Department of Neuropsychiatry, Kawasaki Municipal Hospital, Kanagawa, Japan.
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Acta Psychiatr Scand. 2020 Sep;142(3):242-248. doi: 10.1111/acps.13217. Epub 2020 Aug 2.
Synthetic glucocorticoids cause various psychiatric symptoms. Prescription of psychotropic drugs could be considered to be a proxy for manifestation of psychiatric symptoms. The aim of this study was to investigate the prescriptions of psychotropics in outpatients receiving synthetic glucocorticoids.
We used the claims sampling data during January 2015 from the National Database of Health Insurance Claims and Specific Health Checkups of Japan made by the Ministry of Health, Labor, and Welfare in Japan. We compared the prescription rates of psychotropics between outpatients receiving oral synthetic glucocorticoids and age- and sex-matched controls and the prescription rates of psychotropics among the eight dosage groups of synthetic glucocorticoids by chi-squared test, and chlorpromazine/imipramine/diazepam equivalent doses (or daily defined doses) of respective psychotropics among these groups using Welch's t-test.
Synthetic glucocorticoids were prescribed to 3.1% (n = 18 122) of 581 990 patients. The prescription rates of psychotropics were significantly higher among the synthetic glucocorticoid recipients than among the non-recipients: antipsychotics, 1.8% (n = 321) vs. 1.1% (n = 201) (P = 1.4 × 10 ); antidepressants, 4.0% (n = 724) vs. 2.0% (n = 359) (P = 8.7 × 10 ); anxiolytics/hypnotics, 16.7% (n = 3029) vs. 10.2% (n = 1841) (P = 2.7 × 10 ); and mood stabilizers, 1.3% (n = 238) vs. 0.7% (n = 120) (P = 3.6 × 10 ) respectively. There was no significant difference in the prescription rates of any psychotropic drugs, other than anxiolytics/hypnotics, among the eight synthetic glucocorticoid dosage groups.
Prescriptions of oral synthetic glucocorticoids were found to be associated with the use of any of the types of psychotropic drugs, other than anxiolytics/hypnotics, although a causal relationship could not be confirmed due to the retrospective and cross-sectional nature of this study.
合成糖皮质激素可引起各种精神症状。精神药物的处方可被视为精神症状表现的一个指标。本研究旨在调查接受合成糖皮质激素治疗的门诊患者的精神药物处方情况。
我们使用了日本厚生劳动省在 2015 年 1 月从国民健康保险索赔和特定健康检查的全国数据库中抽取的数据。我们通过卡方检验比较了接受口服合成糖皮质激素治疗的门诊患者与年龄和性别匹配的对照组之间精神药物的处方率，并使用 Welch 的 t 检验比较了这 8 个合成糖皮质激素剂量组中精神药物的氯丙嗪/丙咪嗪/地西泮等效剂量（或每日规定剂量）。
在 581990 名患者中，有 3.1%（n=18122）接受了合成糖皮质激素治疗。与未接受治疗的患者相比，接受合成糖皮质激素治疗的患者的精神药物处方率显著更高：抗精神病药，1.8%（n=321）vs. 1.1%（n=201）（P=1.4×10）；抗抑郁药，4.0%（n=724）vs. 2.0%（n=359）（P=8.7×10）；抗焦虑药/催眠药，16.7%（n=3029）vs. 10.2%（n=1841）（P=2.7×10）；心境稳定剂，1.3%（n=238）vs. 0.7%（n=120）（P=3.6×10）。在 8 个合成糖皮质激素剂量组中，除了抗焦虑药/催眠药之外，其他任何精神药物的处方率均无显著差异。
尽管由于本研究的回顾性和横断面性质，无法确认因果关系，但我们发现口服合成糖皮质激素的处方与除抗焦虑药/催眠药以外的任何类型精神药物的使用有关。
