的研究
A Hamina1,2, T Paljärvi1, A Tanskanen1
1Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.
Acta psychiatrica Scandinavica
|September 7, 2023
概括
治疗指南建议在精神病性抑郁症中服用抗精神病药和抗抑郁药,但这项研究发现,不到一半的患者接受这种组合. 这种低于最佳的治疗可能会对康复结果产生负面影响.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 精神病性抑郁症治疗指南主张结合抗精神病和抗抑郁药物治疗.
- 目前关于这种联合治疗方法的临床实践在很大程度上仍然没有特征.
研究的目的:
- 为了调查抗精神病和抗抑郁药在第一次精神病性抑郁症中的使用率.
- 为了确定与诊断后抗精神病药物使用相关的因素.
主要方法:
- 利用全国性的芬兰医疗保健和人口登记 (2000-2018) 识别16-65岁的个人与第一次精神病性抑郁症.
- 在每三个月的两周间隔内,每3个月进行一次就业点流行率测量,分析药物使用周期和审查数据.
主要成果:
- 这项研究包括了18490人;抗抑郁药,抗精神病药和两种药物在诊断后3个月观察到的峰值流行率 (分别为75.0%,56.4%,50.0%).
- 诊断后3年,患病率下降至51.8% (抗抑郁药),34.1% (抗精神病药) 和28.7% (两者).
- 与降低抗精神病药物的使用相关的因素包括年龄较小,饮食障碍,物质使用障碍和职业不活动;增加的几率与住院诊断和较晚的队列进入年份有关.
结论:
- 只有不到一半的新诊断的精神病抑郁症患者接受了抗精神病药和抗抑郁药的建议组合.
- 这种联合药物治疗的不足使用可能会降低治疗疗效和患者的治疗结果.
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