Pharmacological treatment patterns at study entry for the first 500 STEP-BD participants
Pharmacological treatment patterns at study entry for the first 500 STEP-BD participants
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DOI：
10.1176/appi.ps.57.5.660
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发表时间：
2006-05-01
影响因子：
3.8
通讯作者：
Sachs, Gary
中科院分区：
文献类型：
--
作者：
Ghaemi, S. Nassir;Hsu, Douglas J.;Sachs, Gary
目的：本研究评估双相情感障碍的精神药物治疗模式。方法：在双相情感障碍系统性治疗增强计划（STEP-BD）研究（1998 - 1999）中检查了前500例患者的摄入治疗数据。诊断评估使用DSM-IV情绪模块的结构化临床访谈。治疗的数据是通过在最初的精神病检查期间采访患者获得的。结果如下：在500名参与者中，73.6%的人患有双相I型障碍，23.0%的人患有双相II型障碍，3.4%的人患有双相障碍。经检查，63.4%的人情绪正常，24.6%的人抑郁，12.0%的人处于躁狂、轻躁狂或混合状态。标准情绪稳定剂（锂，丙戊酸盐或卡马西平）是参与者在摄入时最常用的处方药物（71.9%）。其次是抗抑郁药（40.6%），其次是新型抗惊厥药（31.8%），第二代抗精神病药（27.2%）和苯二氮卓类药物（25.0%）。11%的患者接受了标准情绪稳定剂单药治疗。这些处方模式进一步分析了疾病的亚型，并与其他临床和社区环境的模式进行了比较。结论：在一个大的，良好的特点，在美国处方模式的横截面分析。S.在精神病学学术环境中，双相情感障碍患者主要用标准的情绪稳定剂治疗，其次是适度使用抗抑郁药、新型抗惊厥药和第二代神经安定药。结果可以是有用的，在了解当前的临床护理标准，以及在指导研究的领域，有一个相对缺乏证据，以告知临床实践。还需要对双相情感障碍的纵向处方模式进行研究。
Objective: This study assessed patterns of psychopharmacological treatment for bipolar disorder. Method: Intake treatment data were examined for the first 500 patients in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study (1998 to 1999). Diagnoses were assessed by using the Structured Clinical Interview for DSM-IV mood modules. Data on treatments were obtained by interviewing patients during the initial psychiatric examination. Results: Of the 500 participants, 73.6 percent had bipolar I disorder, 23.0 percent had bipolar II disorder, and 3.4 percent had bipolar disorder not otherwise specified. Upon examination, 63.4 percent were euthymic, 24.6 percent were depressed, and 12.0 percent were experiencing manic, hypomanic, or mixed states. Standard mood stabilizers (lithium, valproate, or carbamazepine) were the most commonly prescribed class of drugs that participants were taking at intake (71.9 percent). The next most common class of agents was antidepressants (40.6 percent), followed by novel anticonvulsants (31.8 percent), second-generation neuroleptics (27.2 percent), and benzodiazepines (25.0 percent). Eleven percent of patients were treated with standard mood stabilizer monotherapy. These prescribing patterns were further analyzed by subtype of illness and compared with patterns in other clinical and community settings. Conclusion: In a large, well-characterized cross-sectional analysis of prescription patterns in the U. S. psychiatric academic setting, patients with bipolar disorder were primarily treated with standard mood stabilizers, followed by moderate use of antidepressants, novel anticonvulsants, and second-generation neuroleptics. Results can be useful in understanding the current clinical standard of care, as well as in guiding research studies toward areas in which there is a relative absence of evidence to inform clinical practice. Studies of longitudinal prescribing patterns in bipolar disorder are also needed.