提高精神分裂症患者的依从性、主观幸福感和生活质量：长效利培酮起何种作用？
Enhancing adherence, subjective well-being and quality of life in patients with schizophrenia: which role for long-acting risperidone?
作者信息
Niolu Cinzia, Bianciardi Emanuela, Di Lorenzo Giorgio, Marchetta Claudia, Barone Ylenia, Sterbini Nicoletta, Ribolsi Michele, Reggiardo Giorgio, Siracusano Alberto
机构信息
Chair of Psychiatry, Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy Psychiatric Clinic, Fondazione Policlinico 'Tor Vergata', Rome, Italy.
Chair of Psychiatry, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Nomentana 1362, 00137 Rome, Italy.
出版信息
Ther Adv Psychopharmacol. 2015 Oct;5(5):278-88. doi: 10.1177/2045125315596897.
AIM
This study evaluated adherence to treatment, quality of life and subjective well-being in patients with psychosis treated with long-acting injectable risperidone. Subjects enrolled were part of a larger study where patients were observed in an adherence to treatment program of the University of Rome Tor Vergata.
MATERIALS AND METHODS
A total of 27 nonadherent patients (21 men, six women; mean age: 36.1 years; range: 23-63 years) were enrolled. Maximum observational period was 30 months.
RESULTS
A total of 12 patients were under treatment for 30 months (44.44%) but only nine had a valid 30-month follow up, while the remaining three patients initially treated at our unit continued long-acting risperidone at their local centre. Reductions of monthly mean values of Scale for the Assessment of Positive Symptoms (SAPS) [repeated measures analysis of variance (rm-ANOVA): p < 0.0001] and Scale for Assessment of Negative Symptoms (SANS) (p < 0.0001), increase of monthly mean values of Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) (p < 0.0001) and Schizophrenia Quality of Life Scale (S-QoL) (p < 0.01) were observed. Significant differences with respect to SAPS baseline values from the sixth month, SANS baseline values from the seventh month, SWN baseline values from the eighth month, S-QoL baseline values from the eighteenth month were shown in post hoc tests. Reduction of SAPS mean values was associated with increase of SWN (p < 0.0001) and S-QoL (p < 0.0001) mean values as demonstrated by correlation analysis. The same inverse correlation was found between reduction of SANS mean values and increases of SWN (p < 0.0001) and S-QoL (p = 0.0001) mean values.
CONCLUSIONS
Long-term treatment with long-acting risperidone may be associated with improvement to adherence to therapy and quality of life. Patients may show improvement in psychopathological symptoms, subjective well-being and quality of life.
目的
本研究评估了接受长效利培酮治疗的精神病患者的治疗依从性、生活质量和主观幸福感。纳入的受试者是一项更大规模研究的一部分，在该研究中，患者在罗马第二大学的治疗依从性项目中接受观察。
材料与方法
共纳入27例治疗依从性差的患者（21例男性，6例女性；平均年龄：36.1岁；范围：23 - 63岁）。最长观察期为30个月。
结果
共有12例患者接受了30个月的治疗（44.44%），但只有9例有有效的30个月随访，其余3例最初在我们科室接受治疗的患者在当地中心继续使用长效利培酮。阳性症状评定量表（SAPS）月均值降低[重复测量方差分析（rm - ANOVA）：p < 0.0001]，阴性症状评定量表（SANS）月均值降低（p < 0.0001），抗精神病药物治疗下主观幸福感量表（SWN）月均值升高（p < 0.0001），精神分裂症生活质量量表（S - QoL）月均值升高（p < 0.01）。事后检验显示，从第6个月起SAPS基线值、第7个月起SANS基线值、第8个月起SWN基线值、第18个月起S - QoL基线值存在显著差异。相关性分析表明，SAPS均值降低与SWN（p < 0.0001）和S - QoL（p < 0.0001）均值升高相关。SANS均值降低与SWN（p < 0.0001）和S - QoL（p = 0.0001）均值升高之间也发现了相同的负相关。
结论
长效利培酮长期治疗可能与治疗依从性和生活质量的改善有关。患者的精神病理症状、主观幸福感和生活质量可能会有所改善。
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