論文 - 高江洲　義和

「睡眠」に着目した向精神薬の作用再考　薬剤誘発性の睡眠時随伴症

普天間国博, 高江洲義和

臨床精神薬理   25 ( 10 ) 1121 - 1129   2022年10月

掲載種別: 研究論文（その他学術会議資料等）

Second-Generation Antipsychotic Monotherapy Contributes to the Discontinuation of Anticholinergic Drugs in Hospitalized Patients With Schizophrenia.

Tsuyoshi Okada, Hikaru Hori, Naomi Hasegawa, Atsunobu Murata, Yoshitaka Kyou, Fumitoshi Kodaka, Hitoshi Iida, Shinichiro Ochi, Yoshikazu Takaesu, Takashi Tsuboi, Jun-Ichi Iga, Kayo Ichihashi, Hiroyuki Muraoka, Ryuji Furihata, Norio Yasui-Furukori, Masahide Usami, Toshiaki Onitsuka, Kazuyoshi Ogasawara, Hiromi Tagata, Masahiro Takeshima, Kazutaka Ohi, Shusuke Numata, Naoki Hashimoto, Hiroki Yamada, Manabu Makinodan, Hiroshi Komatsu, Akitoyo Hishimoto, Hirotaka Yamagata, Mikio Kido, Chika Kubota, Kiyokazu Atake, Hisashi Yamada, Tatsuya Nagasawa, Junya Matsumoto, Kenichiro Miura, Ken Inada, Koichiro Watanabe, Shiro Suda, Ryota Hashimoto

Journal of clinical psychopharmacology     2022年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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オンラインによる睡眠診察-現状と課題を整理する　オンラインによる睡眠診療 睡眠障害(睡眠障害以外)

普天間国博, 高江洲義和

睡眠医療   16 ( 3 ) 255 - 259   2022年09月

掲載種別: 研究論文（学術雑誌）

Changes in psychotropic polypharmacy and high-potency prescription following policy change: Findings from a large scale Japanese claims database.

Takeshima M, Enomoto M, Ogasawara M, Kudo M, Itoh Y, Yoshizawa K, Fujiwara D, Takaesu Y, Mishima K

Psychiatry and clinical neurosciences ( Psychiatry and Clinical Neurosciences )  76 ( 9 ) 475 - 477   2022年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Development and acceptability of a decision aid for major depressive disorder considering discontinuation of antidepressant treatment after remission.

Aoki Y, Takaesu Y, Baba H, Iga JI, Hori H, Inoue T, Mishima K, Tajika A, Kato M

Neuropsychopharmacology reports ( Neuropsychopharmacology Reports )  42 ( 3 ) 306 - 314   2022年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

AIM: While evidence-based antidepressant treatment is available for major depressive disorder, standard approaches for discontinuation of antidepressants after remission have not yet been established. Decision aids are structured clinical tools that facilitate shared decision-making between patients and healthcare providers. This study aimed to describe the development process and acceptability of decision aids for major depressive disorder following discontinuation of antidepressant treatment after remission. METHODS: We systematically developed a decision aids according to the International Patient Decision Aid Standards. First, a decision aids prototype was created using the results of a systematic review and meta-analysis previously conducted to identify the consequences of continuing and discontinuing antidepressant treatment. Second, a mixed-methods questionnaire (alpha acceptability testing) was administered to patients and healthcare providers to improve the decision aids prototype and develop it into a final version acceptable for clinical settings. RESULTS: Our decision aids consisted of a description of major depressive disorder, the option to continue or discontinue antidepressant treatment, the advantages and disadvantages of each option, the consequences of each option, and value clarification exercises for each option. The patients (n = 22) reported that the decision aids had acceptable language (91%), adequate information (91%), and a well-balanced presentation (95%). Healthcare providers (n = 20) provided favorable feedback. The final decision aids fulfilled all six International Patient Decision Aid Standards qualifying criteria. CONCLUSION: We successfully developed a decision aids for discontinuation of antidepressant treatment after remission, which could be used during the shared decision-making process. Further studies are needed to verify the effects of using the decision aids during the shared decision-making process.

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Effectiveness and Tolerability of Lurasidone for Bipolar Types I and II and Other Specified Bipolar Depression: A 12-Week Observational Study

Takaesu Y.

Journal of Clinical Psychopharmacology ( Journal of Clinical Psychopharmacology )  42 ( 5 ) 485 - 488   2022年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Characteristics of the treatments for each severity of major depressive disorder: A real-world multi-site study.

Muraoka H, Kodaka F, Hasegawa N, Yasui-Furukori N, Fukumoto K, Kashiwagi H, Tagata H, Hori H, Atake K, Iida H, Ichihashi K, Furihata R, Tsuboi T, Takeshima M, Komatsu H, Kubota C, Ochi S, Takaesu Y, Usami M, Nagasawa T, Makinodan M, Nakamura T, Kido M, Ueda I, Yamagata H, Onitsuka T, Asami T, Hishimoto A, Ogasawara K, Katsumoto E, Miura K, Matsumoto J, Ohi K, Yamada H, Watanabe K, Inada K, Nishimura K, Hashimoto R

Asian journal of psychiatry ( Asian Journal of Psychiatry )  74   103174 - 103174   2022年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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PURPOSE: In the treatment guidelines for major depressive disorder (MDD), the recommended treatment differs based on the severity. However, the type of treatment provided based on the severity of MDD in real-world clinical practice has not been investigated. In this study, we clarified the actual situation of MDD treatment in clinical practice and compared the treatment based on the severity of MDD. METHODS: We used data from 1484 patients with MDD at discharge from October 2016 to March 2020. RESULTS: The number of psychotropic prescriptions tended to be lower in those diagnosed with MDD in the severe group compared to in the non-severe group. There were significant differences among the three groups (mild, moderate/severe, and psychotic) in the percentage of patients who were not prescribed antipsychotics (p = 1.9 ×10-6), a combination of antipsychotics and antidepressants (p = 5.0 ×10-4), and the implementation rate of modified electroconvulsive therapy (m-ECT) (p = 3.4 ×10-9). The percentage of patients with a severe diagnosis who underwent m-ECT was higher, which corresponded to the severity. CONCLUSION: Our findings showed that the use of psychotropics decreased when the severity of MDD was diagnosed, and the rate of a combination of antipsychotics and antidepressants and the implementation rate of m-ECT increased with the severity. However, this study suggests that there is still an evidence-practice gap in the treatment of MDD in Japan, and guidelines are only partially adhered to in the treatment of depression.

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Development of a 20-item questionnaire for drinking behavior pattern (DBP-20) toward personalized behavioral approaches for alcohol use disorder.

Kurihara K, Shinzato H, Koda M, Enoki H, Otsuru T, Takaesu Y, Kondo T

Alcohol (Fayetteville, N.Y.) ( Alcohol )  101   9 - 16   2022年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Although screening tools are available for alcohol use disorders (AUD), such as the Alcohol Use Disorders Identification Test (AUDIT), these tools do not directly characterize individual drinking behavior for patients with AUD. Therefore, the aim of this study was to develop a new self-report questionnaire to identify the characteristics of drinking behavior patterns in patients with AUD.The study team developed a self-administered 20-item questionnaire for drinking behavior pattern (DBP-20) based on semi-structured interviews of patients with AUD. The DBP-20 and AUDIT were administered to 232 patients with AUD and 222 normal drinkers (1 ≤ AUDIT <20) as controls. Exploratory factor analysis of the DBP-20 was conducted for patients with AUD, followed by comparisons of its item and subscale scores between patients with AUD and controls. Correlations of AUDIT with total and subscale scores of the DBP-20 were also analyzed. Receiver operating characteristic (ROC) analyses for the DBP-20 and its subscales were performed to distinguish patients with AUD from controls.Exploratory factor analysis revealed a multidimensional 4-factor model of the DBP-20: coping with negative affect, automaticity, enhancement, and social use. Significant differences in DBP-20 total and subscale scores were observed for patients with AUD versus controls for all factors, except the social use subscale. Both the coping with negative affect and automaticity subscale scores as well as total DBP-20 scores were highly correlated with AUDIT scores. Total DBP-20 scores showed the greatest sensitivity, negative predictive value, and area under the ROC curve to distinguish patients with AUD from normal drinkers.Drinking as a means of coping with negative affect and automaticity may be specific for patients with AUD. DBP-20 may help patients with AUD to be aware of their own targeted problematic drinking behaviors and to seek their personalized behavioral approaches in a collaborative relationship with therapists.

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Subjective assessment of participants in education programs on clinical practice guidelines in the field of psychiatry.

Ogasawara K, Numata S, Hasegawa N, Nakataki M, Makinodan M, Ohi K, Takeshima M, Tsuboi T, Hashimoto N, Onitsuka T, Muraoka H, Hori H, Ichihashi K, Inagaki T, Yasui-Furukori N, Hishimoto A, Sugiyama N, Fukumoto K, Nagasawa T, Matsumoto J, Takaesu Y, Furihata R, Nemoto K, Nakamura T, Usami M, Miura K, Fujimoto M, Tagata H, Yamada H, Komatsu H, Ochi S, Atake K, Katsumoto E, Kido M, Kishimoto T, Suwa T, Yamamura S, Iga JI, Iida H, Inada K, Watanabe K, Hashimoto R

Neuropsychopharmacology reports ( Neuropsychopharmacology Reports )  42 ( 2 ) 221 - 225   2022年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

The Effectiveness of Guidelines for Dissemination and Education in psychiatric treatment (EGUIDE) project, which is a nationwide dissemination and implementation program for clinical practice guidelines (CPGs) in the field of psychiatry, is currently ongoing. In the current study, a subjective assessment of the participants in the EGUIDE programs was assessed using a questionnaire. Then, the relationships between the subjective assessment, the characteristics of the participants, and the clinical knowledge of the CPGs were evaluated. More than 90% of the participants gave a high rating for the components of content, recommendation, knowledge, skill, and adherence, but not for the component of confidence. A positive correlation was found between years of professional experience and the score of confidence. These results suggest that it may be necessary to apply the knowledge and skills of CPGs obtained in the education programs into practice to increase confidence in the proper use of psychiatric therapies based on CPGs.

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Metabolic-Syndrome-Related Comorbidities in Narcolepsy Spectrum Disorders: A Preliminary Cross-Sectional Study in Japan.

Futenma K, Takaesu Y, Nakamura M, Hayashida K, Takeuchi N, Inoue Y

International journal of environmental research and public health ( International Journal of Environmental Research and Public Health )  19 ( 10 )   2022年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Narcolepsy types 1 (NT1) and 2 (NT2) and idiopathic hypersomnia (IH) are thought to be a disease continuum known as narcolepsy spectrum disorders (NSDs). This study aimed to assess the prevalence of and factors associated with metabolic-syndrome-related disorders (MRDs) among patients with NSD. Japanese patients with NSD (NT1, n = 94; NT2, n = 83; and IH, n = 57) aged ≥35 years were enrolled in this cross-sectional study. MRD was defined as having at least one of the following conditions: hypertension, diabetes, or dyslipidemia. Demographic variables and MRD incidence were compared among patients in the respective NSD categories. Multivariate logistic regression analysis was used to investigate the factors associated with MRDs. Patients with NT1 had a higher body mass index (BMI) and incidence of MRD than that had by those with NT2 or IH. Age, BMI, and the presence of OSA were significantly associated with the incidence of MRD in NSDs. Age and BMI in NT1, BMI and human leukocyte antigen (HLA)-DQB1*06:02 positivity in NT2, and only age in IH were factors associated with the incidence of MRD. Obesity should be carefully monitored in narcolepsy; however, NT2 with HLA-DQB1*06:02 positive should be followed up for the development of MRD even without obesity.

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増大号特集 精神科診療のピットフォール 疾患各論 双極性障害 双極性障害(維持期)

友利 陽子, 高江洲 義和

精神医学 ( 株式会社医学書院 )  64 ( 5 ) 638 - 642   2022年05月

掲載種別: 研究論文（学術雑誌）

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  CiNii Research

抑うつ状態を呈する起床困難患者に対する評価と介入

高江洲義和

日本精神神経学会総会プログラム・抄録集 (日本精神神経学会総会抄録集)     2022年04月

掲載種別: 研究論文（その他学術会議資料等）

A dissemination and education programme to improve the clinical behaviours of psychiatrists in accordance with treatment guidelines for schizophrenia and major depressive disorders: the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project.

Yamada H, Motoyama M, Hasegawa N, Miura K, Matsumoto J, Ohi K, Yasui-Furukori N, Numata S, Takeshima M, Sugiyama N, Nagasawa T, Kubota C, Atake K, Tsuboi T, Ichihashi K, Hashimoto N, Inagaki T, Takaesu Y, Iga JI, Hori H, Onitsuka T, Komatsu H, Hishimoto A, Fukumoto K, Fujimoto M, Nakamura T, Nemoto K, Furihata R, Yamamura S, Yamagata H, Ogasawara K, Katsumoto E, Murata A, Iida H, Ochi S, Makinodan M, Kido M, Kishimoto T, Yasuda Y, Usami M, Suwa T, Inada K, Watanabe K, Hashimoto R

BJPsych open ( BJPsych Open )  8 ( 3 ) e83   2022年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists. AIMS: The aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes. METHOD: A total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme. RESULTS: All of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending. CONCLUSIONS: All clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists.

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入院うつ病患者におけるECT後の炭酸リチウムの処方実態について

五十嵐 俊, 坪井 貴嗣, 長谷川 尚美, 古郡 規雄, 越智 紳一郎, 飯田 仁志, 村岡 寛之, 高江洲 義和, 岡田 剛史, 柏木 宏子, 小高 文聰, 福本 健太郎, 三浦 健一郎, 松本 純弥, 稲田 健, 渡邊 衡一郎, 橋本 亮太

精神神経学雑誌 ( (公社)日本精神神経学会 )  124 ( 4付録 ) S - 519   2022年04月

掲載種別: 研究論文（学術雑誌）

Association between the examination rate of treatment-resistant schizophrenia and the clozapine prescription rate in a nationwide dissemination and implementation study.

Yasui-Furukori N, Muraoka H, Hasegawa N, Ochi S, Numata S, Hori H, Hishimoto A, Onitsuka T, Ohi K, Hashimoto N, Nagasawa T, Takaesu Y, Inagaki T, Tagata H, Tsuboi T, Kubota C, Furihata R, Iga JI, Iida H, Miura K, Matsumoto J, Yamada H, Watanabe K, Inada K, Shimoda K, Hashimoto R

Neuropsychopharmacology reports ( Neuropsychopharmacology Reports )  42 ( 1 ) 3 - 9   2022年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The decision to initiate clozapine treatment should be made on an individual basis and may be closely related to the early detection of treatment-resistant schizophrenia (TRS), although there is evidence that the early use of clozapine results in a better response to treatment. Therefore, we investigated the relationship between the examination rate of TRS and the prescription rate of clozapine. METHODS: After attending a 1-day educational program on schizophrenia based on the "Guidelines for the Pharmacological Treatment of Schizophrenia," we asked the participating facilities to submit records of whether or not TRS was evaluated for each patient. We calculated the clozapine prescription rate from the schizophrenic patients prescribed clozapine and all of the schizophrenic patients. Forty-nine facilities in 2017 were included in the study. RESULTS: There were dichotomous distributions in the examination rate of TRS and a non-normal distribution in the prescription rate of clozapine. There was a significant correlation between the prescription rate of clozapine and the examination rate of TRS (r s  = 0.531, P = 1.032 × 10-4 ). A significant difference was found in the prescription rate of clozapine between the three groups of facilities according to the examination rate of TRS. CONCLUSION: As a preliminary problem for the use of clozapine, in Japan, the examination rate of TRS varies, and there are many facilities that typically do not consider the possibility of TRS; this trend leads to a low rate of clozapine use. Clearly, further clinician training is needed for the early detection and appropriate management of TRS that includes an explanation of TRS and how to introduce clozapine therapy to patients and their families.

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The characteristics of patients receiving psychotropic pro re nata medication at discharge for the treatment of schizophrenia and major depressive disorder: A nationwide survey from the EGUIDE project.

Ichihashi K, Kyou Y, Hasegawa N, Yasui-Furukori N, Shimizu Y, Hori H, Hashimoto N, Ide K, Imamura Y, Yamada H, Ochi S, Iga JI, Takaesu Y, Ohi K, Tsuboi T, Iida H, Yamagata H, Hishimoto A, Horai T, Usami M, Makinodan M, Nagasawa T, Komatsu H, Kido M, Muraoka H, Atake K, Takeshima M, Kubota C, Inagaki T, Tamai S, Kishimoto T, Furihata R, Matsumoto J, Miura K, Inada K, Watanabe K, Kasai K, Hashimoto R

Asian journal of psychiatry ( Asian Journal of Psychiatry )  69   103007 - 103007   2022年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Development and acceptability of a decision aid for chronic insomnia considering discontinuation of benzodiazepine hypnotics.

Aoki Y, Takaesu Y, Suzuki M, Okajima I, Takeshima M, Shimura A, Utsumi T, Kotorii N, Yamashita H, Kuriyama K, Watanabe N, Mishima K

Neuropsychopharmacology reports ( Neuropsychopharmacology Reports )  42 ( 1 ) 10 - 20   2022年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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AIM: To describe the development and acceptability of a decision aid (DA) for chronic insomnia considering discontinuation of benzodiazepine (BZD) and benzodiazepine receptor agonist (BZRA) hypnotics, and if discontinuing, tapering with or without cognitive behavioral therapy for insomnia (CBT-I). METHODS: We reviewed relevant literature describing chronic insomnia to identify options. We used the results of the systematic review and meta-analysis conducted previously to determine the related outcomes of two options: discontinuation of BZD/BZRA hypnotics by gradual tapering alone and discontinuation of BZD/BZRA hypnotics by gradual tapering with CBT-I. We then developed a prototype of DA following the International Patient Decision Aid Standards. A mixed methods survey was conducted to assess the acceptability among patients and healthcare providers. RESULTS: The prototype consisted of a description of insomnia, options of continuing or discontinuing BZD/BRZA hypnotics (if discontinuing, the options of tapering hypnotics with or without CBT-I), pros and cons of each option, and a value clarification exercise. Patients (n = 24) reported that the DA had acceptable language (79%), adequate information (71%), and well-balanced presentation (91%). Healthcare providers (n = 20) also provided favorable feedback. CONCLUSION: We developed a DA for chronic insomnia considering discontinuation of BZD/BRZA hypnotics, which was acceptable for stakeholders. The developed DA was designed to support patients and healthcare providers to make a decision about whether to discontinue BZD/BRZA hypnotics.

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Three cases of parasomnias similar to sleep terrors occurring during sleep-wake transitions from REM sleep.

Futenma K, Inoue Y, Saso A, Takaesu Y, Yamashiro Y, Matsuura M

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine ( Journal of Clinical Sleep Medicine )  18 ( 2 ) 669 - 675   2022年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Sleep terrors are a non-rapid eye movement (NREM) sleep-related parasomnia characterized by abrupt terror with a frightening scream. However, it remains unknown whether sleep terrors occur only from NREM sleep. We evaluated 3 cases of a sleep terrors-like parasomnia that occurred exclusively during arousals from rapid eye movement (REM) sleep. These parasomnia events occurred at REM sleep-wake transitions, manifesting with screaming or crying, similar to sleep terrors, without alertness or clear orientation. The patients were all young-adult females without notable medical conditions. REM sleep behavior disorder and nocturnal frontal lobe epilepsy were not detected based on their video-polysomnographic findings. These 3 cases should be provisionally diagnosed as "Parasomnia, Unspecified" according to the International Classification of Sleep Disorders, third edition; however, the phenomenological diagnosis is proposed to be "Disorders of Arousal from REM Sleep." Our reported cases indicate that sleep terrors may also arise from REM sleep. CITATION: Futenma K, Inoue Y, Saso A, Takaesu Y, Yamashiro Y, Matsuura M. Three cases of parasomnias similar to sleep terrors occurring during sleep-wake transitions from REM sleep. J Clin Sleep Med. 2022;18(2):669-675.

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Development and field testing of a decision aid to facilitate shared decision making for adults newly diagnosed with attention-deficit hyperactivity disorder.

Aoki Y, Tsuboi T, Takaesu Y, Watanabe K, Nakayama K, Kinoshita Y, Kayama M

Health expectations : an international journal of public participation in health care and health policy ( Health Expectations )  25 ( 1 ) 366 - 373   2022年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The number of individuals who are diagnosed with attention-deficit hyperactivity disorder (ADHD) during adulthood has increased in recent years. However, there is still no decision aid (DA) to help adults newly diagnosed with ADHD make decisions regarding further treatments. OBJECTIVE: This study aimed to describe the development process of a DA for adults newly diagnosed with ADHD and its field testing during the shared decision-making (SDM) process in a clinical setting. METHODS: The development process involved the creation of a DA prototype using the International Patient Decision Aid Standards criteria and revision of the prototype through the stakeholders' reviews. The field testing of the DA compared scores before and after the SDM process on the service users' knowledge scale, decisional conflict scale and the Conners Adult ADHD Rating Scales. RESULTS: The developed DA contained options of watchful waiting with own coping skills and pharmacological treatment, which consisted of several kinds of drug options. Fifteen adults newly diagnosed with ADHD participated in the field testing. The participant decision-making quality outcomes such as their knowledge and decisional conflict improved after the SDM process. ADHD severity did not change. CONCLUSION: A DA for adults with ADHD was systematically developed following the international criteria. Field testing indicated that the DA could serve as a tool to facilitate the SDM process. Further research on this DA is necessary before its routine implementation. PATIENT OR PUBLIC CONTRIBUTION: During the development process of the DA, the service users who had already been diagnosed with ADHD reviewed the DA prototype and provided feedback, which improved the final version of the DA.

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Hypnotic medication use among inpatients with schizophrenia and major depressive disorder: results of a nationwide study.

Furihata R, Otsuki R, Hasegawa N, Tsuboi T, Numata S, Yasui-Furukori N, Kashiwagi H, Hori H, Ochi S, Muraoka H, Onitsuka T, Komatsu H, Takeshima M, Hishimoto A, Nagasawa T, Takaesu Y, Nakamura T, Asami T, Miura K, Matsumoto J, Ohi K, Yasuda Y, Iida H, Ogasawara K, Hashimoto N, Ichihashi K, Yamada H, Watanabe K, Inada K, Hashimoto R

Sleep medicine ( Sleep Medicine )  89   23 - 30   2022年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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STUDY OBJECTIVES: To investigate the proportion of inpatients with schizophrenia and major depressive disorder prescribed hypnotic medication, and the association between such medication and the use of other antipsychotic agents. METHODS: This was a nationwide cross-sectional study performed as part of the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment' (EGUIDE) project. Data from 2146 inpatients with schizophrenia and 1031 inpatients with major depressive disorder were analyzed. All types and dosages of psychotropic drugs were recorded and the data at the time of discharge were analyzed. Associations between the use of hypnotic medication and other antipsychotic agents were evaluated using multivariate logistic regression analyses. RESULTS: The proportions of schizophrenia patients who were prescribed any and two or more hypnotic agents were 55.7% and 17.6%, respectively, and the corresponding proportions for patients with major depressive disorder were 63.6% and 22.6%, respectively. In schizophrenia patients, multivariate logistic regression analyses showed that two or more antipsychotics, anticholinergic drugs, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. In patients with major depressive disorder, multivariate logistic regression analyses revealed that two or more antidepressants, two or more antipsychotics, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. CONCLUSIONS: Prescription of hypnotic agents was found to be highly frequent among inpatients with psychiatric disorders. Prescription of two or more main antipsychotic agents was commonly associated with the use of hypnotic medication for both schizophrenia and major depressive disorder.

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