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首页> 外文期刊>The journal of clinical psychiatry >Patients with schizophrenia at risk for excessive antipsychotic dosing.
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Patients with schizophrenia at risk for excessive antipsychotic dosing.

机译：精神分裂症患者有过量服用抗精神病药的风险。

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BACKGROUND: Patient Outcomes Research Team treatment recommendations were used to investigate the relationship between patient characteristics and higher-than-recommended dosages (> 1000 chlorpromazine equivalents [CPZe]) at discharge. METHOD: Inpatients who met the DSM-IV criteria for schizophrenia or schizoaffective disorder were recruited from 4 general hospitals. For those patients (N = 293) prescribed antipsychotics at discharge, chi-square tests and multiple regression analyses were used to assess the relationship between demographics, admission characteristics, comorbid diagnoses, and antipsychotic dosages. The relationship between clinical symptoms and antipsychotic dosage at discharge was also examined. RESULTS: Antipsychotic dosages conformed to treatment guidelines for approximately 65% of patients; 21% received doses in excess of recommended levels. African American patients and those with a history of psychiatric hospitalization were more likely to be prescribed discharge antipsychotic doses greater than 1000 CPZe. Hospital differences in antipsychotic management were also observed. Regression analyses indicated that higher-than-recommended dosages found among African American patients could not be explained by differences in symptom levels at discharge. Patients with more thought disorder were also more likely to be prescribed antipsychotic dosages in excess of the recommended range. Compared with oral administration, depot administration increased the risk of excess dosage by a factor of 30. Controlling for method of administration reduced the impact of race to nonsignificance. CONCLUSION: These results replicate earlier findings that minority individuals are more likely to be prescribed dosages in excess of the recommended range and suggest that this pattern is due to higher use of depot injection in African American patients. Further research should examine how patient characteristics and institutional factors influence medication use.
机译：背景：患者结果研究小组的治疗建议用于研究患者特征与出院时高于推荐剂量（> 1000氯丙嗪当量[CPZe]）之间的关系。方法：从4家综合医院招募符合DSM-IV标准的精神分裂症或精神分裂症患者。对于出院时规定的抗精神病药（N = 293）的患者，卡方检验和多元回归分析用于评估人口统计学，入院特征，合并症诊断和抗精神病药剂量之间的关系。还检查了临床症状与出院时抗精神病药剂量之间的关系。结果：大约65％的患者抗精神病药物剂量符合治疗指南; 21％的人接受的剂量超过推荐水平。非裔美国人患者和有精神病住院史的患者更有可能开出大于1000 CPZe的抗精神病药物处方。还观察到医院在抗精神病药物治疗方面的差异。回归分析表明，非洲裔美国人患者中发现的高于推荐剂量的现象不能用出院时症状水平的差异来解释。思想障碍较多的患者也更有可能被处方使用超出推荐范围的抗精神病药物。与口服给药相比，贮库给药将过量剂量的风险增加了30倍。控制给药方法可减少种族无关紧要的影响。结论：这些结果重复了先前的发现，即少数人更可能被处方开出超出推荐范围的剂量，这表明这种模式是由于非裔美国人患者更多地使用了注射剂。进一步的研究应检查患者的特征和机构因素如何影响用药。

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