Karthik M S, Warikoo Nisha, Chakrabarti Subho, Grover Sandeep, Kulhara Parmanand
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychol Med. 2014 Jul;36(3):288-93. doi: 10.4103/0253-7176.135382.
Given the paucity of research in this area, this study attempted to assess attitudes toward antipsychotic medications and its correlates among patients with schizophrenia, either on first-generation antipsychotics (FGAs) or second-generation antipsychotics (SGAs) medications.
Structured assessments of attitudes to antipsychotics, psychopathology, insight and side-effects were carried out in 120 patients with DSM-IV schizophrenia; 89 of these were on SGAs and 31 on FGAs.
Patients had predominantly positive attitudes toward antipsychotics. Severity of side-effects was the principal correlate of attitudes, explaining 19.5% of the variance, followed by greater insight (4.2% of the variance). Other factors such as younger age, male gender, employment, higher family income, urban residence and lower symptom-severity explained only a negligible proportion of the variance (0.2%) in attitudes. Patients on SGAs had more positive views of their medications than those on FGAs. They felt more normal on their medications, believed that their thoughts were clearer on medications, felt that good things about their medications outweighed the bad and believed that their medications helped them from falling ill again. In addition, they did not feel as tired and sluggish on their medications and did not believe that medications were unnatural or controlled their bodies.
Positive attitudes toward antipsychotics were common among patients with schizophrenia. Attitudes were principally determined by severity of side-effects and insight levels. Patients on SGAs had better attitudes, possibly because of less severe side-effects and greater insight among them. The importance of exploring patients' attitudes toward their antipsychotics is highlighted by this study.
鉴于该领域研究匮乏,本研究试图评估精神分裂症患者对第一代抗精神病药物(FGAs)或第二代抗精神病药物(SGAs)的态度及其相关因素。
对120例符合DSM-IV精神分裂症诊断标准的患者进行了关于抗精神病药物态度、精神病理学、自知力和副作用的结构化评估;其中89例使用SGAs,31例使用FGAs。
患者对抗精神病药物大多持积极态度。副作用严重程度是态度的主要相关因素,解释了19.5%的变异,其次是自知力增强(解释4.2%的变异)。其他因素如年龄较小、男性、就业、家庭收入较高、居住在城市以及症状严重程度较低,仅解释了态度变异中可忽略不计的比例(0.2%)。使用SGAs的患者对其药物的看法比使用FGAs的患者更积极。他们服药后感觉更正常,认为服药后思维更清晰,觉得药物的好处大于坏处,并且相信药物能帮助他们避免再次生病。此外,他们服药后不会感到那么疲惫和慵懒,也不认为药物不自然或能控制他们的身体。
精神分裂症患者对抗精神病药物普遍持积极态度。态度主要由副作用严重程度和自知力水平决定。使用SGAs的患者态度更好,可能是因为副作用较轻且自知力更强。本研究强调了探索患者对抗精神病药物态度的重要性。