Renkel Sabine, Rasmussen Kirsten
Regional sikkerhetsavd, Brøset/St.Olavs Hospital, Trondheim, Norway.
Nord J Psychiatry. 2006;60(2):132-6. doi: 10.1080/08039480600583662.
The aim of this study was to evaluate psychopharmacological treatment and the length of stay (LOS) of patients with schizophrenia in a maximum-security psychiatric unit. Data were collected from the hospital files of 82 consecutively admitted patients with schizophrenia who were both admitted and discharged between the years 1987 and 2000. Psychotropic medication and LOS at the time of discharge were registered. Ninety-five per cent of the patients received antipsychotic medication. Zuclopenthixol was the most frequent medication, given to 43% of the patients. Antipsychotic polypharmacy was found in 20% of the cases. Twenty-seven per cent of the patients were medicated with doses above the recommended therapeutic dose range. During the study period, there was no change in the administration and number of psychotropics, but there was an increase in the dosage of antipsychotics. However, LOS was unchanged during the same time. This supports other findings, which suggest that there is no clinical benefit of higher antipsychotic dosage. It is suggested that an optimized medication practice could yield beneficiary effects, not only for schizophrenic symptoms, but also for violence in schizophrenic patients.
本研究旨在评估在一所高度设防的精神科病房中,精神药物治疗及精神分裂症患者的住院时间(LOS)。研究数据收集自1987年至2000年间连续收治的82例精神分裂症患者的医院档案,这些患者均已入院并出院。记录了出院时的精神药物使用情况及住院时间。95%的患者接受了抗精神病药物治疗。氯噻吨是最常用的药物,43%的患者使用该药。20%的病例存在抗精神病药物联合使用情况。27%的患者所使用药物剂量高于推荐治疗剂量范围。在研究期间,精神药物的使用及种类没有变化,但抗精神病药物的剂量有所增加。然而,同期住院时间没有改变。这支持了其他研究结果,即更高剂量的抗精神病药物并无临床益处。研究表明,优化药物治疗方案不仅对精神分裂症症状有益,对精神分裂症患者的暴力行为也可能产生有益影响。