Cullivan R, Crown J, Walsh N
Department of Psychiatry, St. Camillus Unit, St. Vincent's Hospital, Elm Park, Dublin, Ireland.
Psychooncology. 1998 Jul-Aug;7(4):301-6. doi: 10.1002/(SICI)1099-1611(199807/08)7:4<301::AID-PON367>3.0.CO;2-I.
The purpose of this study was to investigate the use of psychotropic medication in patients referred to a psycho-oncology service. While depressive disorders and psychological difficulties are being increasingly recognised in oncology patients, the use of psychotropic medication has not been frequently studied, nor has it been studied in patients who are subsequently referred for psychiatric assessment. The use of psychotropic medication in all patients referred to a psycho-oncology service over a 6-month period was examined prospectively. Details recorded included class of psychotropic medication used and by whom it was prescribed. Demographic details and clinical diagnoses were also recorded. Sixty-three patients were referred over the initial 6 months of the service and the majority had advanced or metastatic disease (62%). Clinically, 44.5% had some form of major psychiatric disorder, and 40% had an adjustment disorder. Over half (55.5%) were already on psychotropic medication at referral; mainly minor tranquillisers (51%) and antidepressants (24%); 22% were on more than one drug. Of those medications prescribed pre-referral, 46% had been prescribed by the oncology team and 31% were from the GP. Following psychiatric review, further medication was prescribed in 30% of the subjects, leaving a total of 79% on some form of psychotropic drug. While the overall psychotropic prescribing and the use of minor tranquillisers appears to be similar to those found in earlier studies, the high rate of use of antidepressants suggests psychological distress is being increasingly recognised, and pharmacotherapy is a commonly used strategy in this group.
本研究的目的是调查在转诊至精神肿瘤服务机构的患者中精神药物的使用情况。虽然肿瘤患者中的抑郁症和心理问题越来越受到重视，但精神药物的使用情况尚未得到充分研究，尤其是在那些随后被转诊进行精神科评估的患者中。我们前瞻性地研究了在6个月内转诊至精神肿瘤服务机构的所有患者中精神药物的使用情况。记录的详细信息包括所使用的精神药物类别及其处方医生。还记录了人口统计学细节和临床诊断。在该服务机构最初的6个月内，共转诊了63名患者，其中大多数患有晚期或转移性疾病（62%）。临床上，44.5%的患者患有某种形式的重度精神障碍，40%的患者患有适应障碍。超过一半（55.5%）的患者在转诊时已经在服用精神药物；主要是小剂量镇静剂（51%）和抗抑郁药（24%）；22%的患者服用不止一种药物。在转诊前开具的药物中，46%是由肿瘤学团队开具的，31%是由全科医生开具的。经过精神科评估后，30%的患者被开具了进一步的药物，最终共有79%的患者服用某种形式的精神药物。虽然总体精神药物处方情况和小剂量镇静剂的使用情况似乎与早期研究相似，但抗抑郁药的高使用率表明心理困扰越来越受到重视，药物治疗是该群体常用的治疗策略。
