125例双相情感障碍药物使用现况调查

Survey on medication treatment patterns in 125 patients with bipolar disorder

目的调查河北省双相情感障碍患者精神药物的使用现况及3级(省级、市级、县级)医院精神科的处方差异。方法按一定的抽样比例,选取河北省37所精神疾病专科医院或综合医院精神科的125例双相情感障碍患者,于2007年11月19日至23日使用自制的调查问卷进行双相情感障碍处方方式的现况调查。结果 (1)125例患者中,躁狂相104例(83.2%),抑郁相21例(16.8%);123例(94.4%)患者接受精神药物治疗。(2)主要治疗药物为心境稳定剂98例(78.4%),抗精神病药89例(71.2%)。(3)躁狂相患者使用心境稳定剂(84.6%)和抗精神病药(79.8%)治疗为主,抑郁相患者使用抗抑郁药的频率较高(85.7%)。(4)市级医院抗抑郁剂的使用频率(32.8%)高于省级(4.8%)、县级(9.1%)医院(P<0.05)。结论河北省双相情感障碍精神药物的使用基本符合中国双相情感障碍防治指南,但在县、市级医院有使用不合理之处。建议进一步加强双相情感障碍防治指南的基层培训。

Objective To evaluate the use patterns of a medication treatment in the patients with bipolar disorder in Hebei province, and analyze the difference among the hospitals at 3 Cevels. Methods 125 patients with bipolar disorder were surveyed using the retested and revised self-made questionnaire, with the same sampling ratio, 37 hospitals in Hebei Province during 19th-23th, Nov, 2007. Results （1） The total number of sample was 125, including 104 （83.2%） patients with bipolar mania and 21 （16.8%） with bipolar depression, and 123 cases were treated with psychotropic drugs. （2） Most frequently prescribed was mood stabilizers （98 cases, 78.4%）. 89 cases （71.2%） were treated with antipsychotic agents. （3） Bipola rmania were treated mainly with mood stabilizers （84.6%） and anfipsychotic agents （79.8%）. Most patients with bipolar depression （85.7%） were treated with the antidepressants. （4） The frequently prescribed antidepressants in municipal hospitals （32.8%） was higher than in provincial hospitals （4.8%） and county hospitals （9.1%）, （P〈0.05）. Conclusion Medication prescription pattern for patients with bipolar disorder in Hebei province is in principle adherent to published practice guidelines, but high rate of antidepressants used in bipolar depression remains in clinical practice.Training of guidelines should be strengthed.