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服用精神类药物导致的体重增加:综合述评。

Weight gain associated with taking psychotropic medication: an integrative review.

机构信息

Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Int J Ment Health Nurs. 2011 Jun;20(3):202-22. doi: 10.1111/j.1447-0349.2010.00721.x. Epub 2011 Feb 18.

Abstract

People with serious mental illness have higher morbidity and mortality rates than general populations, and overweight/obesity-related conditions are prevalent. Psychotropic medications are a primary factor in significant weight gain. Adolescents and young adults, particularly those with first-episode psychoses taking atypical antipsychotics, are susceptible to weight gain. This paper reports findings from an integrative review of research investigating the impact and treatment of psychotropic-induced weight gain. Four databases were searched, yielding 522 papers. From these and hand-searched papers, 36 research reports were systematically classified and analysed. The review revealed people experiencing psychotropic-induced weight gain perceive it as distressing. It impacts on quality of life and contributes to treatment non-adherence. Weight management and prevention strategies have primarily targeted adults with existing/chronic illness rather than those with first-episode psychoses and/or drug naiveté. Single and multimodal interventions to prevent or manage weight gain produced comparable, modest results. This review highlights that the effectiveness of weight management interventions is not fully known, and there is a lack of information regarding weight gain prevention for young people taking psychotropics. Future research directions include exploring the needs of young people regarding psychotropic-related weight gain and long-term, follow-up studies of lifestyle interventions to prevent psychotropic-related weight gain.

摘要

患有严重精神疾病的人群比一般人群有更高的发病率和死亡率,超重/肥胖相关疾病普遍存在。精神药物是导致体重显著增加的主要因素。青少年和年轻人,尤其是首次出现精神病症状并服用非典型抗精神病药物的人群,容易出现体重增加。本文报告了一项综合研究的结果,该研究调查了精神药物引起的体重增加的影响和治疗方法。我们对四个数据库进行了搜索,共得到 522 篇论文。从这些论文和手动搜索的论文中,系统地对 36 篇研究报告进行了分类和分析。综述结果显示,经历精神药物引起的体重增加的人认为这是令人痛苦的。它会影响生活质量,并导致治疗不依从。体重管理和预防策略主要针对已有/慢性疾病的成年人,而不是首次出现精神病症状和/或药物初治的人群。预防或管理体重增加的单一和多模式干预措施产生了相当的、适度的结果。本综述强调,体重管理干预措施的有效性尚不完全清楚,而且对于服用精神药物的年轻人预防体重增加的信息也很缺乏。未来的研究方向包括探索年轻人对精神药物相关体重增加的需求,以及预防精神药物相关体重增加的生活方式干预的长期随访研究。

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