Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Early Interv Psychiatry. 2019 Aug;13(4):902-907. doi: 10.1111/eip.12697. Epub 2018 Jun 11.
To investigate medication, rehospitalizations and mortality after first-episode hospital-treated psychosis.
A population-based nation-wide cohort (n = 2488) with a first hospitalization for psychosis at ages between 16 and 25 was identified. Cases were followed for up to 5 years after the first psychosis hospitalization with regard to mortality, hospitalizations and dispensations of antipsychotics and benzodiazepines.
The proportion of patients dispensing antipsychotics decreased from 80% year 1 after first discharge to 55% year 5. The proportion of patients having episodes of inpatient care also decreased year by year from 46% year 1 to 27% year 5. Of 863 cases with 5 years of observation time 41% had dispensations of antipsychotics every year; 21% had no dispensation of antipsychotics or hospitalization after the first year. The cumulative 5-year mortality was 3.9%. Cumulative suicide mortality was 2.4%. Incidence of suicide was highest in the first year. Male gender, benzodiazepines, recent hospital-discharge and self-harm were identified as risk factors for suicide.
The proportion of cases dispensing antipsychotics decreases year by year after first discharge. Mortality and rates of rehospitalization also decrease year by year from high levels the first year.
调查首发住院治疗精神病后的用药、再住院和死亡率。
本研究为基于人群的全国性队列研究（n=2488），纳入了年龄在 16-25 岁之间首次因精神病住院的患者。对这些病例进行了长达 5 年的随访，以观察其死亡率、住院情况和抗精神病药及苯二氮䓬类药物的配药情况。
首发出院后第 1 年，患者中开具抗精神病药物的比例从 80%下降到第 5 年的 55%。住院治疗的患者比例也逐年下降，从第 1 年的 46%下降到第 5 年的 27%。在 863 例具有 5 年观察时间的患者中，41%的患者每年都有抗精神病药物配药；21%的患者在第 1 年后没有抗精神病药物配药或住院。5 年累积死亡率为 3.9%。累积自杀死亡率为 2.4%。自杀的发生率在第 1 年最高。男性、苯二氮䓬类药物、近期出院和自残被确定为自杀的危险因素。
首发出院后，开具抗精神病药物的患者比例逐年下降。死亡率和再住院率也从第 1 年的高水平逐年下降。
Zotero 插件