The Department of Clinical Pharmacology, The Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
Neuropsychopharmacol Rep. 2022 Jun;42(2):199-204. doi: 10.1002/npr2.12247. Epub 2022 Mar 22.
Understanding how local "psychiatry clinic" characteristics shape research findings is essential for applying research into evolution, outcomes, and costs of mental health. However, a paucity of "psychiatry clinics" details has implications for the interpretation and utilization of this research.
We reviewed data of 746 patients with new-onset schizophrenia on antipsychotic monotherapy seen over four years in an "adult psychiatry clinic" at Jazan Health, Saudi Arabia. Protocol-driven interviews and investigations were recorded prospectively and extracted from the medical records for the study. Summary statistics and logistic regression analyses were applied to assess patients' characteristics and outcomes.
The median patient age was 32 (IQR 27-39) years. Of patients, 589 (79.0%) were male, and 679 (91.0%) had a low-level education. The median follow-up duration was 51.4 (IQR 27.4-96.3) weeks. The most used initial antipsychotic drugs were olanzapine (48.8%), haloperidol (13.9%), and aripiprazole (11.3%). The numbers of patients who retained the initial drug at 24 and 52 weeks were 539 (72.3%) and 325 (43.6%), respectively. The initial drug was changed in 246 (33.0%) patients. The median time to initial drug change was 43.9 (IQR 14.8-85.0) weeks. The logistic regression demonstrated that male sex (P < 0.004), young adult age group (P < 0.027), predominant positive symptoms (P < 0.021), treatment with haloperidol (P < 0.024), and khat use (P < 0.006) were significant factors for drug change.
This clinical records study demonstrated substantial individual variations in characteristics and in responding to initial antipsychotic medication. Insight into these findings will facilitate the planning for comprehensive research programs.
了解当地“精神科诊所”的特征如何影响精神健康的研究结果对于应用该研究的演变、结果和成本至关重要。然而,缺乏“精神科诊所”的详细信息会影响对这些研究的解释和利用。
我们回顾了在沙特阿拉伯吉赞卫生中心的一家“成人精神科诊所”中,4 年内接受抗精神病药单药治疗的 746 例首发精神分裂症患者的数据。方案驱动的访谈和调查被前瞻性记录并从病历中提取出来用于研究。应用统计描述和逻辑回归分析评估患者的特征和结局。
中位患者年龄为 32(IQR 27-39)岁。其中 589 例(79.0%)为男性,679 例(91.0%)接受低水平教育。中位随访时间为 51.4(IQR 27.4-96.3)周。最常用的初始抗精神病药物是奥氮平(48.8%)、氟哌啶醇(13.9%)和阿立哌唑(11.3%)。在 24 和 52 周时保留初始药物的患者人数分别为 539 例(72.3%)和 325 例(43.6%)。246 例(33.0%)患者初始药物发生了改变。初始药物改变的中位时间为 43.9(IQR 14.8-85.0)周。逻辑回归显示,男性(P<0.004)、年轻成年年龄组(P<0.027)、主要阳性症状(P<0.021)、氟哌啶醇治疗(P<0.024)和使用阿拉伯茶(P<0.006)是药物改变的显著因素。
这项临床记录研究表明,患者特征和对初始抗精神病药物治疗的反应存在显著个体差异。深入了解这些发现将有助于规划全面的研究计划。