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Consultation-liaison psychiatrists' use of antidepressants in the physically ill.

机译:咨询联络精神科医生对身体不适的患者使用抗抑郁药。

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摘要

In a practice-based, prospective study of 917 inpatients referred to a consultation-liaison psychiatry service and diagnosed as depressed, 41% were prescribed an antidepressant: 40% tricyclics, 35% selective serotonin reuptake inhibitors (SSRIs), 15% monoamine oxidase inhibitors (MAOIs)/reversible inhibitors of monoamine (RIMAs) (mainly moclobemide), and 11% tetracyclics (mianserin). Factors associated with choice of antidepressant type included age, referral for pain, length and seriousness of physical illness, type of physical illness, and concurrent antipsychotics (P < 0.01). Tetracyclics and MAOI/RIMAs were used significantly more often than tricyclics in the more severely physically ill and the elderly. The percentage of patients prescribed an antidepressant increased significantly over time, which is accounted for by the greater use of SSRIs across all age groups and degrees of seriousness of illness. There is a paucity of randomized controlled trials on which to base practice guidelines. Practice-based research such as this helps inform those guidelines.
机译:在一项针对917名住院患者的基于实践的前瞻性研究中,他们转诊至咨询精神病学服务部门,被诊断为抑郁症,其中41%的患者开了抗抑郁药:40%三环类,35%选择性5-羟色胺再摄取抑制剂(SSRIs),15%单胺氧化酶抑制剂(MAOIs)/单胺(RIMA)(主要是吗氯米德)和11%四环(米安色林)的可逆抑制剂。与抗抑郁药类型选择相关的因素包括年龄,疼痛转诊,身体疾病的时间和严重程度,身体疾病的类型以及并发抗精神病药(P <0.01)。在身体较重的人和老年人中,四环和MAOI / RIMA的使用频率明显高于三环。服用抗抑郁药的患者百分比随时间而显着增加,这是由于所有年龄段的SSRI使用量增加以及疾病的严重程度所致。很少有作为实践指南基础的随机对照试验。这样的基于实践的研究有助于为这些指南提供信息。

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