精神分裂症患者首次抗精神病药物治疗中断的影响因素

The influence factors of first antipsychotic medication interruption in schizophrenic patients

目的探讨精神分裂症患者首次抗精神病药物治疗中断影响因素。方法纳入2022年1月1日~2023年1月1日芜湖市第四人民医院收治的首发精神分裂症患者,所有患者均采用第二代抗精神病药物为主的居家治疗,首次治疗后随访6个月,记录中断治疗发生情况,比较有无中断治疗患者年龄、性别、学历等一般资料,采用Logistic回归分析中断治疗影响因素。结果89例精神分裂症患者有30例患者出现过中断治疗情况;有无中断治疗患者学历、服药种类、居住地、家庭监护能力、副反应量表评分(Treatment Emergent Symptom Scale,TESS)、婚姻情况、复诊情况差异具有统计学意义(P<0.05),两组年龄、性别、精神疾病家族史差异无统计学意义(P>0.05);Logistic回归分析显示,小学及以下学历、服药种类≥2种、居住农村、家庭监护能力差、TESS评分>30分是精神分裂症患者首次抗精神病药物中断治疗的影响因素。结论精神分裂症患者首次抗精神病治疗时容易出现药物治疗中断的现象,学历低、服药种类多等可能增加药物中断治疗风险,应加强随访以及健康教育。

Objective To explore the influence factors of first antipsychotic medication interruption in patients with schizophrenia.Methods The patients with first-episode schizophrenia admitted to the Fourth People's Hospital of Wuhu City from January 1,2022 to January 1,2023 were included.All patients were treated with second-generation antipsychotic drugs mainly at home.The occurrence of treatment interruption was recorded at 6-month follow-up after the first treatment.General data such as age,gender,and education of patients with and without treatment interruption were compared.Logistics regression was used to analyze the factors affecting treatment interruption.Results Thirty of the 89 schizophrenic patients had treatment interruptions.The dfferences in education,type of medication,place of residence,family guardianship,Treatment Emergent Symptom Scale(TESS),marital status,and follow-up were statistically significant(P<0.05).The differences in age,gender,and family history of mental illness between the two groups were not statistically significant(P>0.05).Logistics regression analysis showed that elementary school education and below,taking≥2 types of medication,living in rural areas,poor family guardianship,and TESS score>30 were the influencing factors for the first time of antipsychotic medication interruption in schizophrenic patients.Conclusion Patients with schizophrenia are susceptible to medication interruptions during their first antipsychotic treatment,and low educational attainment and the variety of medications taken may increase the risk of medication interruptions,so follow-up as well as health education should be strengthened.