RESUMO
The use of a structured diagnostic interview (The Schedule for Affective Disorders and Schizophrenia) with 58 consecutively admitted general adult psychiatric patients revealed that 62.1% of them abused alcohol and 58.6% had a substance use disorder. The drug abusers did not differ significantly from the nonabusers on mean psychoticism (Brief Psychiatric Rating Scale) scores. However, they received higher doses of antipsychotic agents (mean daily dose 1022 mg CPZ EQ (SD = 614) vs 609 mg CPZ EQ (SD = 481); z = 2.58, p < .01) to achieve stabilization. The clinical implications of this finding are discussed.
Assuntos
Clorpromazina/administração & dosagem , Clorpromazina/uso terapêutico , Relação Dose-Resposta a Droga , Etanol , Transtornos Mentais/complicações , Transtornos Mentais/tratamento farmacológico , Entorpecentes , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The records of 377 bipolar disorder patients who were consecutively admitted to a general inpatient psychiatric unit in mid-Michigan over a 6-year period were examined. The seasonal variation of hospitalization, total sleep time, thyroid stimulating hormone, creatinine levels, lithium dosage and serum levels, aggressive behavior, and treatment outcome were analyzed. Among men, the admission rate peaked in the springtime. Women demonstrated a bimodal season distribution, with peak admission rates in spring and fall. Aggressive behavior in both men and women peaked in the spring (z = 2.50, p < 0.05). Men maintained on lithium achieved higher serum lithium levels during the summer months. These findings parallel previous reports regarding the influence of seasons upon bipolar disorder. The therapeutic implications related to seasonality and mania are discussed.
Assuntos
Transtorno Bipolar/epidemiologia , Admissão do Paciente/estatística & dados numéricos , Estações do Ano , Adulto , Agressão/efeitos dos fármacos , Agressão/psicologia , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Estudos Transversais , Relação Dose-Resposta a Droga , Feminino , Humanos , Incidência , Lítio/farmacocinética , Lítio/uso terapêutico , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A retrospective review of 493 patients treated during a single month in a general hospital in mid-Michigan revealed that a majority (84.2%) of them received prescriptions for sedative-hypnotic drugs. These were p.r.n. in 66% of cases and routine prescriptions in the remainder. Prescriptions were equally distributed across the specialties: internal medicine 15%, surgery 23%, family practice 19%, psychiatry 22%, and OB/GYN 20%. Flurazepam was the most frequently prescribed drug (48.4%), followed by triazolam (24.6%) and temazepam (12.2%). Actual utilization rates were highest among psychiatric patients (85%) and lowest in obstetrics (33%). The therapeutic rationale for prescribing sedative hypnotic agents to hospitalized patients is discussed.
