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[莱比锡大学神经精神病医院抗精神病药物的引入及其对其他治疗形式、住院时间和转院的影响]

[The introduction of antipsychotics in the neurological psychiatric hospital of the University of Leipzig and their effects on other forms of therapy, the length of stay and transferrals].

作者信息

Oeser Christian, Steinberg Holger

机构信息

Forschungsstelle für die Geschichte der Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Semmelweisstr. 10, 04103, Leipzig, Deutschland.

Klinik für Psychiatrie und Psychotherapie im Fachkrankenhaus Hubertusburg, Wermsdorf, Deutschland.

出版信息

Nervenarzt. 2021 Jan;92(1):69-80. doi: 10.1007/s00115-020-00931-y.

Abstract

AIM

The impacts of the introduction of antipsychotics on psychiatric care in a clinic were investigated for the first time, specifically in the Neurological and Psychiatric Clinic of the University of Leipzig from 1946 to 1965.

RESEARCH QUESTIONS

When and which antipsychotics were first used, to what extent and how did this affect the use of traditional forms of therapy?

MATERIAL AND METHODS

According to psychopathological criteria, 306 cases were selected from the database of patient records from the hospital archive and systematically reviewed with respect to the research question.

RESULTS

The use of antipsychotics began in 1953 and subsequently with increasing frequency and duration. Traditional therapies and antipsychotics were frequently used in combination. In particular, the use of antipsychotics and electroconvulsive therapy represented the new basic therapy. A decrease in the length of hospitalization could not be demonstrated. From 1955, however, fewer transfers to the provincial hospitals were necessary and more patients could be discharged into domestic life as "improved". Beginning in 1961, for the first time a discharge medication was mentioned and evidence of outpatient therapies including electric shock therapies were recorded.

CONCLUSION

Evidence of facilitation of mental rehabilitation through the use of antipsychotics cannot be directly confirmed; however, it appears that the administration beyond a time-limited treatment has contributed to this development and also to the establishment of outpatient facilities. Thus, both a watershed in the psychiatric treatment and a change for the patients themselves could be identified.

摘要

目的

首次调查了抗精神病药物的引入对一家诊所精神科护理的影响,具体是对1946年至1965年莱比锡大学神经精神病诊所的影响。

研究问题

何时首次使用了哪种抗精神病药物,这在多大程度上以及如何影响了传统治疗方式的使用?

材料与方法

根据精神病理学标准,从医院档案中的患者记录数据库中选取306例病例,并针对研究问题进行系统回顾。

结果

抗精神病药物的使用始于1953年,随后使用频率和持续时间不断增加。传统疗法和抗精神病药物经常联合使用。特别是,抗精神病药物和电休克疗法成为了新的基础疗法。住院时间并未缩短。然而,从1955年起,转往省级医院的患者减少,更多患者能够以“病情好转”的状态出院回归家庭生活。从1961年开始,首次提及出院用药,并记录了包括电击疗法在内的门诊治疗证据。

结论

无法直接证实使用抗精神病药物有助于精神康复;然而,似乎超出限时治疗的用药对这一发展以及门诊设施的建立都有贡献。因此,可以确定这既是精神科治疗的一个分水岭,也是患者自身的一个转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e072/8642364/f255c4e6f262/115_2020_931_Fig4_HTML.jpg

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