测试一项美国心理学会实践指南：针对边缘型人格障碍患者的症状靶向药物使用情况
Testing an APA practice guideline: symptom-targeted medication utilization for patients with borderline personality disorder.
作者信息
Oldham John M, Bender Donna S, Skodol Andrew E, Dyck Ingrid R, Sanislow Charles A, Yen Shirley, Grilo Carlos M, Shea M Tracie, Zanarini Mary C, Gunderson Edd John G, McGlashan Thomas H
机构信息
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
出版信息
J Psychiatr Pract. 2004 May;10(3):156-61. doi: 10.1097/00131746-200405000-00003.
BACKGROUND
The goal of this study was to test whether the use of psychotropic medication treatment for borderline personality disorder (BPD) was consistent with proposals in the recently published American Psychiatric Association's Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.
METHOD
Medication utilization by patients with BPD was assessed prospectively over a 2-year period prior to the publication of the Guideline. Three BPD symptom clusters--cognitive-perceptual, affective dysregulation, and impulsive-behavioral dyscontrol--along with demographic and functioning variables were used to predict the use of five classes of medication.
RESULTS
Symptoms of impulsive-behavioral dyscontrol significantly predicted use of both neuroleptics and anticonvulsants. Cognitive-perceptual symptoms were inversely related to anticonvulsant use.
CONCLUSION
While some pre-Guideline medication practices with BPD patients were consistent with the recommended algorithms, physicians may also have been influenced by a variety of considerations, including level of functional impairment and the presence of comorbid Axis I conditions.
背景
本研究的目的是检验使用精神药物治疗边缘型人格障碍（BPD）是否符合美国精神病学协会最近发布的《边缘型人格障碍患者治疗实践指南》中的建议。
方法
在该指南发布前的2年时间里，对BPD患者的药物使用情况进行前瞻性评估。使用三个BPD症状群——认知-感知、情感失调和冲动-行为失控——以及人口统计学和功能变量来预测五类药物的使用情况。
结果
冲动-行为失控症状显著预测了抗精神病药物和抗惊厥药物的使用。认知-感知症状与抗惊厥药物的使用呈负相关。
结论
虽然一些在指南发布前对BPD患者的用药做法与推荐算法一致，但医生也可能受到了多种因素的影响，包括功能损害程度和共病的轴I障碍情况。
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