Department of Psychiatry, Dokkyo Medical University, School of Medicine, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.
BMC Psychiatry. 2020 Nov 23;20(1):555. doi: 10.1186/s12888-020-02967-5.
Several evidence-based practice guidelines have been developed to better treat bipolar disorder. However, the articles cited in these guidelines were not sufficiently based on real-world clinical practice.
The MUlticenter treatment SUrvey on BIpolar disorder in Japanese psychiatric clinics (MUSUBI) is a study conducted to accumulate evidence on the real-world practical treatment of bipolar disorder. Psychiatrists were asked to complete a questionnaire about patients with bipolar disorder by performing a retrospective medical record survey. The questionnaire included patient characteristics (age, gender, height, weight, academic background, and occupational status), comorbidities, mental status, treatment period, Global Assessment of Functioning (GAF) score, and details of pharmacological treatment.
Data on 2705 patients were included in this study. The proportion of patients receiving antidepressant prescriptions was 40.9%. The most commonly used antidepressant was duloxetine, and the most frequently used antidepressant class was selective serotonin reuptake inhibitors (SSRIs). Binomial logistic regression analysis and bivariate analysis revealed that the usage of antidepressants was correlated with low prescription rates for mood stabilizers, high prescription rates for anxiolytics and hypnotics, and low GAF scores. In addition, patients in a depressive state had a significantly higher rate of antidepressant prescriptions than patients with other mental states.
Approximately 40% of patients in Japan with a diagnosis of bipolar disorder have received antidepressants. Antidepressants were most often prescribed in combination with mood stabilizers, antipsychotics or both. Patients who were prescribed antidepressants received fewer mood stabilizers, more anxiolytics, and more hypnotics than those who did not receive antidepressant prescriptions.
已经制定了几项基于证据的实践指南，以更好地治疗双相情感障碍。然而，这些指南中引用的文章并没有充分基于现实临床实践。
多中心治疗调查双相情感障碍在日本精神科诊所（MUSUBI）是一项研究，旨在积累关于现实世界中双相情感障碍实际治疗的证据。精神科医生被要求通过回顾病历调查完成一份关于双相情感障碍患者的问卷。问卷包括患者特征（年龄、性别、身高、体重、学历和职业状况）、合并症、精神状态、治疗期、总体功能评估（GAF）评分以及药物治疗细节。
本研究纳入了 2705 名患者的数据。接受抗抑郁药处方的患者比例为 40.9%。最常用的抗抑郁药是度洛西汀，最常用的抗抑郁药类别是选择性 5-羟色胺再摄取抑制剂（SSRIs）。二项逻辑回归分析和双变量分析显示，使用抗抑郁药与心境稳定剂处方率低、抗焦虑药和催眠药处方率高以及 GAF 评分低有关。此外，处于抑郁状态的患者抗抑郁药处方的比例明显高于其他精神状态的患者。
日本约 40%的双相情感障碍诊断患者接受了抗抑郁药治疗。抗抑郁药最常与心境稳定剂、抗精神病药或两者联合使用。与未开抗抑郁药处方的患者相比，开抗抑郁药处方的患者接受的心境稳定剂较少，抗焦虑药和催眠药较多。
