在跨诊断性第一期精神病样本中的药物坚持
Stephanie M London1,2,3, Philip B Cawkwell1,2, Ann K Shinn1,2
1Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts.
The Journal of clinical psychiatry
|November 2, 2023
概括
在第一发精神病 (FEP) 中,药物坚持至关重要. 非白人种族,不良洞察力和物质使用预测了不遵守,突出了临床干预的领域.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 药物坚持显著影响了第一发精神病 (FEP) 的治疗结果.
- 了解不坚持的预测因素对于改善患者轨迹至关重要.
- 来自FEP诊所的现实数据对于为临床实践提供信息至关重要.
研究的目的:
- 在现实世界的FEP诊所中调查药物不服药的时间.
- 确定与FEP患者药物不服药相关的人口和临床因素.
主要方法:
- 使用学术精神病医院FEP诊所219名患者的数据进行了生存分析 (2012年5月 - 2017年10月).
- 这项研究重点关注了122名最初6个月的患者,分析了长达66个月的数据.
- 考克斯的比例危险模型被用来评估不遵守的预测因素.
主要成果:
- 在122名患者中,30%的人经历了非坚持事件.
- 在24个月后,不遵守的风险为35%,在36个月后为49%,此后趋于平稳.
- 有意义的预测因素包括非白人种族 (aHR=3.69),缺乏洞察力 (aHR=3.24),和物质使用 (aHR=2.58).
结论:
- 针对治疗联盟,洞察力和物质使用的干预措施对于提高FEP药物坚持至关重要.
- 解决这些因素可能会改善第一发精神病患者的长期结果.
- 应量身定制临床策略,以减轻未遵守的确定的风险.
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