Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Research Unit of Biomedicine, Medical Research Center Oulu and Oulu University Hospital, University of Oulu, Oulu, Finland.
Acta Psychiatr Scand. 2022 Sep;146(3):227-239. doi: 10.1111/acps.13472. Epub 2022 Jul 12.
Increasing number of people have been prescribed antipsychotics (APs) off-label in recent decades. This study aimed to identify the characteristics and predictors of receiving prescription of antipsychotics off-label.
The study sample was part of the Northern Finland Birth Cohort 1966 (n = 7071). Data included questionnaires and national register data. Information on prescribed medications was extracted from the national register. The sample was divided into three groups: Persons who had been prescribed APs off-label (n = 137), individuals with non-psychotic mental disorders without APs off label (n = 1478) and individuals who had been diagnosed with psychosis or bipolar disorder and who had been prescribed APs (n = 151). We compared sociodemographic, lifestyle and clinical characteristics between the off-label and the comparison groups using logistic regression.
The most common diagnoses in the off-label group were depression (n = 96, 70.1%) and anxiety (n = 55, 40.1%). Compared with individuals with non-psychotic mental disorders who were not prescribed APs off-label, individuals with prescribed off-label APs had a lower level of education, lower socioeconomic status, were less often married, had a higher level of somatic and psychiatric morbidity, were more often smokers and more often had a substance abuse disorder and heavy alcohol consumption. When comparing the off-label group to individuals with psychosis or bipolar disorder who used APs, there were less differences, though individuals with psychosis or bipolar disorder had more markers of morbidity and a lower level of education.
Individuals who had been prescribed APs off label had a higher level of mental and somatic morbidity and poorer socioeconomic status than individuals with non-psychotic mental disorders who did not use APs.
近几十年来，越来越多的人被开处非适应证的抗精神病药物（APs）。本研究旨在确定接受非适应证抗精神病药物处方的特征和预测因素。
研究样本是芬兰北部出生队列 1966 年（n=7071）的一部分。数据包括问卷调查和国家登记数据。从国家登记处提取处方药物信息。该样本分为三组：接受非适应证抗精神病药物处方的人（n=137）、无非精神病性精神障碍且未开非适应证抗精神病药物的个体（n=1478）和被诊断为精神病或双相障碍且开抗精神病药物的个体（n=151）。我们使用逻辑回归比较了标签外和对照组之间的社会人口统计学、生活方式和临床特征。
标签外组最常见的诊断是抑郁症（n=96，70.1%）和焦虑症（n=55，40.1%）。与未开非适应证抗精神病药物的非精神病性精神障碍个体相比，开非适应证抗精神病药物的个体受教育程度较低，社会经济地位较低，结婚较少，躯体和精神疾病发病率较高，吸烟较多，物质滥用障碍和大量饮酒的情况较多。与使用抗精神病药物的精神病或双相障碍个体相比，标签外组的差异较小，但精神病或双相障碍个体的发病标志物更多，受教育程度较低。
与未使用抗精神病药物的非精神病性精神障碍个体相比，开非适应证抗精神病药物的个体的精神和躯体发病率更高，社会经济地位更低。
