Spreat S, Conroy J
Woods Services, Inc., Langhorne, PA 19047, USA.
Psychiatr Serv. 1998 Apr;49(4):510-2. doi: 10.1176/ps.49.4.510.
The study examined the use of psychotropic medications to treat persons with mental retardation living in nursing homes in Oklahoma.
Data were gathered on all 1,056 individuals funded through the Oklahoma mental retardation service system in 1995 to live in nursing homes. The Developmental Disabilities Quality Assurance Questionnaire was used to assess adaptive behavior, living site conditions, health, use of medications, and other variables.
The most frequently used class of psychotropic medications was antipsychotic medication, used by 31.8 percent of subjects. Sixteen percent received anxiolytic medication, and 6.1 percent received antidepressant medication. Stepwise multiple regression analysis indicated that use of antipsychotic medication was marginally predictable (less than 15 percent of the variance was explained) with a linear combination of six variables: mental health problems; violence toward others; adaptive behavior; screaming, yelling, or crying behavior; hyperactivity; and age.
A relatively high percentage of subjects received various forms of psychotropic medications, especially antipsychotics. The presence of behavior problems or mental health problems did not sufficiently explain the high rate of use of antipsychotic medication. The risks of this type of medication and its lower rate of use in group homes raise the question of the appropriateness of placing persons with mental retardation in nursing homes as they are currently conceived.
本研究调查了俄克拉何马州疗养院中使用精神药物治疗智力障碍患者的情况。
收集了1995年通过俄克拉何马州智力障碍服务系统资助住在疗养院的所有1056名患者的数据。使用发育障碍质量保证调查问卷来评估适应性行为、居住场所条件、健康状况、药物使用情况及其他变量。
最常使用的精神药物类别是抗精神病药物,31.8%的患者使用该类药物。16%的患者使用抗焦虑药物,6.1%的患者使用抗抑郁药物。逐步多元回归分析表明,抗精神病药物的使用可通过六个变量的线性组合进行微弱预测(解释的方差不到15%),这六个变量分别是:心理健康问题;对他人的暴力行为;适应性行为;尖叫、大喊或哭闹行为;多动;以及年龄。
相当高比例的患者接受了各种形式的精神药物治疗,尤其是抗精神病药物。行为问题或心理健康问题的存在并不能充分解释抗精神病药物的高使用率。这类药物的风险以及其在集体之家的较低使用率引发了一个问题,即按照目前的设想,将智力障碍患者安置在疗养院是否合适。