中国社区精神分裂症患者的精神药物治疗模式：城乡比较。
Psychotropic medication treatment patterns in community-dwelling schizophrenia in China: comparisons between rural and urban areas.
机构信息
Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 7/F, No.123, Huifuxi Road, Guangzhou, Guangdong Province, China.
The Third People's Hospital of Luoding, Luoding, Guangdong Province, China.
出版信息
BMC Psychiatry. 2019 Aug 5;19(1):242. doi: 10.1186/s12888-019-2217-1.
BACKGROUND
To date no study has compared more specifically the psychotropic medication treatment patterns for patients with schizophrenia living in community between rural and urban areas. This study examined the rural-urban differences of the use of psychotropic drugs among community-dwelling individuals with schizophrenia in China.
METHOD
Data on 993 community-dwelling patients with schizophrenia (n = 479 in rural area and n = 514 urban area) were collected by interviews during 2013-2014, and 2015-2016 according to the diagnosis of DSM-IV or ICD-10. Data on patients' socio-demographic and clinical characteristics, prescriptions of psychotropic drugs were collected using a standardized protocol and data acquisition procedure.
RESULTS
Multivariate analyses revealed that in comparison with the rural counterparts, the patients from the urban area were significantly more frequently prescribed antipsychotic polypharmacy, clozapine, and benzodiazepines, but the patients from the rural area had more frequently prescribed anticholinergics.
CONCLUSIONS
Substantial variations in psychotropic medication treatment patterns for patients with schizophrenia living in community were found between rural and urban areas in China. Common use of antipsychotic polypharmacy, clozapine and benzodiazepines in urban area, and anticholinergics in rural area need to be further addressed.
背景
迄今为止，尚无研究专门比较农村和城市社区中精神分裂症患者的精神药物治疗模式。本研究考察了中国农村和城市社区精神分裂症患者使用精神药物的城乡差异。
方法
2013-2014 年和 2015-2016 年，根据 DSM-IV 或 ICD-10 诊断，通过访谈收集了 993 名居住在社区的精神分裂症患者（农村地区 479 例，城市地区 514 例）的数据。使用标准化方案和数据采集程序收集了患者的社会人口统计学和临床特征以及精神药物处方数据。
结果
多变量分析显示，与农村患者相比，城市患者更常被开抗精神病药联合用药、氯氮平、苯二氮䓬类药物，但农村患者更常被开抗胆碱能药物。
结论
在中国，农村和城市社区中居住的精神分裂症患者的精神药物治疗模式存在显著差异。需要进一步解决城市地区普遍使用抗精神病药联合用药、氯氮平和苯二氮䓬类药物以及农村地区使用抗胆碱能药物的问题。
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