CAJ | 학술논문

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(mood disorder,MD)患者中双相情感障碍(bipolar disorder,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.
목적 료해북경삼급갑등의원정신과상관의생접진적심경장애(mood disorder,MD)환자중쌍상정감장애(bipolar disorder,BPD)소점비례,탐토의생대쌍상정감장애발병정황적인지급림상용약방안.방법 자의조사문권,선택북경안정의원문진출진적소유정신과의생、선무의원신경내과문진출진적소유신경과의생급량소의원접진적소유심경장애환자진행문권조사,중점관주심경장애환자중쌍상정감장애적구성비례、의생대문진쌍상정감장애발병적고산비례、쌍상정감장애치료중의생대항억욱약물적사용의향급림상중적실제용약방안.결과 북경안정의원화북경선무의원정신과상관적의생접진심경장애중쌍상정감장애비례분별위41.79％、12.24％,평고문진접진MD중BPD구성비례저우40％적분별점60.87％、100％,사용항억욱약억욱상치료BPD분별점100％、72.22％,치료중선택“항억욱약+정감은정제”혹“항억욱약+정감은정제+항정신병약물”분별위100％、66.67％.결론 쌍상장애식별솔편저,무론시전과의원환시종합의원,정신과상관의생유필요중시대심경장애환자중쌍상정감장애적식별여용약합이성적론증공작.
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.Results ①BPD 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 rationality of drug prescription.