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私立精神病学机构中接受治疗的精神分裂症患者使用抗精神病药物的情况。

Antipsychotic use in patients with schizophrenia treated in private psychiatry.

作者信息

Simon Andor E, Peter Manuela, Hess Lorenzo, Valterio Claude

机构信息

Spezialsprechstunde zur Abklärung und Behandlung psychotischer Frühphasen, Externe Psychiatrische Dienste Baselland, CH-4101 Bruderholz, Switzerland.

出版信息

Swiss Med Wkly. 2005 Feb 19;135(7-8):109-15. doi: 10.4414/smw.2005.10727.

Abstract

QUESTIONS UNDER STUDY

The aim of this study was to assess antipsychotic treatment practices among private psychiatrists in Switzerland.

METHODS

For each patient seen during 4 consecutive weeks, 101 participating private psychiatrists documented psychiatric diagnosis. For each schizophrenic patient, demographic details as well as treatment issues were assessed in a questionnaire-based survey. Participating psychiatrists were representative for Swiss private psychiatry with regards to gender distribution and region of practice.

RESULTS

Overall, 8425 patients were assessed in our survey. Of these, 905 patients (10.7%) received a diagnosis of schizophrenic psychoses, of whom 733 details on antipsychotic treatment were documented. 73.1% of these patients received second generation antipsychotics. Most private psychiatrists prescribed antipsychotic monotherapy and maintained antipsychotic treatment according to recommendation from international guidelines. Almost half of these patients had a history of medication non-adherence, with non-compliance being the most frequent reason.

CONCLUSION

The findings of this survey suggest that Swiss private psychiatrists prescribe according to international guidelines in terms of drug choice as well as maintenance treatment. Moreover they show low rates of polypharmacy and comedication practice as compared to their colleagues in other European countries. This may reflect solid experience in prescribing second-generation antipsychotics of a subgroup of private psychiatrists in Switzerland.

摘要

研究问题

本研究旨在评估瑞士私立精神病医生的抗精神病药物治疗实践。

方法

101名参与研究的私立精神病医生对连续4周内接待的每位患者进行精神科诊断记录。对于每位精神分裂症患者,通过问卷调查评估其人口统计学细节以及治疗问题。参与研究的精神病医生在性别分布和执业地区方面代表了瑞士私立精神病学领域。

结果

总体而言,我们的调查共评估了8425名患者。其中,905名患者(10.7%)被诊断为精神分裂症性精神病,其中733名患者记录了抗精神病药物治疗的详细情况。这些患者中有73.1%接受了第二代抗精神病药物治疗。大多数私立精神病医生采用抗精神病药物单一疗法,并根据国际指南的建议维持抗精神病药物治疗。这些患者中近一半有药物治疗依从性不佳的病史,不依从是最常见的原因。

结论

本次调查结果表明,瑞士私立精神病医生在药物选择和维持治疗方面遵循国际指南进行处方。此外,与其他欧洲国家的同行相比,他们的联合用药和合并用药率较低。这可能反映出瑞士一部分私立精神病医生在开具第二代抗精神病药物方面有丰富的经验。

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