两极性障碍成年人症状严重程度与药物坚持之间的关联 报告坚持挑战
Martha Sajatovic1, Farren Briggs2, Clara Adeniyi3
1Sajatovic, MD, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Psychopharmacology bulletin
|July 12, 2024
概括
双相情感障碍 (BD) 中的药物坚持与抑郁症和功能有关,但自我报告可能无法完全捕捉坚持行为. 在本研究中,客观测量与临床变量没有相关性.
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:
- 药物坚持对于双相情感障碍 (BD) 患者至关重要.
- 这项研究分析了一项随机对照试验 (RCT) 的数据,重点关注患有BD的不良成年人.
- 了解影响坚持治疗的因素对于治疗成功至关重要.
研究的目的:
- 检查双相情感障碍症状,功能和药物坚持之间的关系.
- 为了比较自我报告的遵守与客观的电子监控.
- 确定预测BD中药物坚持的潜在标志物.
主要方法:
- 纳入标准:成年人 (≥18) 患有BD类型1或2,不良坚持和活跃症状 (BPRS≥36,YMRS>8或MADRS>8).
- 通过自我报告的药片常规问卷 (TRQ) 和电子药片容器 (eCap) 测量了坚持.
- 使用MADRS,YMRS,CGI和GAF评估的BD症状和功能.
主要成果:
- 自我报告的坚持 (TRQ) 与较高的抑郁症 (MADRS) 和临床严重程度 (CGI) 和较低的功能 (GAF) 有着显著的关联.
- 电子粘附 (eCap) 与临床变量没有显著关联.
- 报告了高比例的遗漏药物,TRQ显示在查时~40%的遗漏剂量,在基线时~30%.
结论:
- 抑郁和功能可能作为药物坚持的间接指标.
- 仅仅依赖患者的自我报告或症状严重程度可能会对坚持不完全理解.
- 与BD的自我报告措施相比,客观的遵守监测可能会提供不同的见解.
相关概念视频
Drug Therapy
41
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
41
Mania and Antimanic Drugs: Overview
163
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
163
Bipolar Disorder
64
Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
64
Psychosis: Goals of Pharmacotherapy
119
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
119
Psychosis and Antipsychotic Drugs: Overview
229
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
229
Antidepressant Drugs: MAOIs and Other Agents
215
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
215


