一项关于英国法医服务中氯氮平治疗的主观体验、效果和总体满意度的评估。
An evaluation of subjective experiences, effects and overall satisfaction with clozapine treatment in a UK forensic service.
机构信息
Ashworth Hospital, Mersey Care NHS Trust, Liverpool, UK.
Ashworth Hospital, Mersey Care NHS Trust, Parkbourn, Liverpool, Merseyside L31 1HW, UK.
出版信息
Ther Adv Psychopharmacol. 2015 Jun;5(3):146-50. doi: 10.1177/2045125315581996.
OBJECTIVES
Patients prescribed clozapine were surveyed to assess (a) the effects, both positive and adverse, and overall satisfaction with clozapine in comparison to previously prescribed antipsychotics and (b) the relative significance of effects experienced, both positive and adverse, in terms of impact on subjective well-being.
METHODS
A total of 56 male patients prescribed clozapine at a forensic psychiatric hospital were surveyed using a 27-item questionnaire. All patients had been prescribed clozapine for a minimum of 3 months. Respondents were asked to rate effects and satisfaction with clozapine treatment in comparison with previously prescribed antipsychotic medication on a five-point scale. Respondents were also asked to rate effects experienced with clozapine treatment in terms of impact on subjective well-being on a five-point scale.
RESULTS
A total of 89% of respondents reported greater satisfaction with clozapine than with previously prescribed antipsychotic medication. A majority of patients reported positive effects in terms of an improvement in their quality of life (68%) and social abilities (52%) with clozapine in comparison with previously prescribed antipsychotics. Nocturnal hypersalivation (84%) and weight gain (57%) were the most common adverse effects. Hedonic responses were assessed for each effect in order to determine the associated subjective experiences. The most positive hedonic responses were for quality of life, mood and alertness. In terms of adverse impact on subjective well-being, nocturnal hypersalivation ranked highest.
CONCLUSIONS
Patients in a UK forensic sample are largely satisfied with clozapine treatment. The subjective effects of clozapine treatment should be taken into account by clinicians when assessing response. This may provide an opportunity to highlight the positive changes and prioritize management of the most undesirable adverse effects, which is likely to promote compliance and improve longer term treatment outcomes.
目的
调查服用氯氮平的患者，评估（a）与之前开的抗精神病药相比，氯氮平的积极和消极影响以及总体满意度，以及（b）积极和消极影响在多大程度上影响主观幸福感。
方法
对一家法医精神病院开氯氮平的 56 名男性患者进行了一项 27 项问卷调查。所有患者至少开氯氮平 3 个月。受访者被要求在五分制上对氯氮平治疗的效果和满意度与之前开的抗精神病药物进行评分。受访者还被要求在五分制上对氯氮平治疗的影响进行评分，以评估对主观幸福感的影响。
结果
89%的受访者表示，与之前开的抗精神病药物相比，他们对氯氮平更满意。大多数患者报告说，与之前开的抗精神病药物相比，他们的生活质量（68%）和社会能力（52%）有了改善，氯氮平有积极影响。夜间唾液分泌过多（84%）和体重增加（57%）是最常见的不良反应。为了确定相关的主观体验，对每种影响进行了享乐反应评估。对生活质量、情绪和警觉性的享乐反应最为积极。就对主观幸福感的不良影响而言，夜间唾液分泌过多排名最高。
结论
英国法医样本中的患者对氯氮平治疗基本满意。当评估反应时，临床医生应考虑氯氮平治疗的主观影响。这可能为突出积极变化并优先管理最不理想的不良反应提供机会，这可能会提高依从性并改善长期治疗结果。
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