喹硫平早期辅助治疗对首诊强迫症患者脱落率的影响

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (9): 1042-1047.

喹硫平早期辅助治疗对首诊强迫症患者脱落率的影响

王继辉, 吴小立, 甘照宇, 温盛霖

中山大学附属第三医院心理科,广州 510630,广东

收稿日期:2012-04-05 修回日期:2012-05-21 发布日期:2012-09-25
通讯作者: 温盛霖,通信作者,男,硕士,副教授,研究方向:生物精神医学。Tel: 020-85252190 E-mail: wenshl@mail.sysu.edu.cn
作者简介:王继辉,男,硕士,主治医师,研究方向:焦虑障碍。Tel: 020-85252190 E-mail: jonny928@126.com
基金资助:
广东省自然科学基金(9151008901000027)

Quetiapine(QUE) augmentation of selective serotonin reuptake inhibitors (SSRIs) on initial phase for drugfree obsessive-compulsive disorder(OCD):about dropout

WANG Ji-hui, WU Xiao-li, GAN Zhao-yu, WEN Sheng-lin

Department of Psychiatry, Third Affiliated Hospital of Sun-Yat Sen University, Guangzhou 510630, Guangdong,China

Received:2012-04-05 Revised:2012-05-21 Published:2012-09-25

摘要/Abstract

摘要： 目的研究早期联合喹硫平(quetiapine,QUE)治疗对首诊强迫症(obsessive-compulsive disorder,OCD)药物治疗脱落率的影响。方法对146例门诊首诊并且接受5-羟色胺再摄取抑制剂 (selective serotonin reuptake inhibitors ,SSRIs) 治疗的OCD患者进行回顾性研究,调查一般资料、治疗前症状自评量表(SCL-90)评分、首诊药物方案、脱落情况,按照首诊药物方案分为SSRIs组(108例)和SSRIs+QUE组(38例)。脱落定义为在12周之前终止治疗。通过二元Logistic回归分析了解脱落的影响因素。结果首诊SSRIs+QUE组的脱落率为 34.2%(13/38),SSRIs组脱落率为 70.4%(76/108),差异具有统计学意义(χ²=15.44,P<0.01)。回归分析结果显示,脱落的发生和首诊药物方案、治疗前强迫症状严重程度相关,首诊联合喹硫平治疗可降低脱落率(Wals=10.041,P<0.01),治疗前强迫症状轻的患者更容易发生脱落(Wals=8.196,P<0.01)。结论首诊联合喹硫平可降低OCD患者的脱落率,使得更多的患者从随后的治疗中获益。

关键词: 强迫症, 脱落, 喹硫平, 治疗

Abstract: AIM: To evaluate the impact of quetiapine augmentation of selective serotonin reuptake inhibitors (SSRIs) on dropout in drugfree obsessive-compulsive disorder(OCD) patients in real practice. METHODS: 146 drugfree OCD patients who were prescribed SSRIs either alone or with quetiapine on initial phase were investigated retrospectively about dropout and relevant information. Dropout was defined as treatment interruption prior to the end of the first 12 week treatment period. Symptom Checklist-90 (SCL-90) were assessed on baseline. Chisquare and Mann-Whitney tests were used to compare the difference between dropouts and completers. Prediction of dropout was conducted using logistic regression analysis. Variables with a P value<0.05 with respect to the difference between dropouts and completers in this initial analysis were included in the logistic regression analysis where dropout was the response variable. RESULTS: The patients who were prescribed SSRIs+QUE on initial phase were less likely to drop out than those who were prescribed only SSRIs(dropout rates, 40% vs 70.4%,χ²=9.37,P<0.01). According to the result of the logistic regression analysis, the initial prescription type(P<0.01)and the severity of pretreatment OCD symptoms(P<0.01) were significantly associated with the probability of dropout. CONCLUSION: SSRIs+QUE therapy on initial phase could decrease the dropout from treatment for drugfree OCD patients, which meant OCD patients would have more chance to benefit from continuing treatment .

Key words: Obsessive-compulsive disorder, Dropout, Quetiapine, Treatment

中图分类号:

R749

王继辉, 吴小立, 甘照宇, 温盛霖. 喹硫平早期辅助治疗对首诊强迫症患者脱落率的影响[J]. 中国临床药理学与治疗学, 2012, 17(9): 1042-1047.

WANG Ji-hui, WU Xiao-li, GAN Zhao-yu, WEN Sheng-lin. Quetiapine(QUE) augmentation of selective serotonin reuptake inhibitors (SSRIs) on initial phase for drugfree obsessive-compulsive disorder(OCD):about dropout[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(9): 1042-1047.

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