Department of Public Health, EA 3279 Research Unit, University Hospital, Boulevard Jean Moulin 13385 Marseille, France.
BMC Psychiatry. 2011 Feb 11;11:24. doi: 10.1186/1471-244X-11-24.
To compare the rate of relapse as a function of antipsychotic treatment (monotherapy vs. polypharmacy) in schizophrenic patients over a 2-year period.
Using data from a multicenter cohort study conducted in France, we performed a propensity-adjusted analysis to examine the association between the rate of relapse over a 2-year period and antipsychotic treatment (monotherapy vs. polypharmacy).
Our sample consisted in 183 patients; 50 patients (27.3%) had at least one period of relapse and 133 had no relapse (72.7%). Thirty-eight (37.7) percent of the patients received polypharmacy. The most severely ill patients were given polypharmacy: the age at onset of illness was lower in the polypharmacy group (p = 0.03). Patients that received polypharmacy also presented a higher general psychopathology PANSS subscore (p = 0.04) but no statistically significant difference was found in the PANSS total score or the PANSS positive or negative subscales. These patients were more likely to be given prescriptions for sedative drugs (p < 0.01) and antidepressant medications (p = 0.03). Relapse was found in 23.7% of patients given monotherapy and 33.3% given polypharmacy (p = 0.16). After stratification according to quintiles of the propensity score, which eliminated all significant differences for baseline characteristics, antipsychotic polypharmacy was not statistically associated with an increase of relapse: HR = 1.686 (0.812; 2.505).
After propensity score adjustment, antipsychotic polypharmacy is not statistically associated to an increase of relapse. Future randomised studies are needed to assess the impact of antipsychotic polypharmacy in schizophrenia.
比较抗精神病药物治疗（单药治疗与联合用药）对精神分裂症患者 2 年内复发率的影响。
利用法国多中心队列研究的数据，通过倾向评分调整分析，考察了 2 年内复发率与抗精神病药物治疗（单药治疗与联合用药）之间的关系。
本研究共纳入 183 例患者；50 例（27.3%）患者至少有 1 次复发，133 例患者无复发（72.7%）。38 例（37.7%）患者接受了联合用药。病情最重的患者接受了联合用药：联合用药组的发病年龄较低（p = 0.03）。接受联合用药的患者还表现出更高的一般精神病 PANSS 子评分（p = 0.04），但 PANSS 总分和 PANSS 阳性或阴性子量表无统计学差异。这些患者更有可能接受镇静药物（p < 0.01）和抗抑郁药物（p = 0.03）的处方。单药治疗组的复发率为 23.7%，联合用药组为 33.3%（p = 0.16）。根据倾向评分五分位数分层后，消除了所有基线特征的显著差异，抗精神病药物联合用药与复发增加无关：HR = 1.686（0.812；2.505）。
在进行倾向评分调整后，抗精神病药物联合用药与复发增加无统计学关联。需要开展未来的随机研究，评估抗精神病药物联合用药对精神分裂症的影响。
