Ochitill H, Dilley J, Kohlwes J
San Francisco General Hospital, Department of Psychiatry, California 94110.
Am J Med. 1991 May;90(5):601-5.
The purpose of this study was to investigate the prescribing practices for the use of psychoactive medication in treating hospitalized patients with the acquired immunodeficiency syndrome (AIDS).
The medical charts were studied for all patients admitted to a 20-bed AIDS inpatient ward from July through December 1986. One hundred and fifty-one patient-admissions comprised the sample. The average age of the patients was 37 years, and the average length of the hospital stay was 13 days. Retrospective chart review collected demographic data, length of stay, medical diagnosis, psychiatric history, and mental status on admission. Data on psychoactive drugs included the reasons for use, maximum daily dose and duration, and side effects ascribed to the drugs.
Psychoactive drugs were used in 89% of the cases. Anxiolytics accounted for 49% of the psychoactive prescriptions, and hypnotics made up 43% of these prescriptions. The five most frequently used psychoactive drugs were benzodiazepines. The most frequent reasons for psychotropic prescriptions were insomnia (39%), psychologic distress (20%), and nausea (16%). The most frequently used anxiolytic and anti-psychotic medications were used in moderate dosage, while the most frequently used antidepressant was prescribed in low dosage.
Hospitalized AIDS patients are highly likely to be prescribed a psychotropic medication, especially an anxiolytic or hypnotic. Anxiolytics are used for several purposes, including reduction of nausea associated with the use of antibiotics. Antidepressants and antipsychotics are rarely used. Practitioners must be sensitive to the presence of psychiatric conditions presenting as insomnia or disturbed mood so that the most specific and appropriate treatments can be used.
本研究旨在调查在治疗获得性免疫缺陷综合征（艾滋病）住院患者时使用精神活性药物的处方习惯。
对1986年7月至12月入住一家拥有20张床位的艾滋病住院病房的所有患者的病历进行研究。151例患者入院病例构成样本。患者的平均年龄为37岁，平均住院时间为13天。通过回顾性病历审查收集了人口统计学数据、住院时间、医学诊断、精神病史和入院时的精神状态。关于精神活性药物的数据包括使用原因、最大日剂量和持续时间以及归因于这些药物的副作用。
89%的病例使用了精神活性药物。抗焦虑药占精神活性药物处方的49%，催眠药占这些处方的43%。最常用的五种精神活性药物是苯二氮䓬类药物。精神药物处方最常见的原因是失眠（39%）、心理困扰（20%）和恶心（16%）。最常用的抗焦虑药和抗精神病药物以中等剂量使用，而最常用的抗抑郁药则以低剂量开处方。
住院的艾滋病患者极有可能被开精神药物，尤其是抗焦虑药或催眠药。抗焦虑药用于多种目的，包括减轻与使用抗生素相关的恶心。抗抑郁药和抗精神病药很少使用。从业者必须对表现为失眠或情绪紊乱的精神疾病状况保持敏感，以便能够使用最具针对性和适当的治疗方法。
