Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study
Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study
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DOI：
10.1017/s0033291714000610
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发表时间：
2014-10-01
影响因子：
6.9
通讯作者：
Faull, R. N.
中科院分区：
文献类型：
--
作者：
Harrow, M.;Jobe, T. H.;Faull, R. N.
背景。这项研究评估了抗精神病药物的多年治疗是否可以减少或消除精神分裂症的精神病。它提供了 20 年关于接受治疗的精神分裂症患者 (SZ) 样本与未接受抗精神病药物治疗的样本中精神病活动频率和严重程度的纵向数据。总共 139 名年轻的早期精神分裂症和情绪障碍患者在首次住院时接受了评估，然后在 20 年间对精神病和其他主要变量进行了六次重新评估。结果。在 20 年来的每次随访评估中，纵向接受抗精神病药物治疗的精神分裂症患者中有精神病活动的比例高得惊人。超过 70% 的连续服用抗精神病药物的 SZ 患者在 20 年来的六次随访评估中的四次或以上经历了精神病活动。纵向来看，未服用抗精神病药物的 SZ 表现出的精神病活动显着低于服用抗精神病药物的患者 (p < 0.05)。结论。 20年的数据表明，纵向来看，在最初几年之后，抗精神病药物并不能消除或减少精神分裂症中精神病的发生频率，也不能减轻急性后精神病的严重程度，尽管在纯粹的自然主义或观察性研究中很难就治疗效果得出明确的结论。纵向来看，根据他们的精神病活动和功能障碍，大多数多年来服用抗精神病药物的 SZ 患者的状况会引发这样的问题：他们中有多少人真正处于缓解状态。
Background. This research assesses whether multi-year treatment with antipsychotic medications reduces or eliminates psychosis in schizophrenia. It provides 20 years of longitudinal data on the frequency and severity of psychotic activity in samples of schizophrenia patients (SZ) treated versus those not treated with antipsychotic medications.Method. A total of 139 early young schizophrenia and mood-disordered patients were assessed at index hospitalization and then reassessed six times over 20 years for psychosis and other major variables.Results. At each follow-up assessment over the 20 years, a surprisingly high percentage of SZ treated with antipsychotics longitudinally had psychotic activity. More than 70% of SZ continuously prescribed antipsychotics experienced psychotic activity at four or more of six follow-up assessments over 20 years. Longitudinally, SZ not prescribed antipsychotics showed significantly less psychotic activity than those prescribed antipsychotics (p < 0.05).Conclusions. The 20-year data indicate that, longitudinally, after the first few years, antipsychotic medications do not eliminate or reduce the frequency of psychosis in schizophrenia, or reduce the severity of post-acute psychosis, although it is difficult to reach unambiguous conclusions about the efficacy of treatment in purely naturalistic or observational research. Longitudinally, on the basis of their psychotic activity and the disruption of functioning, the condition of the majority of SZ prescribed antipsychotics for multiple years would raise questions as to how many of them are truly in remission.