ABSTRACT
Objective To compare the differences of prescription pattern, adverse events, economic burden and drug-use adherence between preferred mood stabilizers and preferred antipsychotics in patients with bipolar disorder. Methods We investigated 240 cases of patients with bipolar disorder from 39 mental health institutions in 11 cities in Hebei province. The self-made questionnaire was used to investigate the demographic information, disease characteris-tics, prescription pattern and medical expense. The clinical global impression scale-severity of illness (CGI-SI) was used to assess the disease severity. The treatment emergent symptom scale (TESS) was used to assess the adverse drug reac-tions. The medication adherence rating scale (MARS) was used to assess drug therapy compliance in patients. Results One hundred fifty-two patients (63.3%) used antipsychotics as the first choice (antipsychotics group), 88 patients (36.7%) used mood stabilizers as the first choice (mood stabilizers group). The number of patients in-patient (90.1%vs. 76.1%), patients with psychotic symptom (27.0%vs. 11.4%), incidences of adverse events (46.1%vs. 31.8%), drug daily cost (me-dians 12.00 yuan vs. 8.37 yuan) and drug total cost (medians 344.61 yuan vs. 144.64 yuan) were larger in antipsychotics group than in mood stabilizers group (P0.05). Conclusion The bipolar disorder patients more frequently use antipsychotics as the first choice in Hebei province. The use of antipsychotics does not alter the combina-tion medication pattern. In addition, antipsychotics cause a higher incidence of adverse events and heavier economic bur-den compared with mood stabilizers, suggesting that mood stabilizers should be the first choice to bipolar disorder.
ABSTRACT
Objective:To test the validity and reliability of the Chinese version of the Br?set Violence Check-list (BVC-C).Methods:With the authorizing permission by the author,the BVC was translated into Chinese and a-dapted,and five psychiatry experts who had worked more than 20 years were invited (3 clinical doctors and 2 nur-ses)to evaluate the content validity of the scale as the content validity index.Totally 556 inpatients who met the di-agnosis criteria for mental disorders according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were totally selected to proceed the formal testing.The BVC scale was used to evaluate inpatients every 8 hours,the Modified Overt Aggression Scale (MOAS)was used to test concurrent validity;the results of the real attacking incidents were used to test the criterion validity;the internal consistency re-liability of the scale was tested by Cronbach αcoefficient.Results:The content validity index of the scale was0.93.In addition to the own attack subscale,the MOAS total scores and the other 3 subscales scores were positively correlated with the BVC total scores and each item score (r =0.11 -0.69,P <0.01).The best criterion validity was 8 hours through analyzed,the AUC was 0.98.When the cut-off was 2,the sensitivity and specificity were 78.9% and 95.1% respectively.The Cronbach αcoefficient was 0.76 and the item total correlations were 0.47 -0.80 (P <0.01).Conclusion:It suggests that the BVC-C has good validity and reliability,which could be used as an effective prediction tool for psychiatric violence risk assessment.
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OBJECTIVE:To provide reference for rational use of antipsychotic drugs in schizophrenia patients. METHODS:The general information and antipsychotic treatment information,which were extracted from the database of prior drug investigation in Mental Health Center of Hebei Province in 2002,2006 and investigation data in 2012 of 5014 schizophrenia patients,were ana-lyzed. RESULTS:Over time,the frequency of the first generation antipsychotic drugs decreased(P0.05). Over time,the proportion of inpatients receiving monotherapy decreased,while that of inpatients receiving combination treatment increased (χ2=18.682,P<0.01). CONCLUSIONS:The second generation antipsychotic drugs have gradually replaced the first generation antipsy-chotic drugs,and have became the leading drugs in the treatment of schizophrenia in Hebei province. The proportion of inpatients receiving combination treatment has increased,which is different from the domestic and foreign prevention and treatment guide-lines.