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抗精神病药物在减少自杀意念方面的有效性:可能的生理机制

Effectiveness of Antipsychotics in Reducing Suicidal Ideation: Possible Physiologic Mechanisms.

作者信息

Hassan Ahmed, De Luca Vincenzo, Dai Nasia, Asmundo Alessio, Di Nunno Nunzio, Monda Marcellino, Villano Ines

机构信息

Group for Suicide Studies, CAMH, Department of Psychiatry, University of Toronto, Toronto, ON M5T1R8, Canada.

Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5T1R8, Canada.

出版信息

Healthcare (Basel). 2021 Apr 1;9(4):389. doi: 10.3390/healthcare9040389.

Abstract

: The aim of this study is to evaluate whether any specific antipsychotic regimen or dosage is effective in managing suicidal ideation in schizophrenia. Four comparisons were conducted between: (1) clozapine and other antipsychotics; (2) long-acting injectable and oral antipsychotics; (3) atypical and typical antipsychotics; (4) antipsychotics augmented with antidepressants and antipsychotic treatment without antidepressant augmentation. : We recruited 103 participants diagnosed with schizophrenia spectrum disorders. Participants were followed for at least six months. The Beck Scale for Suicidal Ideation (BSS) was used to assess the severity of suicidal ideation at each visit. We performed a multiple linear regression model controlling for BSS score at study entry and other confounding variables to predict the change in the BSS scores between two visits. : Overall, there were 28 subjects treated with clozapine (27.2%), and 21 subjects with depot antipsychotics (20.4%). In our sample, 30 subjects experienced some suicidal ideation at study entry. When considering the entire sample, there was a statistically significant decrease in suicidal ideation severity in the follow-up visit compared to the study entry visit ( = 0.043). : To conclude, our preliminary analysis implies that antipsychotics are effective in controlling suicidal ideation in schizophrenia patients, but no difference was found among alternative antipsychotics' classes or dosages.

摘要

本研究的目的是评估任何特定的抗精神病药物治疗方案或剂量在管理精神分裂症患者自杀观念方面是否有效。我们进行了四项比较:(1)氯氮平与其他抗精神病药物;(2)长效注射用抗精神病药物与口服抗精神病药物;(3)非典型抗精神病药物与典型抗精神病药物;(4)联用抗抑郁药的抗精神病药物治疗与未联用抗抑郁药的抗精神病药物治疗。

我们招募了103名被诊断为精神分裂症谱系障碍的参与者。对参与者进行了至少六个月的随访。每次随访时使用贝克自杀观念量表(BSS)评估自杀观念的严重程度。我们进行了多元线性回归模型,控制研究入组时的BSS评分和其他混杂变量,以预测两次随访之间BSS评分的变化。

总体而言,有28名受试者接受氯氮平治疗(27.2%),21名受试者接受长效抗精神病药物治疗(20.4%)。在我们的样本中,30名受试者在研究入组时存在一些自杀观念。在考虑整个样本时,与研究入组访视相比,随访访视时自杀观念严重程度有统计学意义的下降(P = 0.043)。

总之,我们的初步分析表明,抗精神病药物在控制精神分裂症患者的自杀观念方面是有效的,但在不同类别的抗精神病药物或剂量之间未发现差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a39/8066782/08bf06f22d99/healthcare-09-00389-g001.jpg

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