본문 바로가기
KERD
논문KCI 등재

치료 위저항성 조현병: 치료 비순응을 중심으로

Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment

이승재|김혜림
대한조현병학회 (Korean Academy of Schizophrenia)|2020.10|대한조현병학회지 (Korean Journal of Schizophrenia Research)|제23권 제2호|pp. 51-57|DOI 10.16946/kjsr.2020.23.2.51

1

조회

0

다운로드

0

인용

0

참고문헌

주제분류정신과학

초록

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

Abstract

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

참고문헌 (53)

  1. Howes OD, "Treatment-resistant schizophrenia : treatment response and resistance in psychosis(TRRIP)working group consensus guidelines on diagnosis and terminology", Am J Psychiatry, 174, pp.216~229 (2017)
  2. Siskind D, "Clozapine response rates among people with treatment-resistant schizophrenia : data from a systematic review and meta-analysis", Can J Psychiatry, 62, pp.772~777 (2017)
  3. Kane JM, "Clinical guidance on the identification and management of treatment-resistant schizophrenia", J Clin Psychiatry, 80, pp.18com12123~ (2019)
  4. Kinon BJ, "The group of treatment resistant schizophrenias. heterogeneity in treatment resistant schizophrenia (TRS)", Front Psychiatry, 9, pp.757~ (2018)
  5. Potkin SG, "The neurobiology of treatment-resistant schizophrenia : paths to antipsychotic resistance and a roadmap for future research", NPJ Schizophr, 6, pp.1~ (2020)
  6. Dold M, "Pharmacotherapy of treatment-resistant schizophrenia : a clinical perspective", Evid Based Ment Health, 17, pp.33~37 (2014)
  7. Jung Suk Lee, "Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms", Clinical Psychopharmacology and Neuroscience, 18(3), pp.386~394 (2020), 대한정신약물학회[DOI]
  8. Czobor P, "Treatment adherence in schizophrenia : a patient-level meta-analysis of combined CATIE and EUFEST studies", Eur Neuropsychopharmacol, 25, pp.1158~1166 (2015)
  9. Haddad PM, "Adverse effects of atypical antipsychotics : differential risk and clinical implications", CNS Drugs, 21, pp.911~936 (2007)
  10. Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
  11. Lacro JP, "Prevalence of and risk factors for medication nonadherence in patients with schizophrenia : a comprehensive review of recent literature", J Clin Psychiatry, 63, pp.892~909 (2002)
  12. Sajatovic M, "Treatment adherence with antipsychotic medications in bipolar disorder", Bipolar Disord, 8, pp.232~241 (2006)
  13. Valenstein M, "Antipsychotic adherence over time among patients receiving treatment for schizophrenia : a retrospective review", J Clin Psychiatry, 67, pp.1542~1550 (2006)
  14. Byerly M, "A comparison of electronic monitoring vs. clinician rating of antipsychotic adherence in outpatients with schizophrenia", Psychiatry Res, 133, pp.129~133 (2005)
  15. Bozzatello P, "Predictive factors of treatment resistance in first episode of psychosis : a systematic review", Front Psychiatry, 10, pp.67~ (2019)
  16. McCutcheon R, "Antipsychotic plasma levels in the assessment of poor treatment response in schizophrenia", Acta Psychiatr Scand, 137, pp.39~46 (2018)
  17. Horvitz-Lennon M, "The role of antipsychotic plasma levels in the treatment of schizophrenia", Am J Psychiatry, 174, pp.421~426 (2017)
  18. De Leon J, "Atypical antipsychotic dosing : the effect of smoking and caffeine", Psychiatr Serv, 55, pp.491~493 (2004)
  19. Kennedy WK, "Clinically significant drug interactions with atypical antipsychotics", CNS Drugs, 27, pp.1021~1048 (2013)
  20. "Drug interactions: cytochrome P450 drug interaction table" (2007)[URL]
  21. Kitada M, "Genetic polymorphism of cytochrome P450 enzymes in Asian populations : focus on CYP2D6", Int J Clin Pharmacol Res, 23, pp.31~35 (2003)
  22. Bernard S, "Interethnic differences in genetic polymorphisms of CYP2D6 in the U.S. population:clinical implications", Oncologist, 11, pp.126~135 (2006)
  23. Lee SY, "Sequencebased CYP2D6 genotyping in the Korean population", Ther Drug Monit, 28, pp.382~387 (2006)
  24. Hogan TP, "A self-report scale predictive of drug compliance in schizophrenics : reliability and discriminative validity", Psychol Med, 13, pp.177~183 (1983)
  25. 윤보현, "한국판 약물태도 척도의 심리측정적 특성", 대한정신약물학회지, 16(6), pp.480~487 (2005), 대한정신약물학회
  26. Thompson K, "Reliability and validity of a new medication adherence rating scale(MARS)for the psychoses", Schizophr Res, 42, pp.241~247 (2000)
  27. 장진구, "한국판 약물 순응척도의 표준화 연구", 대한정신약물학회지, 26(2), pp.43~49 (2015), 대한정신약물학회
  28. Hemingway S, "Medicines adherence-involving patients in decisions about prescribed medicines and supporting adherence : NICE clinical guideline 76", Ment Health Nurs, 29, pp.10~ (2009)
  29. Wilder CM, "Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives", Psychiatr Serv, 61, pp.380~385 (2010)
  30. Pfeiffer PN, "Dosing frequency and adherence to antipsychotic medications", Psychiatr Serv, 59, pp.1207~1210 (2008)
  31. ), "National Institute of Mental Health", 1976
  32. Waddell L, "A new self-rating scale for detecting atypical or second-generation antipsychotic side effects", J Psychopharmacol, 22, pp.238~243 (2008)
  33. Day J, "Liverpool university neuroleptic side effect rating scale", Br J Psychiatry, 166, pp.650~653 (1995)
  34. Jung HY, "Liverpool university neuroleptic side-effect rating scale(LUNSERS)as a subjective measure of drug-induced parkinsonism and akathisia", Hum Psychopharmacol, 20, pp.41~45 (2005)
  35. Xia J, "Psychoeducation for schizophrenia", Cochrane Database Syst Rev (2011)
  36. Hasan AA, "Evaluation of the impact of a psycho-educational intervention for people diagnosed with schizophrenia and their primary caregivers in Jordan : a randomized controlled trial", BMC Psychiatry, 15, pp.72~ (2015)
  37. Alhadidi MM, "A systematic review of randomized controlled trials of psychoeducation interventions for patients diagnosed with schizophrenia", Int J Soc Psychiatry, 66, pp.542~552 (2020)
  38. Boczkowski JA, "Neuroleptic compliance among chronic schizophrenic outpatients : an intervention outcome report", J Consult Clin Psychol, 53, pp.666~ (1985)
  39. Razali SM, "Psychosocial interventions for schizophrenia", J Ment Health, 9, pp.283~289 (2000)
  40. Turkington D, "Cognitive behavior therapy for schizophrenia", Am J Psychiatry, 163, pp.365~373 (2006)
  41. Cramer JA, "Enhancing medication compliance for people with serious mental illness", J Nerv Ment Dis, 187, pp.53~55 (1999)
  42. Eckman TA, "Technique for training schizophrenic patients in illness self-management : a controlled trial", Am J Psychiatry, 149, pp.1549~1555 (1992)
  43. Kemp R, "Randomised controlled t rial of compliance therapy. 18-month follow-up", Br J Psychiatry, 172, pp.413~419 (1998)
  44. Velligan DI, "Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia", Am J Psychiatry, 157, pp.1317~1328 (2000)
  45. Velligan DI, "Comparing the efficacy of interventions that use environmental supports to improve outcomes in patients with schizophrenia", Schizophr Res, 102, pp.312~319 (2008)
  46. Subotnik KL, "Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia. A randomized clinical trial", JAMA Psychiatry, 72, pp.822~829 (2015)
  47. Kane JM, "Optimizing treatment choices to improve adherence and outcomes in schizophrenia", J Clin Psychiatry, 80 (2019)
  48. Tiihonen J, "Real-world effectiveness of antipsychotic treatments in a nationwide cohort of 29823 patients with schizophrenia", JAMA Psychiatry, 74, pp.686~693 (2017)
  49. Gibson TB, "Cost-sharing effects on adherence and persistence for secondgeneration antipsychotics in commercially insured patients", Manag Care, 19, pp.40~47 (2010)
  50. Priebe S, "Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial", BMJ, 347, pp.f5847~ (2013)
  51. Burton A, "Do financial incentives increase treatment adherence in people with severe mental illness? a systematic review", Epidemiol Psichiatr Soc, 19, pp.233~242 (2010)
  52. Schierenberg A, "Efficacy of contingency management for cocaine dependence treatment : a review of the evidence", Curr Drug Abuse Rev, 5, pp.320~331 (2012)
  53. 허정운, "정신병적 장애로 첫 내원한 환자들의 임상 특징과 투약 순응도 및 의료 이용 추이: 예비 연구", 대한조현병학회지, 22(2), pp.35~50 (2019), 대한조현병학회[DOI]

관련 논문AI추천

치료 저항성 조현병의 이해와 치료김의태대한신경정신의학회 · 신경정신의학2018 · 제57권 제3호치료저항성 조현병: 정의와 임상양상이건석대한조현병학회 · 대한조현병학회지2020 · 제23권 제2호클로자핀의 지연된 사용이 치료저항성 조현병 환자의 급성기 약물 반응에 미치는 영향박선영, 박재섭, 양소영, 최정규대한조현병학회 · 대한조현병학회지2021 · 제24권 제2호치료저항성 조현병에서 클로자핀 치료의 현황김세현대한조현병학회 · 대한조현병학회지2021 · 제24권 제1호조현병 재발방지를 위한 약물치료 전략김지현, 박염홍, 신광범, 정영철대한신경정신의학회 · 신경정신의학2018 · 제57권 제3호장기지속형 항정신병약물의 임상 실제이규영대한신경정신의학회 · 신경정신의학2019 · 제58권 제1호

이 간행물의 다른 논문 (4건)

치료저항성 조현병: 정의와 임상양상이건석pp. 45-50조현병 관련 주요 일간지 기사에 대한 텍스트 마이닝 분석남희정, 유승형pp. 58-64유럽인 자료로 산출된 조현병 다유전자 위험도 점수의 한국인 조현병 환자를 대상으로 한 적용홍경수, 백지현, 조은영, 이동빈, 이진영pp. 65-70조현병 환자에서의 지연성 운동이상 발생과 세로토닌 1A 수용체유전자 rs6295 다형성과의 연관성이윤정, 조아름, 이헌정, 남궁윤pp. 71-77
원문 보기