双相障碍门诊的代谢综合征：系统躯体监测的必要性。
Metabolic Syndrome at an Outpatient Clinic for Bipolar Disorders: A Case for Systematic Somatic Monitoring.
机构信息
Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands (Simoons, Mulder); Interdisciplinary Centre for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands (Simoons, Schoevers, Ruhé); Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom (Ruhé); Outpatient Clinics and Department of Specialized Training, Psychiatric Hospital Mental Health Services Drenthe, Assen, the Netherlands (Mulder, Doornbos, Raats, Cath); Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen (Bruggeman); Unit of Pharmacotherapy, Epidemiology, and Economics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands, and Department of Clinical Pharmacy and Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands (van Roon).
出版信息
Psychiatr Serv. 2019 Feb 1;70(2):143-146. doi: 10.1176/appi.ps.201800121. Epub 2018 Dec 10.
OBJECTIVES
The primary objective of the study was to determine whether the Monitoring Outcomes of Psychiatric Pharmacotherapy (MOPHAR) program improved somatic monitoring practices at an outpatient clinic for bipolar disorders in the Netherlands. The secondary objective was to determine in MOPHAR the frequency of metabolic syndrome (compared with its measurability before MOPHAR) and treatment thereof.
METHODS
Frequencies of physical examinations and laboratory tests before (retrospectively) and after (prospectively) the active introduction of MOPHAR were compared among adult patients (N=155).
RESULTS
A median of three measurements (range 0-19) per patient were performed before MOPHAR, compared with 24 measurements (range 3-24) after MOPHAR (p<0.001). MOPHAR revealed somatic abnormalities previously unknown to treating physicians. Metabolic syndrome was present in 53% of patients; of these, 98% were not known to have metabolic syndrome before MOPHAR.
CONCLUSIONS
Introducing a monitoring program largely improved knowledge regarding metabolic abnormalities, which are frequently present among patients with bipolar disorder.
目的
本研究的主要目的是确定精神药理学监测结果（MOPHAR）计划是否提高了荷兰双相情感障碍门诊的躯体监测实践。次要目的是确定 MOPHAR 中代谢综合征的频率（与 MOPHAR 之前的可测量性相比）及其治疗情况。
方法
比较了在 MOPHAR 积极引入前后（前瞻性）成年患者（N=155）的体格检查和实验室检查频率。
结果
MOPHAR 前每位患者的中位数为 3 次测量（范围 0-19），MOPHAR 后为 24 次测量（范围 3-24）（p<0.001）。MOPHAR 揭示了治疗医生以前不知道的躯体异常。代谢综合征在 53%的患者中存在；其中，98%的患者在 MOPHAR 之前不知道自己有代谢综合征。
结论
引入监测计划大大提高了对经常存在于双相情感障碍患者中的代谢异常的认识。
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