1556例儿童、青少年精神疾病患者抗精神病药使用情况回顾性分析

Retrospective analysis of antipsychotic medications in 1556 children and adolescents with psychiatric disorders

目的调查北京回龙观医院近5年收治的儿童、青少年精神障碍患者抗精神病药及镇静催眠药联合使用情况。方法对2016年1月—2020年12月在北京回龙观医院住院治疗的儿童、青少年患者出院当日的诊断分类及使用的抗精神病药、镇静催眠药等进行回顾性分析。结果(1)共有1556例患者出院当日使用了抗精神病药;使用频率前5的依次为阿立哌唑、喹硫平、奥氮平、利培酮、帕利哌酮缓释片。(2)1556例患者全部为单一诊断,频率依次为抑郁障碍、精神分裂症及相关精神障碍、双相障碍、强迫障碍以及通常起病于儿童青少年的行为与情绪障碍。(3)抑郁障碍患者使用频率前3位的抗精神病药为阿立哌唑、喹硫平、奥氮平。精神分裂症及相关精神障碍使用频率前3的药物为阿立哌唑、奥氮平、利培酮;双相情感障碍使用频率最高的药物为喹硫平;使用频率最高的镇静催眠药为劳拉西泮。(4)青少年组使用阿立哌唑、奥氮平的剂量显著高于儿童组(P<0.01),女性患者使用利培酮的剂量显著高于男性(P<0.01);阿立哌唑、喹硫平使用频率呈逐年上升趋势,奥氮平、利培酮呈逐年下降趋势。结论儿童、青少年精神疾病患者的抗精神病药治疗以非典型抗精神病药为主,不同年龄、性别用药剂量不同,阿立哌唑、喹硫平的使用频率呈上升趋势。

Objective To investigate the application of antipsychotics and sedative hypnotics in children and adolescents with mental disorders hospitalized in Beijing Huilongguan Hospital in past 5 years.Methods A retrospective analysis was conducted in children and adolescents who discharged from Beijing Huilongguan Hospital from January 2016 to December 2020.The analysis focused on the diagnostic classification,therapeutic drug types,and drug doses on discharge day.Results(1)A total of 1556 patients received antipsychotics on discharge day,and the top five antipsychotics were aripiprazole,quetiapine,olanzapine,risperidone and paliperidone extended-release tablet,respectively.(2)Each of the 1556 patients was diagnosed as single diseases,such as depressive disorders,schizophrenia and schizophrenia spectrum disorders,bipolar disorders,obsessive compulsive disorders,usually originating from behavioral and emotional disorders in children and adolescents.(3)The top three antipsychotic drugs for treatment of depression were aripiprazole,quetiapine,olanzapine.The top three types for schizophrenia related mental disorders were aripiprazole,olanzapine,risperidone.We also found that the most frequently used drug in bipolar disorder was quetiapine and the most frequently used sedative hypnotics was lorazepam.(4)The dosages of aripiprazole,olanzapine were significant higher in adolescents than children(P<0.01).Females were significantly higher than males in the dosages of risperidone(P<0.01).The application of aripiprazole and quetiapine was increased while olanzapine and risperidone were decreased year by year.Conclusion The atypical antipsychotics have become the main choices for young patients and the dosage was different in different ages and genders.The prescriptions of aripiprazole and quetiapine were increased significantly.