Van Dorn Richard A, Swanson Jeffrey W, Swartz Marvin S, Elbogen Eric B
Services Effectiveness Research Program, Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Ment Health Serv Res. 2005 Jun;7(2):123-34. doi: 10.1007/s11020-005-3783-z.
This study examined the impact of race and arrest history on the likelihood of being prescribed, and maintaining an atypical antipsychotic prescription for 90 or more days among patients with schizophrenia in the community. Participants were 224 adults with schizophrenia-spectrum disorders receiving services in public-sector mental health systems in North Carolina. The data used for this report were from a subsample of a larger group of participants being followed in an observational study and consisted of individuals who were prescribed either an atypical or conventional antipsychotic medication for 90 or more days. The purpose of the analyses presented here was to investigate differences in the likelihood of being prescribed an atypical antipsychotic by demographic and other characteristics. Logistic regression analysis indicated that African American patients were significantly less likely to receive atypical antipsychotics than their white counterparts, even when controlling for key clinical and demographic variables. However, white patients with a history of arrest were no more likely than black patients to receive atypical antipsychotics; that is, minority racial status and criminal involvement each functioned to limit patients' access to the novel medications. Implications for equal access to mental health services, in this case, effective psychopharmacologic treatment, are discussed.
本研究考察了种族和逮捕史对社区中精神分裂症患者开具非典型抗精神病药物处方以及维持90天及以上非典型抗精神病药物处方可能性的影响。研究对象为224名在北卡罗来纳州公共部门心理健康系统接受服务的患有精神分裂症谱系障碍的成年人。本报告所用数据来自一项观察性研究中一个较大参与者群体的子样本，包括那些被开具非典型或传统抗精神病药物达90天及以上的个体。此处进行分析的目的是调查根据人口统计学和其他特征开具非典型抗精神病药物处方可能性的差异。逻辑回归分析表明，即使在控制关键临床和人口统计学变量的情况下，非裔美国患者获得非典型抗精神病药物的可能性也显著低于白人患者。然而，有逮捕史的白人患者获得非典型抗精神病药物的可能性并不比黑人患者更高；也就是说，少数族裔身份和犯罪经历均起到了限制患者获得新型药物的作用。本文讨论了在这种情况下平等获得心理健康服务（即有效的精神药物治疗）的意义。
