Antipsychotic Medications in Major Depression and the Association with Treatment Satisfaction and Quality of Life： Findings of Three National Surveys on Use of Psychotropics in China Between 2002 and 2012  

作　　者：Yu-Xi Wang Yu-Tao Xiang Yun-Ai Su Qian Li Liang Shu Chee H Ng Gabor S Ungvari Helen FK Chiu Yu-Ping Nin Gao-Hua Wang Pei-Shen Bai Tao Li Li-Zhong Sun Jian-Guo Shi Xian-Sheng Chen Qi-Yi Mei Ke-Qing Li Xin Yu Tian-Mei Si 

机构地区：[1]National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital/Institute of Mental Health), and The Key Laboratory of Mental Health Ministry of Health (Peking University), Beijing 100191, China [2]Faculty of Health Sciences, University of Macao, Macao SAR, China [3]Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia [4]The University of Notre Dame Australia/Marian Centre, Perth, Australia [5]School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia [6]Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China [7]Guangzhou Psychiatric Hospital, Guangzhou, Guangdong 510370, China [8]Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, Hubei 430060, China [9]Department of Mental Health, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China [10]Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China [11]Neuropsychiatric Hospital, Siping, Jilin 136000, China [12]Shaanxi Mental Health Center, Xran, Shaanxi 710061, China [13]Jiangxi Mental Health Center, Nanchang, Jiangxi 330029, China [14]Suzhou Guangji Hospital, Suzhou, Jiangsu 215008, China [15]Hebei Mental Health Center, Baoding, Hebei 071051, China

出　　处：《Chinese Medical Journal》2015年第14期1847-1852,共6页中华医学杂志（英文版）

摘　　要：Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns ofantipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life （QOL）. Methods： A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients＇ socio-demographic and clinical characteristics including psychopathology, medication side effects. satisfaction with treatment and QOL were recorded using a standardized protocol and data collection. Results： The frequency ofantipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively （χ^2 = 90.3, df= 2, P 〈 0.001 ）. Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals （i.e., Level-Ⅲ hospital）. Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups. Conclusions： Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients＇ and relatives＇ satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.Background： Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns ofantipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life （QOL）. Methods： A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients＇ socio-demographic and clinical characteristics including psychopathology, medication side effects. satisfaction with treatment and QOL were recorded using a standardized protocol and data collection. Results： The frequency ofantipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively （χ^2 = 90.3, df= 2, P 〈 0.001 ）. Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals （i.e., Level-Ⅲ hospital）. Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups. Conclusions： Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients＇ and relatives＇ satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.

关 键 词：Antipsychotic Medication Major Depression Prescription Patterns 

分 类 号：O212.1[理学—概率论与数理统计] F126[理学—数学]