Stanković Zana, Ille Tatjana
Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia.
Vojnosanit Pregl. 2013 Mar;70(3):267-73. doi: 10.2298/vsp1303267s.
BACKGROUND/AIM: There is a high rate of schizophrenic patients who do not adhere to their prescribed therapy, despite the implementation of antipsychotic long-acting injections and the introduction of atypical antipsychotics. The aim of this study was to investigate the differences in sociodemographic, clinical and medication adherence variables between the two groups of schizophrenic patients on maintenance therapy with depot antipsychotic fluphenazine decanoate and oral antipsychotics only as well as a correlation between the medication adherence and other examined variables.
A total of 56 patients of both genders, aged < 60 years, with the diagnosis of schizophrenia (F20) (ICD-10, 1992) clinically stable for at least 6 months were introduced in this cross-sectional study. The patients from the depot group (n = 19) were on classical depot antipsychotic fluphenazine decanoate administering intramuscularly every 4 weeks (with or without oral antipsychotic augmentation) and the patients from the oral group (n = 37) were on oral therapy alone with classical or atypical antipsychotics, either as monotherapy or combined. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity. Item G12 of the PANSS was used to assess insight into the illness. The patients completed the Medical Adherence Rating Scale (MARS) was used to assess adherence to the therapy. A higher MARS score indicates behavior [Medical Adherence Questionnaire (MAQ subscale)] and attitudes toward medication [Drug Attitude Inventory (DAI subscale)] that are more consistent with treatment adherence. The exclusion criteria were determined. The Pearson's chi2 test was used to compare categorical variables, Student's t-test to compare continuous variables and Pearson's correlation to test the correlation significance; p = 0.05.
Significant between-group differences in age, illness duration, chlorpromazine equivalents, PANSS score and DAI subscore were found. Item G12 of the PANSS subscore and MARS score correlated significantly negatively. A significant positive correlation between receiving depot antipsychotic and DAI subscore as well as between illness duration and both DAI subscore and MARS score were also found.
Schizophrenic patients on classical depot antipsychotic maintenance therapy might present subpopulation of patients with significantly longer illness duration, more favorable medication attitude and outcome in relation to those on oral antipsychotics alone.
背景/目的：尽管实施了抗精神病长效注射剂并引入了非典型抗精神病药物，但仍有很高比例的精神分裂症患者不坚持规定的治疗。本研究的目的是调查两组接受长效抗精神病药物氟奋乃静癸酸酯维持治疗的精神分裂症患者与仅接受口服抗精神病药物治疗的患者在社会人口统计学、临床和药物依从性变量方面的差异，以及药物依从性与其他检查变量之间的相关性。
本横断面研究纳入了总共56名年龄小于60岁、诊断为精神分裂症（F20）（ICD - 10，1992）且临床稳定至少6个月的男女患者。长效注射组（n = 19）的患者每4周接受一次经典长效抗精神病药物氟奋乃静癸酸酯肌肉注射（有或没有口服抗精神病药物增效），口服组（n = 37）的患者仅接受经典或非典型抗精神病药物的口服治疗，可采用单一疗法或联合疗法。使用阳性和阴性症状量表（PANSS）评估症状严重程度。PANSS的项目G12用于评估对疾病的洞察力。患者完成了药物依从性评定量表（MARS）以评估对治疗的依从性。MARS得分越高表明行为[药物依从性问卷（MAQ子量表）]和对药物的态度[药物态度量表（DAI子量表）]与治疗依从性更一致。确定了排除标准。采用Pearson卡方检验比较分类变量，采用学生t检验比较连续变量，并采用Pearson相关性检验相关性的显著性；p = 0.05。
发现两组在年龄、病程、氯丙嗪等效剂量、PANSS评分和DAI子评分方面存在显著差异。PANSS子评分的项目G12与MARS评分呈显著负相关。还发现接受长效抗精神病药物治疗与DAI子评分之间以及病程与DAI子评分和MARS评分之间存在显著正相关。
与仅接受口服抗精神病药物治疗的患者相比，接受经典长效抗精神病药物维持治疗的精神分裂症患者可能是病程明显更长、药物态度更积极且预后更好的亚组患者。
