中国口服抗精神病药物治疗青少年精神分裂症的治疗特点

The treatment characteristics of oral antipsychotics in treatment of adolescents with schizophrenia in China.

作者信息

Wang Huaning, Zhang Yongjing, Wu Tao, Dong Sijia, Chi Rui, Jiang Kun, Qiu Hong, Dong Wentian, Si Tianmei

机构信息

Xijing Hospital, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, China.

Global Epidemiology, Janssen Research & Development, LLC, Shanghai, China.

出版信息

BMC Psychiatry. 2025 Jul 1;25(1):657. doi: 10.1186/s12888-025-07113-7.

DOI:10.1186/s12888-025-07113-7

PMID:40597976

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12220016/

Abstract

BACKGROUND

Evidence on treatment for adolescent with schizophrenia in China is limited. Understanding the current practice of antipsychotics utilization is imperative to inform appropriate use in this population.

METHODS

This retrospective cohort study used electronic medical records (2018-2022) from two hospitals in China. Adolescents (12-17y) with schizophrenia (ICD-10: F20.x) who were prescribed oral antipsychotics during the study period were included. Index date was the date of the first antipsychotics prescription. Patients were followed up until the earliest of last antipsychotics prescription, 18y, or study end. Antipsychotic utilization was described by commonly prescribed antipsychotics, polypharmacy, dosage and medication adherence (indicated by proportion of days covered [PDC]). Dosage was converted using defined daily dose(DDD) for unified measurement.

RESULTS

Overall, 869 (mean age: 15.6y, male 50.6%) and 618 (mean age: 16.1y, male 50.7%) patients were included in PKU6H and XJH, respectively. Most patients (99.65% and 100.00%) had ever used second-generation antipsychotics (SGAs), while relatively few (4.14% and 4.21%) had ever used first-generation antipsychotics (FGAs). The top three ever-prescribed SGAs were aripiprazole (50.46%), olanzapine (38.45%), risperidone (34.41%) in PKU6H, and aripiprazole (35.76%), risperidone (28.96%), paliperidone (27.83%) in XJH, 32.34% and 11.49% patients had polypharmacy, respectively. The average daily dose was 0.77(SD 0.40) DDDs and 1.00(SD 0.52) DDDs, respectively, with most (81.59% and 63.27%) ≤ 1 DDD. Medication adherence was both around 0.8 and observed with a steady trend over long-term.

CONCLUSIONS

In Chinese adolescent patients, SGA is the mainstream mostly prescribed as monotherapy. Polypharmacy is observed with a steady pattern. Antipsychotics were prescribed with equal or reduced dose compared to adults DDD, and good adherence observed.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

中国关于青少年精神分裂症治疗的证据有限。了解抗精神病药物的当前使用情况对于指导该人群的合理用药至关重要。

方法

这项回顾性队列研究使用了中国两家医院的电子病历（2018 - 2022年）。纳入在研究期间开具口服抗精神病药物处方的12 - 17岁青少年精神分裂症患者（ICD - 10：F20.x）。索引日期为首次抗精神病药物处方日期。对患者进行随访，直至最后一次抗精神病药物处方日期、18岁或研究结束三者中最早的时间点。通过常用的抗精神病药物、联合用药情况、剂量和用药依从性（以覆盖天数比例[PDC]表示）来描述抗精神病药物的使用情况。剂量使用限定日剂量（DDD）进行换算以便统一测量。

结果

总体而言，北京大学第六医院（PKU6H）纳入了869例患者（平均年龄：15.6岁，男性占50.6%），西安精神卫生中心（XJH）纳入了618例患者（平均年龄：16.1岁，男性占50.7%）。大多数患者（分别为99.65%和100.00%）曾使用第二代抗精神病药物（SGA），而曾使用第一代抗精神病药物（FGA）的患者相对较少（分别为4.14%和4.21%）。PKU6H中最常开具的三种SGA分别是阿立哌唑（50.46%）、奥氮平（38.45%）、利培酮（34.41%），XJH中则是阿立哌唑（35.76%）、利培酮（28.96%）、帕利哌酮（27.83%），分别有32.34%和11.49%的患者使用联合用药。平均日剂量分别为0.77（标准差0.40）DDD和1.00（标准差0.52）DDD，大多数患者（分别为81.59%和63.27%）≤1 DDD。用药依从性均约为0.8，且长期观察呈稳定趋势。