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항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구

Body Weight and Metabolic Changes in First-Episode Psychotic Patients with Antipsychotics Use : A Retrospective Study

김성진|김정은|김현정|박민경|김민걸|정도운|강제욱|문정준|심주철|공보금|김우진
대한생물치료정신의학회 (Korean Society Of Biological Therapies In Psychiatry)|2011.12|생물치료정신의학 (Journal of the Korean Society of Biological Therapies in Psychiatry)|제17권 제2호|pp. 229-238

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키워드

항정신병 약물·초발 정신증·체중증가· 신체비만지수Antispychotics · First-episode psychosis · Body weight · Body mass index(BMI)
주제분류정신과학

초록

목적: 본 연구는 항정신병약물을 처음으로 사용하는 초발 정신증 환자를 대상으로 체중 및 대사성 변화를 알아보고, 초발 정신증 환자와 기존에 항정신병약물을 사용하던 정신증 환자를 비교하여 항정신병약물을 사용하였을 때 나타나는 대사성 변화의 차이를 조사하였다. 방법: DSM-IV TR 진단기준에 의해 정신분열병, 분열정동장애, 양극성 장애로 진단된 초발 정신증 환자 28명과 대조군(기존에 항정신병약물 24개월 이상 투약한 병력이 있는 정신증환자) 28명을 대상으로 시행한 후향적 연구이다. 대상자들에서 키와 체중 등의 기본정보, 혈액검사결과 및 약물 정보 등을 조사하였고, 항정신병약물의 사용 이후에 변화한 체중 및 대사성지표를 조사하였다. 또한 초발 정신증 환자에서 체중 증가에 영향을 미치는 요인에 대해서도 분석하였다. 결과: 초발 정신증 환자가 대조군에 비하여 체중, 신체비만지수의 더 큰 변화를 보였으며, 이러한 변화는 12개월 이상 지속적으로 나타난다는 것을 확인할 수 있었다. 반면 초발 정신증 환자에서 항정신병약물의 사용 후 나타난 체중 증가와 연관된 유의한 요인은 찾을 수 없었다. 결론: 정신증 환자에서 나타나는 체중 증가의 가장 큰 원인 중 하나는 항정신병약물이며, 항정신병약물로 인한 체중의 증가는 약물을 처음으로 사용할 때 더욱 크게 나타난다는 것을 알 수 있었다.

Abstract

Objectives：This study was to identify weight & metabolic changes in first-episode psychotic patients with antipsychotics use and investigate the differences of weight & metabolic changes between first-episode psychotic patients and controls with antipsychotics use. Method：In this retrospective study, twenty eight first-episode psychotic patients and twenty eight controls with schizophrenia, schizoaffective or bipolar disorder defined by DSM-IV criteria were included. Information about demographic and clinical characteristics of the subjects was gathered from the medical records. Also body weight, sBP, dBP, fasting glucose, lipid profile and WBC count were evaluated before and after antipsychotics use. Rogistic regression was conducted to assess factors associated with weight gain. Results：First-episode psychotic patients showed more weight and BMI changes than controls after antipsychotics use, and these changes continue over 12 months. On the other hand, there were no significant factors associated with weight gain. Conclusion：The results of present study suggest that antispychotics is one of the major causes inducing weight gain of psychotic patients and antipsychotics-induced weight gain is more vulnerable to drug-naive first-episode psychotic patients.

참고문헌 (37)

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