Harding T W, Chrusciel T L
Bull World Health Organ. 1975;52(3):359-67.
Psychotropic drug therapy combined with other forms of treatment provides an effective means for the control and treatment of a number of mental disorders. In developing countries a wide range of health workers must be prepared to use psychotropic drugs if there is to be a significant improvement in mental health care. A number of problems are involved: not all mental disorders respond to drug treatment; the range of available drugs is very wide; side effects are relatively common; patients may not take prescribed drugs regularly; and there are dangers of overuse, abuse, and overdose. Some of the problems could be overcome by: (a) focusing on a limited number of conditions of public health importance; (b) establishing a clear policy as to which drugs should be available at various points in the health service and limiting the range of such drugs; (c) adopting a more flexible system of task sharing in psychotropic drug therapy; (d) coordinating training programmes; and (e) setting up a central policy body concerned with mental health in health ministries.
精神药物治疗与其他治疗形式相结合,为控制和治疗多种精神障碍提供了一种有效手段。在发展中国家,如果要显著改善精神卫生保健状况,必须让众多卫生工作者做好使用精神药物的准备。这涉及到一些问题:并非所有精神障碍都对药物治疗有反应;可用药物种类繁多;副作用相对常见;患者可能不按时服用处方药;而且存在过度使用、滥用和过量用药的风险。其中一些问题可以通过以下方式克服:(a) 关注少数具有公共卫生重要性的病症;(b) 制定明确政策,规定在卫生服务的不同环节应提供哪些药物,并限制此类药物的范围;(c) 在精神药物治疗中采用更灵活的任务分担制度;(d) 协调培训计划;(e) 在卫生部设立一个关注精神卫生的中央政策机构。