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帕利哌酮长效注射剂治疗 6 个月时停药组的精神病理学特征。

The psychopathological characteristics of treatment discontinuation group in 6-month treatment with paliperidone ER.

机构信息

Division of Psychiatry, Department of medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

出版信息

Int J Clin Pract. 2012 Oct;66(10):969-75. doi: 10.1111/j.1742-1241.2012.03016.x.

Abstract

OBJECTIVE

To examine the demographic and psychopathological characteristics of the treatment discontinuation group compared with patients who completed with paliperidone ER treatment for 6 months.

METHODS

A total of 984 patients meeting the DSM-IV criteria for schizophrenia who switched their antipsychotics were recruited from 61 sites in five countries in Southeast Asia. The patients with early discontinuation were then compared with those who completed the 6-month treatment in terms of demographic and psychopathological variables at baseline and also at the end of the evaluation period, which included PANSS score, sleep quality, daytime drowsiness, PSP score, ESRS score and clinical global impression-severity (CGI-S) score. Finally, logistic regression analysis was applied to determine predictive factors that were associated with discontinuation.

RESULTS

Of 984 patients, 284 patients (28.9%) discontinued without completing the 6-month treatment period with paliperidone. Significant differences in patient baseline characteristics for the discontinuation group compared with the completion group were observed for gender, number of previous hospitalisations with psychosis, PANSS total score and all of its subscales, daytime drowsiness score, total ESRS score, CGI-S, PSP and Insight. Patients who completed the study period had significantly better scores in all psychopathology variables compared with the discontinuation group at the end of the evaluation period. Numbers of previous hospitalisations because of psychosis, being exposed with first generation antipsychotics, gender and PANSS total scores were found to be significant predictors of discontinuation.

CONCLUSION

Patients who discontinued early from a 6-month treatment period with Paliperidone have some characteristic differences compared with completion patients. Many factors including frequent hospitalisations, female gender, high PANSS score (indicating more disease severity) and previous exposure to first generation of antipsychotic agent might lead patients to discontinue from treatment.

摘要

目的

考察与完成帕利哌酮延长释放剂 6 个月治疗的患者相比,治疗中断组的人口统计学和精神病理学特征。

方法

共纳入 984 例符合 DSM-IV 精神分裂症标准的患者,他们在东南亚 5 个国家的 61 个地点更换了抗精神病药物。将早期停药的患者与完成 6 个月治疗的患者在基线和评估期末的人口统计学和精神病理学变量进行比较,评估指标包括 PANSS 评分、睡眠质量、白天嗜睡、 PSP 评分、ESRS 评分和临床总体印象严重程度(CGI-S)评分。最后,应用逻辑回归分析确定与停药相关的预测因素。

结果

在 984 例患者中,284 例(28.9%)患者在未完成帕利哌酮 6 个月治疗期的情况下停药。与完成组相比,停药组患者的基线特征存在显著差异,包括性别、因精神病住院次数、PANSS 总分及其各分量表、白天嗜睡评分、总 ESRS 评分、CGI-S、 PSP 和自知力。与停药组相比,完成研究期的患者在评估期末所有精神病理学变量的评分均显著改善。因精神病住院次数、第一代抗精神病药物暴露、性别和 PANSS 总分是停药的显著预测因素。

结论

与完成 6 个月帕利哌酮治疗的患者相比,早期停药的患者存在一些特征差异。许多因素,包括频繁住院、女性、高 PANSS 评分(表明疾病严重程度更高)和之前接触第一代抗精神病药物,可能导致患者停药。

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