Chang Chia-Ming, Wu Chi-Shin, Huang Ya-Wen, Chau Yeuk-Lun, Tsai Hui-Ju
From the *Department of Psychiatry, Chang Gung Memorial Hospital, Lin-Kou and Chang Gung University; †Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei; ‡Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City; §Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan; ∥Department of Public Health, China Medical University, Taichung, Taiwan; and ¶Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
J Clin Psychopharmacol. 2016 Feb;36(1):32-44. doi: 10.1097/JCP.0000000000000440.
The aim of the study was to examine utilization and patterns of psychopharmacological treatment during a 1-year follow-up period among patients with newly diagnosed bipolar disorder from 2001 to 2010.
Patients with newly diagnosed bipolar disorder from 2001 to 2010 were identified from the National Health Insurance Research Database in Taiwan. We assessed prescription records related to 4 kinds of psychopharmacological medication, including antipsychotics (APs), antidepressants, mood stabilizers, and benzodiazepines, as well as health care utilization in a 1-year follow-up period among the study subjects. In addition, logistic regressions were applied to test the trends for utilization of psychopharmacological treatment during the 10-year study period.
A total of 2703 patients newly diagnosed with bipolar disorder were enrolled. The ratio of good adherence, defined as medications possession ratio greater than 0.8, for use of the examined psychopharmacological medication was relatively low during the study period. The use of first-generation APs, selective serotonin reuptake inhibitors, tricyclic antidepressants, lithium, carbamazepine, and benzodiazepines has declined; however, the use of second-generation APs, serotonin and norepinephrine reuptake inhibitors, lamotrigine, and valproate has risen markedly during the 10-year period.
This study presents patterns of pharmacological treatment in patients with newly diagnosed bipolar disorder in Taiwan for a 10-year study period. It would be of importance to further investigate causes and outcomes for polytherapy and nonadherence to psychotropic medications among patients with bipolar disorder.
本研究旨在调查2001年至2010年新诊断双相情感障碍患者在1年随访期内精神药物治疗的使用情况及模式。
从台湾国民健康保险研究数据库中识别出2001年至2010年新诊断双相情感障碍的患者。我们评估了与4种精神药物相关的处方记录，包括抗精神病药（APs）、抗抑郁药、心境稳定剂和苯二氮䓬类药物，以及研究对象在1年随访期内的医疗保健利用情况。此外，应用逻辑回归分析来检验10年研究期内精神药物治疗使用情况的趋势。
共纳入2703例新诊断双相情感障碍患者。在研究期间，所检查精神药物的良好依从率（定义为药物持有率大于0.8）相对较低。第一代抗精神病药、选择性5-羟色胺再摄取抑制剂、三环类抗抑郁药、锂盐、卡马西平和苯二氮䓬类药物的使用有所下降；然而，在这10年期间，第二代抗精神病药、5-羟色胺和去甲肾上腺素再摄取抑制剂、拉莫三嗪和丙戊酸盐的使用显著增加。
本研究呈现了台湾新诊断双相情感障碍患者在10年研究期内的药物治疗模式。进一步调查双相情感障碍患者联合治疗及不依从精神药物治疗的原因和后果具有重要意义。
