精神分裂症的社区治疗获益：基于长效注射用抗精神病药物

doi:10.12114/j.issn.1007-9572.2023.0525

中国全科医学 ›› 2024, Vol. 27 ›› Issue (09): 1021-1027.DOI: 10.12114/j.issn.1007-9572.2023.0525

精神分裂症的社区治疗获益：基于长效注射用抗精神病药物

中华医学会精神医学分会精神分裂症协作组, 中华医学会全科医学分会, 李茜, 司天梅^*()

100191　北京市，北京大学第六医院　北京大学精神卫生研究所　国家卫生健康委员会精神卫生学重点实验室（北京大学）　国家精神心理疾病临床医学研究中心（北京大学第六医院）

收稿日期:2023-08-24 修回日期:2023-11-06 出版日期:2024-03-20 发布日期:2023-12-19
通讯作者: 司天梅
作者贡献：中华医学会精神医学分会精神分裂症协作组及中华医学会全科医学分会专家组讨论提出主要研究目标及思路；李茜负责文献检索、数据提取，撰写论文初稿及修订论文；司天梅负责文章的质量控制，对文章整体负责，监督管理。
基金资助:
首都卫生发展科研专项重点攻关项目(2022-1-4111)

Benefits of Community-based Treatment for Patients with Schizophrenia: Based on Long-acting Injectable Antipsychotic Agents

Schizophrenia Coordination Group, Chinese Society of Psychiatry, Chinese Society of General Practice, LI Qian, SI Tianmei^*()

Peking University Sixth Hospital/Peking University Institute of Mental Health/NHC Key Laboratory of Mental Health (Peking University) /National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China

Received:2023-08-24 Revised:2023-11-06 Published:2024-03-20 Online:2023-12-19
Contact: SI Tianmei

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摘要/Abstract

摘要： 精神分裂症会长期影响患者的社会和职业功能，以社区为基础的精神卫生服务和管理模式通过提高可及性、可接受性、可负担性、实用性和可扩展性来促进患者心理健康。在社区管理模式中，长效注射用抗精神病药物是目前治疗精神分裂症的主要策略之一，但目前缺少相关的证据梳理。本文系统全面地探讨了长效注射用抗精神病药物对精神分裂症患者的获益情况，包括有效性和安全性、依从性、使用态度、社会功能恢复及社区康复等。本文研究结果表明在不同的社区管理模式下，长效注射用抗精神病药物在精神分裂症患者的社区康复中可发挥比口服药物更卓越的疗效，不仅体现在能降低疾病复发率和再住院率，也在患者社会功能恢复、降低肇事率等方面有优秀的表现。但我国依然存在长效注射用抗精神病药物整体处方率低的问题，主要原因包括医疗机构与基层社区信息共享不足，社区医疗服务治疗率较低，患者随访率低，社区精神康复开展较少等。本文可为我国精神分裂症患者的社区治疗提供一定的参考，以探索更多的社区治疗方案，提高精神分裂症患者治疗效果及生活质量。

关键词: 精神分裂症, 抗精神病药, 长效制剂, 长效注射用抗精神病药物, 社区治疗, 获益, 用药依从性

Abstract:

Schizophrenia could affect the social and occupational functions of patients in the long term. Community-based mental health services and management models promote mental health by improving accessibility, acceptability, affordability, practicality and scalability. In the community management model, long-acting injectable antipsychotic agents are one of the main strategies for the treatment of schizophrenia, but there is a lack of relevant evidence. This paper systematically and comprehensively discussed the benefits of long-acting injectable antipsychotic agents in patients with schizophrenia, including effectiveness and safety, compliance, attitude to use, social function recovery and community rehabilitation. The results of this study showed that long-acting injectable antipsychotic agents can exert superior efficacy than oral drugs in the community rehabilitation of schizophrenia patients under different community management modes, not only reflected in the disease recurrence rate and readmission rate, but also in the recovery of social functioning and the reduction of accident rate and other aspects of excellent performance. However, the overall prescription rate of long-acting injectable antipsychotic agents is still low in China. The main reasons include insufficient information sharing between medical institutions and communities in primary level, low community medical services and treatment rate, low follow-up rate of patients, and less community psychiatric rehabilitation. This study can provide some references for the community treatment of schizophrenia patients in China, explore more community treatment programs, and improve the treatment effect and quality of life of schizophrenia patients in China.

Key words: Schizophrenia, Antipsychotic agents, Depot preparation, Long-acting injectable antipsychotic agents, Community treatment, Benefits, Medication adherence

中华医学会精神医学分会精神分裂症协作组,中华医学会全科医学分会,李茜,等. 精神分裂症的社区治疗获益：基于长效注射用抗精神病药物[J]. 中国全科医学, 2024, 27(09): 1021-1027. DOI: 10.12114/j.issn.1007-9572.2023.0525.
Schizophrenia Coordination Group, Chinese Society of Psychiatry,Chinese Society of General Practice,LI Qian, et al. Benefits of Community-based Treatment for Patients with Schizophrenia: Based on Long-acting Injectable Antipsychotic Agents[J]. Chinese General Practice, 2024, 27(09): 1021-1027. DOI: 10.12114/j.issn.1007-9572.2023.0525.

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精神分裂症的社区治疗获益：基于长效注射用抗精神病药物

Benefits of Community-based Treatment for Patients with Schizophrenia: Based on Long-acting Injectable Antipsychotic Agents

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