Amisulpride를 투여한 급성기 정신분열병 환자에서 주관적 삶의 질
Changes of Quality of Life in the Treatment of Acute Onset Schizophrenic Patients with Amisulpride
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초록
목 적이 연구의 목적은 amisulpride로 치료한 급성기 정신분열병 환자의 치료 전후 삶의 질의 변화를 알아보기위함이다. 또한 주관적 삶의 질이 환자의 우울증상 및약물에 대한 태도, 약물에 대한 만족도, 정신병리, 증상의 심각도, 증상의 개선 정도 그리고 환자의 기능 정도와관련성이 있는지를 알아보았다. 방 법대구 및 경북 소재 6개 병원의 54명의 정신분열병 환자에게 amisulpride를 투여하였으며 한국어판 정신분열병 삶의 질 척도(SQLS-R4K), 한국어판 정신분열병의 캘거리 우울증 척도(K-CDSS), 한국판 약물 태도 척도(KDAI-10), 약물 만족도 질문지(DSQ), 양성 및 음성증상 증후군 척도(PANSS), 전반적 임상 인상(CGIS & CGI-I), 전반적 기능 평가 척도(GAF scale)를 이용하여 연구하였다. － 7 8 －결 과Amisulpride 투여 후 정신분열병 환자의 주관적 삶의 질과 우울증상은 의미 있는 호전을 보였다. 주관적삶의 질은 PANSS 총점, 양성 및 음성 증상, 그리고 일반 정신병리 점수와 관련성이 있었으며, 약물 만족도와도 의미 있는 관련성을 보였다. 결 론정신분열병 환자의 치료에 있어서 amisulpride는 환자의 주관적 삶의 질의 향상에 영향을 미치며 환자의 삶의질을 개선하기 위해서는 양성, 음성 증상 및 부작용을적극적으로 조절하는 것이 필요하다.
Abstract
Objectives：The purpose of this study is to assess the changes of quality of life in the treatment of acute onset schizophrenic patients with amisulpride. Also, we investigated how the subjective quality of life is related with patients’depression, attitude to medication, satisfaction to medication, psychopathology, symptom severity, symptom improvement and functioning of schizophrenia. Methods：54 schizophrenic patients in 6 hospitals were administered amisulpride. Psychiatric status was evaluated by Korean version of 4th Revision of Schizophrenia Quality of Life Scale(SQLS-R4K), Korean version of Calgary Depression Scale for Schizophrenia(K-CDSS), Korean version of Drug Attitude Inventory(KDAI-10), Drug Satisfaction Questionaire(DSQ), Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression scale(CGI) and Global Assessment of Functioning Scale(GAF Scale) at baseline, day1, week2, week4 and week6. Results：Subjective quality of life and depressive symptom were improved significantly after administering amisulpride. Subjective quality of life was related significantly with total score, negative, positive symptom and general psychopathology score in PANSS. Subjective quality of life correlated significantly with drug satisfaction, but not drug attitude, depressive symptoms, CGI-S, CGI-I and GAF score. Conclusions：This study suggests that the subjective quality of life of schizophrenic patients, who had treated with amisulpride, is influenced significantly. Active management for positive, negative symptoms and drug side effect is recommended to improve patients’ quality of life.
참고문헌 (38)
- Bobes J, "Quality of life in schizophrenic patients", Dialogues Clin Neurosci, (9), pp.215~226 (2007)
- Bobes J, "Quality of life measures in schizophrenia", Eur Psychiatry, 20(Suppl 3), pp.S313~S317 (2005)
- Weiden P, "Atypical antipsychotic drugs and long-term outcome in schizophrenia", J Clin Psychiatry, 57(Suppl 11), pp.53~60 (1996)
- Davis JM, "A meta-analysis of the efficacy of second-generation antipsychotics", Arch Gen Psychiatry, 60, pp.553~564 (2003)
- Geddes J, "Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis", BMJ, 321, pp.1371~1376 (2000)
- Meyer JM, "Antipsychotic safety and efficacy concerns", J Clin Psychiatry, 68(Suppl 14), pp.20~26 (2007)
- Moller HJ, "Amisulpride: limbic specificity and the mechanism of antipsychotic atypicality", Prog Neuropsychopharmacol Biol Psychiatry, 27, pp.1101~1111 (2003)
- Taylor DM, "Atypical antipsychotics and weight gain--a systematic review", Acta Psychiatr Scand, 101, pp.416~432 (2000)
- Peuskens J, "Amisulpride vs. risperidone in the treatment of acute exacerbations of schizophrenia. Amisulpride study group", Psychiatry Res, 88, pp.107~117 (1999)
- Leucht S, "Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis", Lancet, 373, pp.31~41 (2009)
- American Psychiatric A, "Task Force on D-I. Diagnostic and statistical manual of mental disorders: DSM-IV" (1994), American Psychiatric Association
- Kay SR, "The positive and negative syndrome scale(PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
- 김용구, "한국어판 정신분열병의 캘거리 우울증 척도의 신뢰도 및 타당도 연구", 신경정신의학, 44(4), pp.446~455 (2005), 대한신경정신의학회
- William G, "ECDEU Assessment Manual for psychopharmacology, revised" (1976), National Institute of Mental Health
- Moos RH, "Global assessment of functioning(GAF) ratings: determinants and role as predictors of one-year treatment outcomes", J Clin Psychol, 56, pp.449~461 (2000)
- 김진훈, "한국어판 정신분열병 삶의 질 척도의 개발과 PANSS와의 관련성", 신경정신의학, 45(5), pp.401~410 (2006), 대한신경정신의학회
- 윤보현, "한국판 약물태도 척도의 심리측정적 특성", 대한정신약물학회지, 16(6), pp.480~487 (2005), 대한정신약물학회
- Busner J, "The Clinical Global Impressions scale: errors in understanding and use", Compr Psychiatry, 50, pp.257~262 (2009)
- Diener E, "Assessing subject well-being: Progress and opportunities", Social indicators research, 31, pp.103~157 (1994)
- Mroczek DK, "The effect of age on positive and negative affect: a developmental perspective on happiness", J Pers Soc Psychol, 75, pp.1333~1349 (1998)
- Tollefson GD, "Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial", Am J Psychiatry, 154, pp.457~465 (1997)
- Tollefson GD, "Negative symptoms: a path analytic approach to a double-blind, placebo- and haloperidol-controlled clinical trial with olanzapine", Am J Psychiatry, 154, pp.466~474 (1997)
- Naber D, "Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs", Schizophr Res, 50, pp.79~88 (2001)
- Voruganti L, "Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side-effect profile and impact on quality of life", Schizophr Res, 43, pp.135~145 (2000)
- Zisook S, "Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression", Schizophr Res, 86, pp.226~233 (2006)
- Kim SW, "Amisulpride versus risperidone in the treatment of depression in patients with schizophrenia: a randomized, open-label, controlled trial", Prog Neuropsychopharmacol Biol Psychiatry, 31, pp.1504~1509 (2007)
- Dickerson FB, "Subjective quality of life in out-patients with schizophrenia: clinical and utilization correlates", Acta Psychiatr Scand, 98, pp.124~127 (1998)
- Huppert JD, "Quality of life in schizophrenia: contributions of anxiety and depression", Schizophr Res, 51, pp.171~180 (2001)
- Yamauchi K, "Aki H, Tomotake M, Iga J, Numata S, Motoki I, et al. Predictors of subjective and objective quality of life in outpatients with schizophrenia", Psychiatry Clin Neurosci, 62, pp.404~411 (2008)
- Aki H, "Subjective and objective qualityof life, levels of life skills, and their clinical determinants in outpatients with schizophrenia", Psychiatry Res, 158, pp.19~25 (2008)
- Awad AG, "A conceptual model of quality of life in schizophrenia: description and preliminary clinical validation", Qual Life Res, 6, pp.21~26 (1997)
- Silva de Lima M, "Quality of life in schizophrenia: a multicenter, randomized, naturalistic,controlled trial comparing olanzapine to first-generation antipsychotics", J Clin Psychiatry, 66, pp.831~838 (2005)
- Awad AG, "Intervention research in psychosis: issues related to the assessment of quality of life", Schizophr Bull, 26, pp.557~564 (2000)
- Brissos S, "Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates", Psychiatry Res, 160, pp.55~62 (2008)
- Moller HJ, "Efficacy and safety of direct transition to risperidone long-acting injectable in patients treated with various antipsychotic therapies", Int Clin Psychopharmacol, 20, pp.121~130 (2005)
- Karow A, "PANSS syndromes and quality of life in schizophrenia", Psychopathology, 38, pp.320~326 (2005)
- Awad AG, "New antipsychotics, compliance, quality of life, and subjective tolerability--are patients better off?", Can J Psychiatry, 49, pp.297~302 (2004)
- 윤보현, "리스페리돈으로 교체 투여한 정신분열병 환자에서 주관적 안녕감", 대한정신약물학회지, 15(3), pp.284~295 (2004), 대한정신약물학회