严重精神疾病患者中抗精神病药物与脑血管疾病的关系
Relationship Between Antipsychotic Medications and Cerebrovascular Disease in Patients With Serious Mental Illness.
作者信息
Berrocal-Izquierdo Nuria, Bioque Miquel, Bernardo Miguel
机构信息
BERROCAL-IZQUIERDO: Department of Neurology, Parc Sanitari Sant Joan de Dèu, Sant Boi de Llobregat, Barcelona, Spain BERNARDO: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Center for Biomedical Research in Mental Health (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Barcelona, Spain BIOQUE: Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Center for Biomedical Research in Mental Health (CIBERSAM), Barcelona, Spain.
出版信息
J Psychiatr Pract. 2018 Mar;24(2):72-78. doi: 10.1097/PRA.0000000000000290.
INTRODUCTION AND OBJECTIVES
Cerebrovascular disease (CVD), especially in its asymptomatic forms, is relatively common in patients with serious mental illness (SMI). Nevertheless, the literature on this topic is scarce and sometimes contradictory. Antipsychotic medications, especially atypical agents, play an important role in the overall cardiovascular health of these patients. The goal of this study was to analyze the frequency of CVD in patients with and without SMI.
PATIENTS AND METHODS
This retrospective cohort study compared the frequency of CVD, including silent forms, in a group of patients without mental illness and without a history of taking antipsychotic medication, with another group of patients diagnosed with SMI who had received antipsychotic treatment. The 2 groups were matched for age and sex, and the mean age of the subjects in the 2 groups was 63 years.
RESULTS
The frequency of CVD was the same in both groups and it was not modified by the use of antipsychotic medications. A nonsignificant trend toward an association between CVD and prolonged use of antipsychotic polypharmacy was found.
CONCLUSIONS
In this study, in contrast to previous reports, use of antipsychotic medications and the presence of SMI were not associated with an increased risk of CVD.
引言与目的
脑血管疾病（CVD），尤其是无症状形式的脑血管疾病，在严重精神疾病（SMI）患者中相对常见。然而，关于这一主题的文献较少，且有时相互矛盾。抗精神病药物，尤其是非典型药物，在这些患者的整体心血管健康中起着重要作用。本研究的目的是分析有和没有SMI的患者中CVD的发生率。
患者与方法
这项回顾性队列研究比较了一组无精神疾病且无服用抗精神病药物史的患者与另一组诊断为SMI并接受抗精神病治疗的患者中CVD（包括无症状形式）的发生率。两组在年龄和性别上相匹配，两组受试者的平均年龄均为63岁。
结果
两组中CVD的发生率相同，且未因使用抗精神病药物而改变。发现CVD与长期联合使用多种抗精神病药物之间存在无统计学意义的关联趋势。
结论
在本研究中，与先前的报告相反，使用抗精神病药物和存在SMI与CVD风险增加无关。
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