Awad A G
Dept. of Psychiatry, Wellesley Hospital, Toronto, Ontario, Canada.
Schizophr Bull. 1993;19(3):609-18. doi: 10.1093/schbul/19.3.609.
Subjective response to neuroleptics in patients with schizophrenia is reviewed in terms of its validity and measurement. Evidence is presented to support a correlation between altered subjective state on neuroleptics, and therapeutic outcome and medication compliance. Factors that have been implicated in the genesis of such altered subjective states include demographics, psychiatric characteristics, type and dose of neuroleptic, extrapyramidal symptoms (particularly akathisia), depressive states, and patients' values and attitudes toward health and illness. Factors that may contribute to lack of interest in researching subjective experiences of schizophrenia patients on medications are reviewed, and methodological improvements in study design are proposed to enhance our understanding of this phenomenon. Such understanding may help us to better appreciate the many factors that contribute to variability of responses to neuroleptic therapy in patients with schizophrenia and also help us to develop more effective treatment strategies.
本文从有效性和测量方法的角度，对精神分裂症患者对抗精神病药物的主观反应进行了综述。文中提供的证据支持了服用抗精神病药物后主观状态的改变与治疗效果及药物依从性之间的相关性。与这种主观状态改变的发生有关的因素包括人口统计学特征、精神症状特点、抗精神病药物的类型和剂量、锥体外系症状（尤其是静坐不能）、抑郁状态以及患者对健康和疾病的价值观与态度。本文回顾了可能导致对研究精神分裂症患者药物治疗主观体验缺乏兴趣的因素，并提出了研究设计方面的方法改进，以增进我们对这一现象的理解。这种理解可能有助于我们更好地认识导致精神分裂症患者对抗精神病药物治疗反应差异的诸多因素，也有助于我们制定更有效的治疗策略。
