Day J C, Kinderman P, Bentall R
Department of Clinical Psychology, University of Liverpool, UK.
Acta Psychiatr Scand. 1998 Jan;97(1):93-7. doi: 10.1111/j.1600-0447.1998.tb09969.x.
Neuroleptic side-effects adversely affect clinical outcome in schizophrenic patients. Clinicians therefore require an understanding of the impact of such side-effects. This study compared psychiatrists' estimates of the prevalence of neuroleptic side-effects and associated distress with schizophrenic patients' reports of side-effects and distress. Psychiatrists were asked to estimate the likelihood of informing patients about side-effects. Psychiatrists' estimates of prevalence but not of distress correlated significantly with patients' reports. Psychiatrists' avowed decisions to inform patients about side-effects were significantly correlated with their estimates of prevalence and distress, but not with patients' reported levels of distress. Patients were unlikely to attribute side-effects to neuroleptic medication. These results indicate that patients and psychiatrists share similar views about the prevalence and implications of neuroleptic side-effects. However, psychiatrists' apparent lack of understanding of which side-effects are most likely to cause distress to patients may adversely affect the therapeutic alliance between prescribers and consumers.
抗精神病药物的副作用会对精神分裂症患者的临床治疗结果产生不利影响。因此，临床医生需要了解此类副作用的影响。本研究比较了精神科医生对抗精神病药物副作用发生率及相关痛苦程度的估计与精神分裂症患者对副作用及痛苦程度的报告。研究人员要求精神科医生估计告知患者副作用的可能性。精神科医生对发生率的估计与患者的报告显著相关，但对痛苦程度的估计与患者报告不相关。精神科医生宣称告知患者副作用的决定与他们对发生率和痛苦程度的估计显著相关，但与患者报告的痛苦程度无关。患者不太可能将副作用归因于抗精神病药物治疗。这些结果表明，患者和精神科医生对抗精神病药物副作用的发生率及影响有着相似的看法。然而，精神科医生明显缺乏对哪些副作用最有可能给患者带来痛苦的了解，这可能会对开药者和患者之间的治疗联盟产生不利影响。
