Nagai Nobuhiro, Tani Hideaki, Yoshida Kazunari, Gerretsen Philip, Suzuki Takefumi, Ikai-Tani Saeko, Mimura Masaru, Uchida Hiroyuki
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Department of Psychiatry, Minami-Hanno Hospital, Saitama, Japan.
Neuropsychiatr Dis Treat. 2020 Mar 23;16:781-787. doi: 10.2147/NDT.S240377. eCollection 2020.
While patients' perspectives toward pharmacotherapy are expected to be directly influenced by their motivation and understanding of the treatment that they are currently receiving, no study has comprehensively investigated the impact of insight into illness and knowledge for the ongoing pharmacotherapy on the attitude towards drug treatment among patients with schizophrenia.
One hundred forty-eight Japanese outpatients diagnosed with schizophrenia, according to the International Classification of Diseases 10th edition, were included (mean±SD age, 47.3±12.4 years; 90 men (60.8%)). Attitudes toward antipsychotic treatment and insight into illness were assessed with the Drug Attitude Inventory-10 (DAI-10) and the VAGUS, respectively. In addition, a multiple-choice questionnaire that was designed to examine patients' knowledge about therapeutic effects, types, and implicated neurotransmitters of antipsychotic drugs they were receiving was utilized.
The mean±SD of DAI-10 score was 4.7±4.2. The multiple regression analysis found that lower Positive and Negative Syndrome Scale (PANSS) scores, higher VAGUS scores, and longer illness duration were significantly associated with higher DAI-10 scores (β=-0.226, =0.009; β=0.250, =0.008; β=0.203, =0.034, respectively). There was a significant difference in the DAI-10 scores between the subjects who gave more accurate answers regarding the effects of their primary antipsychotic and those who did not (mean±SD, 5.57±4.38 vs 4.13±4.04, =0.043); however, this finding failed to survive the multiple regression analysis.
Better insight into illness and treatment, lower illness severity, longer illness duration, and possibly greater knowledge about the therapeutic effects of medications may lead to better attitudes towards pharmacotherapy among patients with schizophrenia, which has an important implication for this typically chronic mental condition requiring long-term antipsychotic treatment to sustain stability.
虽然患者对药物治疗的看法预计会直接受到其动机以及对当前所接受治疗的理解的影响,但尚无研究全面调查对疾病的洞察力和对正在进行的药物治疗的了解对精神分裂症患者药物治疗态度的影响。
纳入了148名根据《国际疾病分类》第10版诊断为精神分裂症的日本门诊患者(平均±标准差年龄,47.3±12.4岁;90名男性(60.8%))。分别使用药物态度量表-10(DAI-10)和迷走神经量表评估对抗精神病药物治疗的态度和对疾病的洞察力。此外,还使用了一份多项选择题问卷,旨在检查患者对他们正在服用的抗精神病药物的治疗效果、类型和相关神经递质的了解情况。
DAI-10评分的平均值±标准差为4.7±4.2。多元回归分析发现,较低的阳性和阴性症状量表(PANSS)评分、较高的迷走神经量表评分和较长的病程与较高的DAI-10评分显著相关(β分别为=-0.226,=0.009;β=0.250,=0.008;β=0.203,=0.034)。对于主要抗精神病药物的效果给出更准确答案的受试者与未给出更准确答案的受试者之间,DAI-10评分存在显著差异(平均值±标准差,5.57±4.38对4.13±4.04,=0.043);然而,这一发现未能在多元回归分析中得到验证。
对疾病和治疗有更好的洞察力、较低的疾病严重程度、较长的病程以及可能对药物治疗效果有更多的了解,可能会使精神分裂症患者对药物治疗有更好的态度,这对于这种通常需要长期抗精神病药物治疗以维持稳定的慢性精神疾病具有重要意义。