Patterns of Drug Use and Factors Associated with Polypharmacy in Elderly Patients Visiting Psychiatric Outpatient Clinic / 신경정신의학

OBJECTIVES: The objective of this study was to investigate the patterns and recent trends in polypharmacy among elderly patients visiting psychiatric outpatient clinic. METHODS: 289 elderly patients visiting psychiatric outpatient clinic were interviewed and their medical records were thoroughly reviewed. Inclusion criteria were as follows : 1) 65 years and older age patients, 2) diagnosed with one or more psychiatric disorder according to ICD-10 criteria, 3) who were willing to participate in this research. Demographic data and clinical data, including prevalence of polypharmacy, doses and types of drugs both prescribed and self-administered, were analyzed. Polypharmacy was defined as the long-term simultaneous use of six or more drugs. Data were statistically analyzed by t-test, analysis of variance, and simple regression analysis. RESULTS: 57.1% of the patients were prescribed with more than six drugs simultaneously. Mean number [+/-standard deviation (SD)] of psychiatric drug was 3.42+/-1.41. Prevalence of polyphamacy was different among psychiatric disorder groups, bipolar disorder group being the highest (mean+/-SD drug used=5.17+/-0.98). Regarding sedative-hypnotics, 59.5% of patients were prescribed (mean+/-SD drug used=2.02+/-1.07). Visual Analogue Scale (VAS) and total number of drugs prescribed were positively correlated (p<0.05). Herb medicine/dietary supplement had no influence on total number of used drugs. CONCLUSION: Elderly patients are suffering from many comorbidities and vulnerable to multiple drug use that can be potentially harmful, so it is important and essential to be aware of the possibility of polypharmacy and prescribe appropriate drugs to improve their quality of life.

Dream Recall Frequency among Patients in a Psychiatric Outpatient Clinic in Ile-Ife; Nigeria

Aim: The aim of this study was to find out if the frequency of dream recall among neuropsychiatric patients on psychotropic drugs was significantly different from that of healthy individuals. Methods: The study was done on 53 neuropsychiatric patients with different diagnoses who were on medication and 144 healthy individuals. The number of participants in each group who recalled their dreams and those who did not were compared and analyzed statistically for any significant difference. Results: Thirty-five out of the 53 neuropsychiatric patients and 133 out of the 144 healthy individuals were able to recall their dreams. A significantly (p 0.001) higher proportion of the healthy individuals compared to neuropsychiatric patients on medications were able to recall their dreams. Conclusions: This study has shown that neuropsychiatric patients on medications may have reduced dream episodes or that their ability to remember their dreams may be impaired. A combination of both factors is not unlikely. Thus, the patients have reduced dream recall frequency (DRF) compared to healthy subjects. There might also be individuals who do not dream.

Neutropenia in Psychiatric Out-Patients / 대한정신약물학회지

OBJECT: The study was performed to examine the psychotrophic drugs used in psychiatric out-patients in which neutropenia developed and current state of consultation and to confirm the importance of complete blood count and differential count (CBC/DC). SUBJECTS AND METHODS: The subjects were 60 patients of our university hospital in which neutropenia developed in out-patient department (OPD) of psychiatry during recent three years. The absolute neutrophil counts of patient were below 2,000/mm3. RESULTS: The reasons why exam was performed were mainly to follow-up exam during medications. Mood stabilizers such as carbamazepine, phenytoin, sodium valproate were identified to cause neutropenia in the group using multiple drugs, and clozapine was highly related in the group using single drug. But many kinds of drugs were related with neutropenia. We have not checked well enough the CBC/DC and have not consulted well to hematologist in OPD of neuropsychiatry. CONCLUSIONS: It is important to find neutropenia in the psychiatric out-patients using psychotropic drugs. We had better check CBC/DC routinely and consult to hematologist.

Frequency and Clinical Characteristics of Pain of the Patients in Psychiatric Out-patient Clinics / 신경정신의학

OBJECTIVES: The purposes of this study were to investigate the frequency and clinical characteristics of pain among the psychiatric out-patients in three clinics. METHODS: A Total of 843 psychiatric adult out-patients (298 subjects from a private clinic, 99 subjects from a general hospital, 446 subjects from a university hospital) were assessed for the presence of pain during OPD follow-up and at the time assessed. And, the presence of organic causes, duration and site of pain, aggravating factors, compensation problems, and prescribed drugs were also investigated. RESULTS: 1) The frequency of pain among psychiatric out-patients was overall 41.3% (44.9% in private clinic, 44.5% in general hospital, and 38.1% in university hospital, respectively). 2) The frequency of pain at the time assessed was 24.1%. In severity of pain, the average of VAS was 46.7+/-18.0mm. Patients of private clinic showed more severe pain than that of general hospital. Moreover, patients who experienced over 'marked' occupied 34.0% and pain as over 'distressed' occupied 26.2%. 3) Only a few subjects had the definite organic causes (1.5-5.9%). The most common site of pain was on head. The patients having a pain over 6 months (i.e. chronic pain) occupied 68.7%. 4) The most common drugs prescribed were anxiolytics; 41.4% of patients were prescribed. The analgesics were prescribed only in 3.2% of patients. CONCLUSION: This result revealed that more than 40% of patients experienced pain in psychiatric OPD and two third of patients were suffered from chronic pain. Therefore, the evaluation and management of pain should be more emphasized.