使用抗精神病药物增强氯氮平治疗的精神分裂症住院患者功能及临床结局的预测因素

Predictors of functioning and clinical outcomes in inpatient with schizophrenia on clozapine augmented with antipsychotics.

作者信息

Mukherjee Hindol, Sazhin Vladimir

机构信息

Forensic Psychiatry Advanced Trainee, Cumberland Hospital (Western Sydney Local Health District) and Justice and Forensic Mental Health Network, NSW, Australia.

Consultant Psychiatrist, Macquarie Hospital (Northern Sydney Local Health District), NSW, Australia.

出版信息

Australas Psychiatry. 2022 Feb;30(1):100-104. doi: 10.1177/10398562211037339. Epub 2021 Aug 31.

DOI:10.1177/10398562211037339

PMID:34464166

Abstract

OBJECTIVE

We aimed at exploring predictors of improvement in clinical and functional outcomes of patients on clozapine with chronic treatment-resistant schizophrenia admitted into rehabilitation wards.

METHOD

In a cross-sectional study of 62 patients on clozapine augmented with oral and parenteral antipsychotics, predictors of HoNOS (Health of the Nation Outcome Scales) scores were analysed using ordinal logistic regression.

RESULT

Augmentation with parenteral antipsychotics was associated with lower psychotic symptom scores (OR 0.38 [95%CI 0.15, 0.99]) and activity of daily living scores (OR 0.36 [95%CI, 0.13, 0.96]) compared with oral antipsychotics. Increased age was a predictor of behavioural disturbances, physical illness and cognitive problems for all clozapine patients, and female gender was associated with the increase in depression scores.

CONCLUSION

The addition of parental antipsychotics to clozapine in patients with treatment-resistant schizophrenia might have potential benefits for clinical and functional outcomes and needs a further investigation.

摘要

目的

我们旨在探究入住康复病房的使用氯氮平治疗慢性难治性精神分裂症患者临床及功能预后改善的预测因素。

方法

在一项对62例使用口服和注射用抗精神病药物增效氯氮平治疗患者的横断面研究中，使用有序逻辑回归分析国民健康结果量表（HoNOS）评分的预测因素。

结果

与口服抗精神病药物相比，注射用抗精神病药物增效治疗与更低的精神病性症状评分（比值比[OR]0.38[95%置信区间（CI）0.15,0.99]）及日常生活活动评分（OR 0.36[95%CI 0.13,0.96]）相关。年龄增长是所有氯氮平治疗患者行为障碍、躯体疾病及认知问题的预测因素，女性与抑郁评分增加相关。