智力障碍患者的非标签抗精神病药物撤销:预测模型的开发和内部验证
Joëlle Weijgertze-Lanser1,2, Maureen B G Wissing1,2, Roy G Elbers1,2
1Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Journal of intellectual disability research : JIDR
|September 5, 2025
概括
在智力障碍患者中,抗精神病药物戒断的尝试往往是不成功的. 智力障碍严重程度高,抗精神病剂量增加,
科学领域:
- 精神病学
- 临床心理学
- 药理学
背景情况:
- 在智力障碍和具有挑战性行为的人群中,非标签性抗精神病药物使用很普遍.
- 在临床上建议戒除抗精神病药物,但在该群体中经常失败.
- 预测成功戒断对于优化患者护理和减少多种药物使用至关重要.
研究的目的:
- 开发和内部验证抗精神病药物戒断未成功的预测模型.
- 确定与智力障碍患者不完全戒除抗精神病药物相关的关键预测因素.
- 为临床医生提供工具,以更好地预测和管理戒断尝试.
主要方法:
- 分析了141名接受抗精神病药物戒断的智力障碍患者的数据.
- 多变量逻辑回归与向后选择以确定重要的预测因素.
- 内部验证使用引导来评估模型的性能和通用性.
主要成果:
- 智力障碍的程度,抗精神病药物的确定每日剂量 (DDD) 和异常行为检查清单 (ABC) 的刻板印象得分是未成功戒断的重要预测因素.
- 该模型解释了退出成功率的20%差异 (纳格尔克克的R平方=0.200).
- 该模型显示了公平到良好的歧视 (AUC = 0.728),乐观度调整后的AUC为0.706.
结论:
- 抗精神病药物戒断失败的可能性增加与更严重的智力障碍,更高的抗精神病DD和更高的ABC刻板印象得分有关.
- 这些发现为医疗保健提供者提供了有价值的见解,以预测和支持抗精神病药物戒断尝试.
- 经过验证的预测模型可以为智力残疾人提供个性化治疗策略.
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