Department of Psychiatry, Berkshire Medical Center, Pittsfield, MA, USA.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Community Ment Health J. 2019 Jul;55(5):750-754. doi: 10.1007/s10597-019-00381-0. Epub 2019 Feb 25.
Antipsychotic polypharmacy (APP) is a common practice while treating severe mental illness but the benefits of APP over antipsychotic monotherapy is controversial. This is a retrospective analysis comparing risk factors for people on APP and those on non-APP in inpatient psychiatry units. Two years data with 72 people in non-APP group and 82 people in APP group were analyzed quantitatively. The diagnoses of schizoaffective disorder (OR 11.5), schizophrenia (OR 4.65) and depression (OR 0.31), and history of > 2 psychiatric admissions (OR 3.2) and > 2 psychiatric emergency visits (OR 2.87) in 2 years were studied as potential risk factors for APP. Similarly, history of violence (OR 1.7) and history of substance abuse (OR 0.51) were also studied. Schizophrenia spectrum disorder, higher number of psychiatric hospitalizations, and psychiatric emergency visits were positively associated while depression and substance abuse were negatively associated with APP in our study.
抗精神病药联合用药(APP)在治疗严重精神疾病时很常见,但 APP 相对于抗精神病药单药治疗的益处存在争议。这是一项回顾性分析,比较了住院精神病学单元中使用 APP 和不使用 APP 的患者的风险因素。对 72 名非 APP 组和 82 名 APP 组患者的两年数据进行了定量分析。研究了精神分裂症谱系障碍(OR 11.5)、精神分裂症(OR 4.65)和抑郁症(OR 0.31)、2 年内>2 次精神科住院(OR 3.2)和>2 次精神科急诊(OR 2.87)作为 APP 的潜在风险因素。同样,也研究了暴力史(OR 1.7)和物质滥用史(OR 0.51)。在我们的研究中,精神分裂症谱系障碍、更多的精神科住院次数和精神科急诊次数与 APP 呈正相关,而抑郁和物质滥用与 APP 呈负相关。