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精神分裂症门诊患者对抗精神病药物的态度、自知力及精神病理学

Attitudes toward antipsychotic medication, insight and psychopathology in outpatients with schizophrenia.

作者信息

Vassileva Iglika V, Milanova Vihra K

机构信息

Department of Psychiatry, Medical University, Sofia, Bulgaria.

出版信息

Folia Med (Plovdiv). 2012 Oct-Dec;54(4):62-8. doi: 10.2478/v10153-012-0007-3.

Abstract

OBJECTIVE

Attitude toward antipsychotic medication is considered as one of the main predictors for medication adherence in schizophrenia. The present non-interventional cross-sectional study aims to explore the associations between attitudes toward antipsychotic medication, insight and other clinical variables in outpatients with schizophrenia.

METHOD

Attitudes toward antipsychotic medication, clinical and social variables, sociodemographic and illness-related characteristics were assessed via a set of semi-structured clinical interviews and self-rating scales in a total of 226 patients with schizophrenia on a long-term antipsychotic treatment in community based settings. The associations between attitudes toward medication and severity of psychopathology, insight and medication side effects were examined.

RESULTS

The greater hospitalization rate in the previous year was associated with more severe psychopathology at the time of the study, more pronounced side effects of the therapy and lack of insight. The lack of insight, the presence of more severe negative and depressive symptoms and disease duration less than 5 years correlated significantly with negative attitudes toward antipsychotic medication. The severity of medication side effects was not associated with the drug attitudes.

CONCLUSION

Psychoeducational and psychotherapeutical interventions, along with pharmacotherapy, can be beneficial in forming positive attitudes toward medication and improving medication adherence in schizophrenia, especially in patients with a short duration of the disease.

摘要

目的

对抗精神病药物的态度被认为是精神分裂症患者药物依从性的主要预测因素之一。本非干预性横断面研究旨在探讨精神分裂症门诊患者对抗精神病药物的态度、自知力及其他临床变量之间的关联。

方法

通过一系列半结构化临床访谈和自评量表,对总共226名在社区环境中接受长期抗精神病治疗的精神分裂症患者的抗精神病药物态度、临床和社会变量、社会人口学及疾病相关特征进行评估。研究抗精神病药物态度与精神病理学严重程度、自知力及药物副作用之间的关联。

结果

前一年较高的住院率与研究时更严重的精神病理学、更明显的治疗副作用及自知力缺乏相关。自知力缺乏、存在更严重的阴性和抑郁症状以及病程少于5年与对抗精神病药物的消极态度显著相关。药物副作用的严重程度与药物态度无关。

结论

心理教育和心理治疗干预,连同药物治疗,可能有助于形成对药物的积极态度并提高精神分裂症患者的药物依从性,尤其是病程较短的患者。

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