Mark Tami L, Palmer Liisa A, Russo Patricia A, Vasey Joseph
Medstat, 4301 Connecticut Avenue, NW Suite 330, Washington, District of Columbia 20008, USA.
Ment Health Serv Res. 2003 Dec;5(4):241-50. doi: 10.1023/a:1026281118990.
Examine differences in treatment patterns among Blacks and non-Blacks in the U.S. Schizophrenia Care and Assessment Program. Baseline data from medical record abstraction, participant self-report and clinical assessment used to examine differences by race (race-gender pairings) (n = 2,239). Descriptive and multivariate (logistic) analysis employed. More Blacks were diagnosed with paranoid subtype. Blacks exhibited a more negative PANSS composite score, lower quality of life scores, and higher AIMS scores than non-Blacks. There was no statistically significant difference in the number of outpatient visits or inpatient admissions between Blacks and non-Blacks. Blacks had lower medication adherence and received less second-generation agents and more antiparkinson/anticholinergic agents. Proportion of Black males receiving depot was greater than other race-gender pairings. Regression results indicate Blacks more likely to be prescribed only first-generations after controlling for depot (OR = 1.64; CI = 1.27-2.12; p = 0.0002). Schizophrenia is, on average, accompanied by different diagnoses and symptoms in Blacks. Symptom profiles indicate that second-generation antipsychotics may be underprescribed to Black patients.
研究美国精神分裂症护理与评估项目中黑人和非黑人在治疗模式上的差异。使用来自病历摘要、参与者自我报告和临床评估的基线数据，按种族（种族 - 性别配对）进行差异检验（n = 2239）。采用描述性和多变量（逻辑）分析。更多黑人被诊断为偏执型亚型。与非黑人相比，黑人的阳性和阴性症状量表（PANSS）综合得分更低、生活质量得分更低且异常不自主运动量表（AIMS）得分更高。黑人和非黑人在门诊就诊次数或住院次数上没有统计学显著差异。黑人的药物依从性较低，接受第二代药物的比例较低，而接受抗帕金森/抗胆碱能药物的比例较高。接受长效注射剂的黑人男性比例高于其他种族 - 性别配对。回归结果表明，在控制长效注射剂因素后，黑人更有可能仅被开具第一代药物（比值比 = 1.64；置信区间 = 1.27 - 2.12；p = 0.0002）。平均而言，精神分裂症在黑人中伴有不同的诊断和症状。症状特征表明，第二代抗精神病药物可能在黑人患者中处方不足。
