Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway.
Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; NORMENT, Centre of Excellence, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway.
Schizophr Res. 2022 Oct;248:35-41. doi: 10.1016/j.schres.2022.07.014. Epub 2022 Aug 4.
Evidence is limited for the associations between use of psychotropic medications and overactive, aggressive, disruptive or agitated behavior (OADA) in clinical practice.
To investigate the associations between risk of readmission with OADA and use of antipsychotics, antidepressants, mood stabilizers and benzodiazepines in patients with schizophrenia.
A consecutive total cohort diagnosed with schizophrenia (N = 663) after admission to the Haukeland University Hospital psychiatric acute unit in Bergen, Norway, was followed from discharge over a 10-year period. At every following readmission, the level of OADA was assessed using the first item of the Health of the Nation Outcome Scale (HoNOS). Periods of use versus non-use of antipsychotics, antidepressants, mood stabilizers and benzodiazepines were recorded as time-dependent variables in each patient and compared using Cox multiple regression analyses.
A total of 161 (24.3 %) patients were readmitted with OADA, and the mean (SD) and median times in years to readmission with OADA were 2.8 (2.6) and 2.1, respectively. We found that the risk of readmission with OADA was negatively associated with use of antipsychotics (adjusted hazard ratio (AHR) = 0.33, p < 0.01, CI: 0.24-0.46) and antidepressants (AHR = 0.57, p = 0.03, CI: 0.34-0.95), positively associated with use of benzodiazepines (AHR = 1.95, p < 0.01, CI: 1.31-2.90) and not significantly associated with use of mood stabilizers.
Use of antipsychotics and antidepressants is associated with reduced risk of readmission with OADA whereas benzodiazepines are associated with an increased risk of readmission with OADA in patients with schizophrenia.
在临床实践中，精神药物的使用与过度活跃、攻击性行为、破坏性行为或激越行为（OADA）之间的关联证据有限。
研究精神分裂症患者 OADA 再入院风险与抗精神病药、抗抑郁药、心境稳定剂和苯二氮䓬类药物使用之间的关系。
挪威卑尔根 Haukeland 大学医院精神科急症病房连续收治的 663 例精神分裂症患者被纳入本队列研究，随访 10 年。在每次随后的再入院时，使用健康国家结局量表（HoNOS）的第一项评估 OADA 的严重程度。在每个患者中，将抗精神病药、抗抑郁药、心境稳定剂和苯二氮䓬类药物的使用期和非使用期记录为时间依赖性变量，并使用 Cox 多回归分析进行比较。
共有 161 例（24.3%）患者因 OADA 再入院，OADA 再入院的平均（SD）和中位数时间（年）分别为 2.8（2.6）和 2.1。我们发现，OADA 再入院的风险与抗精神病药的使用呈负相关（调整后的危险比（AHR）=0.33，p<0.01，CI：0.24-0.46）和抗抑郁药（AHR=0.57，p=0.03，CI：0.34-0.95），与苯二氮䓬类药物的使用呈正相关（AHR=1.95，p<0.01，CI：1.31-2.90），与心境稳定剂的使用无显著相关性。
在精神分裂症患者中，抗精神病药和抗抑郁药的使用与 OADA 再入院风险降低相关，而苯二氮䓬类药物的使用与 OADA 再入院风险增加相关。
