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最初使用苯二氮䓬类药物会延迟充分的药物治疗吗?一项针对精神病性和情感性障碍患者的多中心分析。

Does initial use of benzodiazepines delay an adequate pharmacological treatment? A multicentre analysis in patients with psychotic and affective disorders.

作者信息

Grancini Benedetta, De Carlo Vera, Palazzo Mariacarlotta, Vismara Matteo, Arici Chiara, Cremaschi Laura, Benatti Beatrice, Altamura A Carlo, Dell'Osso Bernardo

机构信息

Department of Psychiatry, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico.

Department of Health Sciences, CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.

出版信息

Int Clin Psychopharmacol. 2018 May;33(3):140-146. doi: 10.1097/YIC.0000000000000210.

DOI:10.1097/YIC.0000000000000210
PMID:29461302
Abstract

It is established that delayed effective pharmacotherapy plays a significant role in the overall burden of psychiatric disorders, which are often treated with symptomatic drugs, that is benzodiazepines (BZDs), in relation to their rapid onset of action and safety, despite long-term side effects. We aimed to assess the influence of initial treatment with BZDs on the duration of untreated illness (DUI) and whether specific sociodemographic and clinical factors could influence the choice of BZDs as first treatment in 545 patients affected by schizophrenia, mood and anxiety spectrum disorders. Statistical analyses (one-way analysis of variance and χ) were carried out to compare patients who used BZDs as first treatment (BZD w/) and those who did not (BZD w/o). The overall DUI, irrespective of diagnosis, resulted in significantly longer in BZD w/ versus w/o patients, who also experienced more frequently anxious/depressive symptoms at onset. Furthermore, BZD w/ patients more frequently autonomously decided to look for treatment (mainly refering to psychologists or general practitioners) and experimented more frequently phobias, than BZD w/o ones. The present findings suggest that initial BZDs treatment may prolong the overall DUI, although their prescription seems to be influenced by specific sociodemographic and clinical factors. Further studies are needed to confirm the present findings.

摘要

已确定延迟有效的药物治疗在精神疾病的总体负担中起着重要作用,精神疾病通常使用对症药物治疗,即苯二氮䓬类药物(BZDs),尽管存在长期副作用,但鉴于其起效迅速和安全性。我们旨在评估使用BZDs进行初始治疗对未治疗疾病持续时间(DUI)的影响,以及特定的社会人口统计学和临床因素是否会影响545例患有精神分裂症、心境和焦虑谱系障碍的患者将BZDs作为首选治疗药物的选择。进行了统计分析(单因素方差分析和χ检验),以比较将BZDs作为首选治疗药物的患者(使用BZDs组)和未使用BZDs的患者(未使用BZDs组)。总体DUI,无论诊断如何,使用BZDs组患者均显著长于未使用BZDs组患者,且使用BZDs组患者在发病时出现焦虑/抑郁症状的频率也更高。此外,与未使用BZDs组患者相比,使用BZDs组患者更频繁地自主决定寻求治疗(主要咨询心理学家或全科医生),且出现恐惧症的频率更高。目前的研究结果表明,初始使用BZDs治疗可能会延长总体DUI,尽管其处方似乎受到特定的社会人口统计学和临床因素的影响。需要进一步的研究来证实目前的研究结果。

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