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短期临床稳定性和自知力缺失与精神分裂症和双相情感障碍患者出院时对抗精神病药物治疗的消极态度相关。

Short-term clinical stability and lack of insight are associated with a negative attitude towards antipsychotic treatment at discharge in patients with schizophrenia and bipolar disorder.

作者信息

Medina Esteban, Salvà Joan, Ampudia Rubén, Maurino Jorge, Larumbe Juan

机构信息

AstraZeneca Medical Department, Madrid, Spain.

出版信息

Patient Prefer Adherence. 2012;6:623-9. doi: 10.2147/PPA.S34345. Epub 2012 Aug 29.

Abstract

PURPOSE

The primary aim of this study was to assess the range of attitudes towards antipsychotic treatment at hospital discharge in patients with schizophrenia and bipolar disorder. The secondary aim was to analyze the relationship between patients' attitudes and sociodemographic and clinical parameters.

PATIENTS AND METHODS

A cross-sectional study with a sample of patients admitted due to acute exacerbation of schizophrenia or a manic episode was conducted. Attitude towards pharmacological treatment at discharge was assessed with the 10-item Drug Attitude Inventory (DAI-10). Logistic regression was used to determine significant variables associated with attitude to medication.

RESULTS

Eighty-six patients were included in the study. The mean age was 43.1 years (standard deviation [SD] 12.1), and 55.8% were males. Twenty-six percent of the patients presented a negative attitude towards antipsychotic treatment (mean DAI-10 score of -4.7, SD 2.7). Most of them had a diagnosis of schizophrenia. Multivariate analysis showed that poor insight into illness and a greater number of previous acute episodes was significantly associated with a negative attitude towards medication at discharge (odds ratio 1.68 and 1.18, respectively).

CONCLUSION

Insight and clinical stability prior to admission were related to patients' attitude towards antipsychotic treatment at hospital discharge among patients with schizophrenia and bipolar disorder. The identification of factors related to the attitude towards medication would offer an improved opportunity for clinicians to select patients eligible for prophylactic adherence-focused interventions.

摘要

目的

本研究的主要目的是评估精神分裂症和双相情感障碍患者出院时对抗精神病药物治疗的态度范围。次要目的是分析患者态度与社会人口统计学和临床参数之间的关系。

患者与方法

对因精神分裂症急性加重或躁狂发作入院的患者样本进行了横断面研究。使用10项药物态度量表(DAI-10)评估出院时对药物治疗的态度。采用逻辑回归确定与药物态度相关的显著变量。

结果

86名患者纳入研究。平均年龄为43.1岁(标准差[SD]12.1),55.8%为男性。26%的患者对抗精神病药物治疗持消极态度(DAI-10平均得分为-4.7,SD 2.7)。他们大多数被诊断为精神分裂症。多变量分析显示,对疾病的洞察力差和既往急性发作次数较多与出院时对药物的消极态度显著相关(优势比分别为1.68和1.18)。

结论

在精神分裂症和双相情感障碍患者中,入院前的洞察力和临床稳定性与出院时患者对抗精神病药物治疗的态度有关。识别与药物态度相关的因素将为临床医生提供更好的机会,以选择适合以预防性依从性为重点干预措施的患者。

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