Conley R R, Love R C, Kelly D L, Bartko J J
Maryland Psychiatric Research Center, University of Maryland, Baltimore, USA.
Am J Psychiatry. 1999 Jun;156(6):863-8. doi: 10.1176/ajp.156.6.863.
The purpose of this study was to examine rehospitalization rates of people receiving risperidone or clozapine who had been discharged from state psychiatric hospitals in Maryland.
Rehospitalization status was monitored for all patients discharged from state psychiatric facilities on a regimen of either risperidone or clozapine between March 14, 1994, and Dec. 31, 1995. Patients were followed up with respect to readmission until Dec. 31, 1996. Time to readmission was measured by the product-limit (Kaplan-Meier) formula. Risk factors associated with rehospitalization were examined.
One hundred sixty patients were discharged on risperidone, 75 having the diagnosis of schizophrenia. The patients with schizophrenia were more likely to be readmitted than the 85 patients with other mental disorders. Recidivism rates for schizophrenic patients discharged on risperidone versus those discharged on clozapine were not significantly different over the 24-month study period. However, no patient who received clozapine and remained discharged for more than 10 months (N = 49) was readmitted, while the readmission rate for risperidone-treated patients appeared to be steady up to 24 months. At 24 months 87% of the clozapine-treated patients and 66% of the risperidone-treated patients remained in the community. No clinical or demographic variables were found to predict rehospitalization.
This study demonstrates that the rehospitalization rates of patients taking the second-generation antipsychotics risperidone and clozapine are lower than those in previously published reports of conventional antipsychotic treatment.
本研究旨在调查马里兰州从州立精神病医院出院的服用利培酮或氯氮平的患者的再次住院率。
对1994年3月14日至1995年12月31日期间从州立精神病机构出院并接受利培酮或氯氮平治疗方案的所有患者的再次住院情况进行监测。对患者进行再入院随访直至1996年12月31日。采用乘积限(Kaplan-Meier)公式测量再入院时间。研究与再次住院相关的危险因素。
160名患者出院时服用利培酮,其中75名诊断为精神分裂症。精神分裂症患者比85名患有其他精神障碍的患者更易再次住院。在24个月的研究期内,服用利培酮出院的精神分裂症患者与服用氯氮平出院的患者的复发率无显著差异。然而,没有接受氯氮平治疗且出院超过10个月的患者(N = 49)再次住院,而服用利培酮治疗的患者的再次住院率在24个月内似乎保持稳定。在24个月时,87%接受氯氮平治疗的患者和66%接受利培酮治疗的患者仍留在社区。未发现可预测再次住院的临床或人口统计学变量。
本研究表明,服用第二代抗精神病药物利培酮和氯氮平的患者的再次住院率低于先前发表的传统抗精神病药物治疗报告中的再次住院率。