Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Asia Pac Psychiatry. 2017 Dec;9(4). doi: 10.1111/appy.12277. Epub 2017 Feb 20.
To date no study has compared the treatment patterns for schizophrenia specifically between China and Japan. This study examined the cross-national differences in the use of psychotropic drugs and electroconvulsive therapy (ECT) in schizophrenia.
Data on 3248 schizophrenia inpatients (n = 1524 in China and n = 1724 in Japan) were collected by either chart review or interviews during the designated 3 study periods between 2001 and 2009. Patients' socio-demographic and clinical characteristics, prescriptions of psychotropic drugs, and ECT use were recorded using a standardized protocol and data collection procedure.
Multivariate analyses revealed that compared to their Japanese counterparts, Chinese inpatients had a shorter length of current hospitalization, were significantly less frequently prescribed second-generation antipsychotics (except clozapine), antipsychotic polypharmacy, benzodiazepines, and mood stabilizers, and more likely to receive clozapine, antidepressants, and ECT.
Substantial variations in inpatient treatment patterns for schizophrenia were found between China and Japan. The common use of ECT and clozapine in Chinese inpatients and the frequent use of antipsychotic polypharmacy and high antipsychotic doses in Japanese inpatients need to be addressed.
迄今为止,尚无研究比较中国和日本特有的精神分裂症治疗模式。本研究考察了精神分裂症中美金刚和电抽搐治疗(ECT)在两国的使用差异。
本研究通过图表审查或访谈,在 2001 年至 2009 年的 3 个指定研究期间,共收集了 3248 名精神分裂症住院患者的数据(中国 1524 例,日本 1724 例)。使用标准化协议和数据收集程序记录患者的社会人口统计学和临床特征、精神药物处方和 ECT 使用情况。
多变量分析显示,与日本患者相比,中国患者的当前住院时间较短,第二代抗精神病药物(氯氮平除外)、抗精神病药物联合治疗、苯二氮䓬类药物和心境稳定剂的处方频率显著较低,而氯氮平、抗抑郁药和 ECT 的使用频率较高。
中国和日本的精神分裂症住院治疗模式存在显著差异。中国患者普遍使用 ECT 和氯氮平,日本患者则经常使用抗精神病药物联合治疗和高剂量抗精神病药物,这些情况需要加以关注。