摘要
目的了解北京三级甲等医院精神科相关医生接诊的心境障碍（mooddisorder，MD）患者中双相情感障碍（bipolardisorder，BPD）所占比例，探讨医生对双相情感障碍发病情况的认知及临床用药方案。方法自拟调查问卷，选择北京安定医院门诊出诊的所有精神科医生、宣武医院神经内科门诊出诊的所有神经科医生及两所医院接诊的所有心境障碍患者进行问卷调查，重点关注心境障碍患者中双相情感障碍的构成比例、医生对门诊双相情感障碍发病的估算比例、双相情感障碍治疗中医生对抗抑郁药物的使用意向及临床中的实际用药方案。结果北京安定医院和北京宣武医院精神科相关的医生接诊心境障碍中双相情感障碍比例分别为41．79％、12．24％，评估门诊接诊MD中BPD构成比例低于40％的分别占60．87％、100％，使用抗抑郁药抑郁相治疗BPD分别占100％、72．22％，治疗中选择“抗抑郁药＋情感稳定剂”或“抗抑郁药＋情感稳定剂＋抗精神病药物”分别为100％、66．67％。结论双相障碍识别率偏低，无论是专科医院还是综合医院，精神科相关医生有必要重视对心境障碍患者中双相情感障碍的识别与用药合理性的论证工作。
Objective To acquire the case constitution of bipolar disordered （BPD） in mood disordered （MD） outpatients at two local Beijing hospitals to understand the case constitution and medication intention of clinical psychiatrists in terms of differentiation and treatment of BPD. Methods All psychiatrists at Anding Hospital and neurological physicians at Xuanwu Hospital were surveyed by self-rated questionnaires and the analysis focused on the composition of proportions of BPD cases out of MD patients. The items included estimated ratio of BPD cases, doctors＇ intention of drug prescription and clinical therapeutic regimen for treatment of BPD. Results①BPD ratio in MD outpatients of two hospitals were 41.79% and 12. 24% respectively; ②Doctor＇s ratio who estimated BPD ratio in MD cases 〈 40% were 60% and 100% respectively; ③100% psychiatrists at Beijing Anding Hospital and 72.22% neurological physicians at Beijing Xuanwu Hospital prescribed antidepressant to BPD cases; ④Doctor＇s ratio who adopted therapeutic schedule of ＇antidepressant ＋ mood stabilizer＇ or＇ antidepressant ＋ mood stabilizer ＋ antipsychotic agents for BPD were 100% and 66. 67% respectively. Conclusion Regardless of mental specialized hospital or general hospital, the physicians should pay great attention to the differentiation of BPD and the rationalitv of drug nreseription.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第8期594-596,共3页
National Medical Journal of China
基金
北京市科委研发攻关项目（D10110704780000）
