189例老年住院精神病人分析

目的分析住院老年精神病人的年龄和病种。方法回顾性查阅住院60岁以上老年精神病人的病例资料，对其年龄和病种进行分析。结果60岁以上(含60岁)住院老年精神病人占同期住院精神病人3．12％；60岁及以上住院老年精神病人随年龄增长，比例减少；以精神分裂症(含分裂样精神病)最多，其次为情感性障碍。结论建议加强老年精神病诊断与治疗业务开拓。     

住院病人精神药物应用情况调查

目的：了解目前住院精神病人的药物使用情况。方法：采用一日法对上海精神卫生中心的1042例住院精神病人的诊断和治疗情况进行调查，并与1987年及1995年的调查结果进行比较。结果：(1)本组联用两种精神药物减少，合并ECT较1987年和1995年增多。(2)本组单用氯氮平及其用药频度仍占据首位，但已呈下降趋势，传统抗精神病药的使用明显下降，取而代之的是新型的抗精神病药。(3)本组联用抗胆碱能药物较以前两组明显减少。抗焦虑药使用明显增加。结论：本研究提示近8年来精神药物的使用已发生很大变化，其原因可能与新药的涌现及人们对精神药物认识的深入等有关。     

189例老年住院精神病人分析

目的 分析住院老年精神病人的年龄和病种。方法 回顾性查阅住院60岁以上老年精神病人的病例资料,对其年龄和病种进行分析。结果 60岁以上(含60岁)住院老年精神病人占同期住院精神病人3.12％;60岁及以上住院老年精神病人随年龄增长,比例减少;以精神分裂症(含分裂样精神病)最多,其次为情感性障碍。结论 建议加强老年精神病诊断与治疗业务开拓。     

住院精神病人并发糖尿病的相关因素分析

目的　探讨精神病人并发糖尿病的相关因素。方法　对 10 4 4例住院精神病人进行糖尿病罹患情况调查 ,将其中的 12 8例并发糖尿病者作为糖尿病组 ;并抽取未并发糖尿病的精神病人按性别、年龄、病程以 1∶1匹配作为对照组。对两组的一般资料、抗精神病药使用状况、体重、血脂及其并发症等进行调查与比较。结果　精神病人并发糖尿病的患病率为 12 2 % ;糖尿病发生与有糖尿病家族史、精神病发病年龄低、抗精神病药使用时间过长有关 (P <0 0 5 ) ,与抗精神病药剂量、用药种类无关 (P >0 0 5 )。糖尿病组的肥胖、血脂及其它并发症均明显高于对照组 (P <0 0 1)。结论　精神病人患糖尿病远高于普通人群 ;有糖尿病家族史、长期服用抗精神病药要定期监测血糖。     

自编住院精神病人《社会功能评定量表》:信度、效度的初步检验

目的 编制一套适合于研究精神科住院病人的《社会功能评定量表(SSFPI)》。方法 根据住院精神病人的实际生活状况及康复活动特点，拟定出含12个条目的量表，并将条目性质类同者归纳为三个因子。同时在住院病人中进行初测及信度、效度检验。结果 总分及各条目重测相关在0．72～0．89之间；分半信度相关为0．943；总分及各因子间内部一致性相关在0．46～0．89之间；与SDSS进行效度检验相关r值为-0．863，社会功能缺陷阳性区分率达98．3％。结论 SSFPI信度和效度符合要求，与中、基层医院的住院精神病人的生活特点吻合，具有一定的研究及应用价值。     

住院精神病人攻击行为相关因素分析

本文采用“修订的明显攻击行为量表（ＭＯＡＳ）”评定９２例符合ＣＣＭＤ—２诊断标准的住院精神病人，发现攻击行为者（ＭＯＡＳ总分≥４）占３８．０％。对照分析，结果显示：既往暴力行为史、住院方式、神经质水平研究组与对照组有显著差异；研究组ＢＰＲＳ总分以及思维障碍、激活性、敌对猜疑三个因子分显著高于对照组；研究组病人幻觉、妄想、易激惹、敌意、精神运动性兴奋等精神症状出现频率较高。上述诸因素对住院精神病人的攻击行为具有预测价值。     

对107例住院老年精神病人日用药的临床调查

目的了解住院老年精神病人使用精神药物情况,分析老年精神病人使用精神药物的合理性。方法对我院2010年3月22日住院老年病人用药情况进行调查。结果临床用药的频度列在前三位依次为抗精神病药物、镇静催眠药及抗抑郁剂。其中抗精神病药物的使用频度列在前三位依次为喹硫平、利培酮及氯氮平;镇静催眠药依次为氯硝西泮、阿普唑仑及唑吡坦;抗抑郁剂依次为帕罗西汀、文拉法辛,西酞普兰及曲唑酮并列第三。结论老年病人目前使用精神药物以新型精神药物为主,低剂量为宜,用药趋于合理。     

北京、潍坊两所精神病医院精神药物使用情况的调查和比较

为了解部属和地市级精神病医院精神药物的使用情况,采用时点统计分别对北京医科大学精神卫生研究所(简称北京)和山东省潍坊市精神卫生中心(简称潍坊)全部住院病人的用药情况进行了调查和比较。结果显示两院最常使用的三种精神药物都是氟氮平、氧丙嗪和奋乃静;单一用药率潍坊非常显著地低于北京;三种精神药物合用率潍坊非常显著地高于北京;二种精神药物合用率两院无差异;抗精神病药总合用率潍坊非常显著高于北京。表明基层精神病医院合并用药现象较为突出。     

初次住院精神病人躯体健康状况调查

目的 了解初次住院精神病人躯体健康情况。方法 对2002年和2003年共375例初次住院精神病人，在躯体检查中发现的生物学指标异常及躯体疾病，进行发生率及相关统计学研究。结果 375例精神病患者中，87例合并躯体疾病，发生率为23．2％。排前6位的躯体疾病或异常生物学指标依次为：高血脂(14．4％)；肝病或肝功能异常(12．8％)；贫血(10．4％)；急性感染(5．6％)；糖尿病(5．1％)；心脏病／心电图异常、低血钾(分别为4％)。结论 初次住院精神病人合并躯体疾病的风险相当高。可能对精神药物等专科治疗的安全性构成潜在或现实风险。应在治疗决策中加以重视。     

临床应用精神药物品种的调查和比较

了解最近上海住院精神病人的药物使用情况。采用一日法对住上海市精神卫生中心的９５７例精神病人的诊断和治疗情况进行调查，并与１９８０年及１９８７年的调查结果进行比较。结果１．本组单用一种精神药物者及合并ＥＣＴ者，较１９８０年组及１９８７年组明显增多。２．单用氯氮平和合并抗焦虚药治疗者呈逐年增多趋势，本组有４４３例使用了氯氮平，占４７．１％，居用药的频率的首位。１４７例使用了氯硝安定，占１５．６％，３．     

2005年住院精神疾病患者药物治疗时点调查

目的:了解住院精神疾病患者精神药物的应用情况及其演变。方法:采用一日法对上海精神卫生中心679例住院精神疾病患者的精神药物应用状况进行调查,将其结果与2004年和2002相比较。结果:精神药物的使用频度发生了显著变化;新型精神药物的使用正在逐渐增多;精神药物的使用剂量基本都在安全范围之内。结论:精神药物应用的多样性已是一种趋势。     

Female alcoholics. I. Alcohol dependence and problems associated with prescribed psychotropic drug use

A case note study of 518 alcohol-dependent (DSM-III) inpatients examined their reported past history of prescribed psychotropic drug use patterns between 1973-1985. The subjects were cross-matched for gender, age and admission date and stratified into 3 time periods. The characteristics of psychotropic medication recipients were compared with those patients who reported no use of licit medications. Statistical analysis by logistic regression indicated that there was a significant relationship between the past use of psychotropic drugs with a parental history of excessive alcohol intake, the higher levels of MAST scores and the occurrence of past parasuicide events. Patients in their middle years (35-54) tended to have received significantly less psychotropic drugs than the younger or older age groups. The female (70%) to male (48%) ratio of past psychotropic use was 1.4:1. Gender differences were also noted in the use of antidepressants and illicit substances.     

Polypharmacy among psychiatric patients.

The purpose of the present study is to determine the frequency of polypharmacy among psychiatric patients in Helsinki, and to ascertain whether this practice is supported by clinical trials. The drugs prescribed in 1 day to a sample of patients (n = 694) in mental hospitals and outpatient clinics in Helsinki were studied. 69% of patients received more than on psychotropic drug in 1 day (61% received "proper" psychotropic drugs). On the average there were 2.1 different psychotropic drugs per patient, and the maximum was 6. A review of controlled clinical trials on the simultaneous use of more than one proper psychotropic drug in psychiatric diseases (excluding fixed combinations) revealed 14 trials. In only three trials was the combination better than its single components or placebo. Thus, there seems to be no evidence from clinical trials defending the frequent polypharmacy. A radical reduction in the number of psychotropic drugs prescribed for psychiatric patients is apparently desirable.     

Use of psychotropic drugs in general medical geriatric inpatients. Relationship with various parameters of psychological distress (evaluated 'in blind')

The authors have evaluated the psychotropic drug use patterns and psychological distress (with the Symptom Distress Checklist, SCL-90) amongst 331 elderly medical inpatients. Forty-two percent of the sample took psychotropic drugs during their hospitalization period. The drugs most commonly used were anxiolytics and hypnotics of the benzodiazepine class. Subjects to whom psychotropic drugs were prescribed reported higher psychological distress compared to those not receiving them; however, a score of moderate distress in the depression and sleep disturbances subscales was reported by a relatively high percentage of subjects not receiving psychotropics. Patients taking antidepressants reported scores of psychological suffering higher than those under benzodiazepine treatment: such a difference not only related to the depression subscale, but to the majority of the symptom areas investigated by the SCL-90.     

Evaluation of psychotropic drug consumption related to psychological distress in the elderly: hospitalized vs. nonhospitalized

The use of psychotropic drugs in general has become more extended in the past 20 years. The elderly, particularly geriatric inpatients, are the group with the highest consumption. The aim of the present study was to evaluate in two groups of elderly, hospitalized patients (H) vs. nonhospitalized subjects (nH), psychotropic drug consumption related to psychological distress. This was carried out in a total 238 subjects aged above 65 years (112 geriatric inpatients and 126 interviewed in social welfare centers). Sociodemographic, clinical and pharmacological data, general health and psychological distress were evaluated. The latter was assessed by means of the Symptom Distress Checklist (SCL-90) which included 9 subscales. 23% of the subjects received psychotropic drugs (P), of which 84% were benzodiazepines, 10% antidepressants and 1.5% antipsychotics. After evaluating the SCL-90 subscales, it was noted that anxiety, depression and obsessiveness/compulsiveness scored higher in P subjects than in those not receiving psychotropic drugs (nP). When treated nH and H were analyzed separately, it was observed that the former scored higher in anxiety and depression, while the latter showed higher scores in anxiety and obsessiveness/compulsiveness. Considered globally, the H group compared to nH showed higher scores in depression. Although evaluating psychotropic drug utilization in geriatric patients is complex due to the large number of influencing factors, SCL-90 has proved to be useful for assessing the qualitative aspects of this drug consumption in the elderly.     

Prescribing patterns in psychiatric hospitals in Israel

A survey conducted by pharmacists working in four psychiatric hospitals in Israel to assess the prescribing of psychotropic drugs revealed that polypharmacy was common: patients were receiving up to 11 different drugs and up to six different psychotropic drugs. The average number of psychotropic drugs per patient was two. The most popular combinations of drugs used were; one containing an antipsychotic drug(s) and an antiparkinson drug(s) and the other was a combination of more than one antipsychotic agent. Up to 30 doses per day were taken orally by one patient. Drugs that could have easily been administered on a once-a-day time schedule were often administered several times a day. Differences in prescribing patterns in the various hospitals and often times on different wards of the same institution could more easily be attributed to different educational backgrounds, habits and personal beliefs and perhaps the physician's experience as well, rather than to the types of patients treated.     

Clinical characteristics and pharmacotherapy of extremely disruptive behavior disorders in people with mental retardation

People with mental retardation often have behavioral problems. Psychotropic medications are used for the treatment of extremely disruptive behavior disorders in many cases. We surveyed the clinical characteristics and the current status of the pharmacotherapy regimens for inpatients with severe intellectual disabilities and behavior disorders at 8 national psychiatric hospitals. Many of them were men between 20 and 40 years and more than half of them had both extremely mental retardation and high motor ability. Antipsychotic drugs and anticonvulsants were frequently used. As they had more severe behavior disorder, they were taken the more psychotropic drugs. Autism was significantly associated and rough behavior was apparently associated with higher doses. A very weak correlation between the total score of extremely disruptive behavior disorders and the number of psychotropic drugs being administered per patient was seen. Use of new medicines, such as atypical antipsychotic drugs, was found about fifteen percent of the cases. In order to establish useful pharmacotherapy regimens for people with severe mental retardation and behavior disorders, it is necessary to perform routine judgment and evaluation of the pharmacotherapy focusing on targeted symptoms. We should also be attention to the quality of life issue. The aim of medical treatment should not be care workers' convenience, but be the improvement of quality of life of patients.     

住院精神疾病患者药物治疗情况3年比较

目的了解三年来住院精神疾病患者精神药物的应用情况及其演变。方法采用一日法对上海市精神卫生中心住院精神疾病患者的精神药物应用状况进行调查，将2006年、2005年和2004年三组情况进行比较。结果①住院精神疾病种类构成发生了较大变化；②新型精神药物的使用正在逐步扩大；③精神疾病首选单药治疗，对于部分难治性病例可使用合并治疗的用药原则基本保持不变。④精神药物的使用剂量基本都在推荐的安全剂量之下；⑤抗焦虑和镇静催眠药物在临床上广泛使用。结果药物选择多样化、新型化，安全使用精神药物已成为目前临床用药的趋势。