Weinmann S, Janssen B, Gaebel W
Department of Psychiatry and Psychotherapy, Heinrich Heine University, Duesseldorf, Germany. stefan.weinmann.de
Acta Psychiatr Scand. 2005 Jul;112(1):18-25. doi: 10.1111/j.1600-0447.2005.00547.x.
To evaluate guideline adherence in in-patient medication care of psychotic disorders.
A total of 508 persons with psychotic disorders were included in a naturalistic multisite hospital study. Subjects were assessed weekly on mental state, social functioning, socioeconomic factors and medication prescriptions.
In total, 17% of individuals were prescribed antipsychotic dosages above the recommended value. Among those with persistent psychotic symptoms, 73% received insufficient antipsychotic drug management. About 58% of patients with depressive symptoms were not treated according to guidelines, and 53% of patients did not receive adequate management of side-effects from antipsychotic medications. Subjects with more than six previous psychiatric hospitalizations (OR 1.80, CI: 1.05-3.08) and those with a prominent thought disorder (OR 2.28, CI: 1.23-4.23) had a higher likelihood of not being treated according to guidelines.
Individuals with chronic and thought-disordered psychosis may be at a higher risk of receiving medication care not supported by guidelines.
评估住院精神障碍患者药物治疗中对指南的遵循情况。
一项自然主义多中心医院研究纳入了总共508名精神障碍患者。每周对受试者的精神状态、社会功能、社会经济因素和药物处方进行评估。
总体而言，17%的个体所使用的抗精神病药物剂量高于推荐值。在有持续性精神病症状的患者中，73%的患者抗精神病药物管理不足。约58%有抑郁症状的患者未按指南接受治疗，53%的患者未得到抗精神病药物副作用的充分管理。既往有超过6次精神科住院史的受试者（比值比1.80，可信区间：1.05 - 3.08）和有明显思维障碍的受试者（比值比2.28，可信区间：1.23 - 4.23）未按指南接受治疗的可能性更高。
患有慢性和思维障碍性精神病的个体接受未得到指南支持的药物治疗的风险可能更高。
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