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患有精神疾病和发育障碍双重诊断患者的心理药物治疗。

Psychopharmacological treatments in persons with dual diagnosis of psychiatric disorders and developmental disabilities.

作者信息

Antochi R, Stavrakaki C, Emery P C

机构信息

Children's Hospital of Eastern Ontario, Child and Family Psychiatric Unit, Ottawa, Ontario, Canada.

出版信息

Postgrad Med J. 2003 Mar;79(929):139-46. doi: 10.1136/pmj.79.929.139.

Abstract

People with developmental disabilities are at considerable risk for the development of comorbid psychiatric conditions. Psychopharmacological treatments may have a crucial role in a multidisciplinary and multimodal approach to the management of psychopathology in this population. Psychiatric illnesses that are particularly amenable include mood disorders, anxiety disorders, schizophrenia, and attention deficit hyperactivity disorders (ADHDs) and antidepressants, mood stabilisers, anxiolytics, antipsychotics, and stimulants should be considered, respectively. ADHD may also respond to alpha(2)-agonists. Psychotropic agents such as beta-antagonists can target aggressive, self injurious, and stereotypical behaviours and opioid antagonists may be helpful in treating self injurious behaviour and stereotypy. Selective serotonin reuptake inhibitors, newer anticonvulsants, and atypical neuroleptics are preferred when treating psychiatric disorders among people with developmental disabilities. This paper will review the major studies of pharmacological treatment of mental illness in individuals with developmental disabilities.

摘要

发育障碍患者患共病精神疾病的风险相当高。在针对该人群精神病理学管理的多学科和多模式方法中,心理药物治疗可能起着关键作用。特别适合治疗的精神疾病包括情绪障碍、焦虑症、精神分裂症和注意力缺陷多动障碍(ADHD),应分别考虑使用抗抑郁药、心境稳定剂、抗焦虑药、抗精神病药和兴奋剂。ADHD也可能对α₂激动剂有反应。β受体阻滞剂等精神药物可针对攻击行为、自我伤害行为和刻板行为,阿片类拮抗剂可能有助于治疗自我伤害行为和刻板行为。在治疗发育障碍患者的精神疾病时,首选选择性5-羟色胺再摄取抑制剂、新型抗惊厥药和非典型抗精神病药。本文将综述发育障碍患者精神疾病药物治疗的主要研究。

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