일 종합병원에서 정신분열병과 분열정동장애를 진단받은 환자에서 항정신병약물의 1차 선택약물의 비율 및 1년 유지율에 관한 연구 (The Study for the First-Drug Prescription Rate and Maintenance Rate of Antipsychotics in Patients who Developed(Were Diagnosed With) Schizophrenia and Schizoaffective Disorder in a General Hospital)

서지정보

· 발행기관 : 대한생물치료정신의학회
· 수록지 정보 : 생물치료정신의학 / 14권 / 1호 / 49 ~ 57페이지
· 저자명 : 왕관수, 김정기, 조동환, 제호준, 서영익, 최성진, 장옥진

초록

본 연구는 미리 통제되지 않은 자연스런 진료 상황에 서 정신분열병 환자들을 대상으로 항정신병 약물의 일 차 처방 빈도 및 1년 유지율을 조사하여 약물의 효과 를 간접적으로 조사하였다. 대부분의 환자들에서 atypic ¬al antipsychotics가 일차처방약물로 선택되어졌고, 1 년 유지율에서 typical antipsychotics가 더 높은 1년 유지율을 보였다. 이번 연구결과에서는 저자들의 예상 과는 달리 typical antipsychotics인 haloperidol이 제 일 높은 1년 유지율을 보였다. 그러나 typical antipsy ¬chotics를 처방받은 환자수가 상대적으로 적었기 때문 에 실제로 typical antipsychotics가 atypical antipsy ¬chotics에 비해 더 높은 1년 유지율을 보인다고 결론 지을 수는 없을 것이다. 따라서 이번 결과를 토대로 앞 으로 여러 기관들이 참여하는, 더 많은 환자들을 대상 으로 하는 연구가 시행되기를 기대한다.

영어초록

Objectives：This study was designed to evaluate prescription rate and indirectly the tolerability of antipsychotics using the maintenance rate for 1 year. The study was done in a situation where the patients who were diagnosed with either schizophrenia or schizoaffective disorder were given the antipsychotics and were looked into the pre¬scription rate and the state of use of drugs at first regardless of kind of drugs.
Methods： This was a retrospective, naturalistic study using the data from medical record conducted in both in ¬patients and outpatients from January 1st in 2002 and June 30th in 2004 with a diagnosis of schizophrenia and schizoaffective disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients were evaluated at 3, 6, 9, and 12th months after the onset of medication for the first-drug prescription rate and maintenance rate.
Results：In total, 105 patients were recruited, and 40 out of 105 were male and 65 out of 105 were female. The mean age was 34.71 years old. The number of patients with schizophrenia was 94 and that of schizoaffective disorderwas 11. For the prescription rate of first drugs, of total risperidone was 56.2%；likely, 25.7% for olanzapine；10.5%for haloperidol；4.8% for quetiapine；and 2.9% for chlorpromazine. For 1-year maintenance rate, of total, haloperidolwas 45.5%；33.3% for chlorpromazine；22.0% for risperidone；14.8% for olanzapine；and 20.0% for quetiapine.
Conclusion：Overall, atypical antipsychotics were far more prescribed than typical ones(86.7% and 13.3% for atypical and typical antipsychotics respectively). Although atypical antipsychotics were more prescribed than typical ones, the one-year maintenance rate was not higher than typical antipsychotics unlike our expectation that atypical antipsychotics would have better compliance and higher maintenance rate for 1 year under the circumstances with uncontrolled naturalistic conditions. There should be more statistical data available with larger sample size in the future.

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