Prevalence of Antipsychotic Drugs Related to Constipation in Patients with Schizophrenia

服用抗精神病藥物治療之思覺失調症病人的便秘盛行率調查

呂宇席(Yu-Shi Lu) ； 陳玉真(Yu-Cheng Chen) ； 郭詩憲(Shih-Hsien Kuo) ； 蔡景宏(Ching-Hong Tsai)

《台灣精神醫學》 30卷4期 (2016/12) Pp. 294-299

摘要

Objective: Constipation is thought to be both common and overlooked in patients with schizophrenia, with no empirical data about its prevalence in the schizophrenic population in Taiwan. In the current study, we intended to investigate prevalence and risk factors of constipation during routine treatment of patients with schizophrenia. Method: We did a retrospective study of inpatients treated with antipsychotic medications in Kaohsiung Kai Syuan Municipal Psychiatric Hospital between January 2008 and December 2013. Totally, 3,107 inpatients diagnosed as schizophrenic were included in this study. Results: The prevalence of constipation was 28.10%. Female gender (odds ratio = 2.12, 95% confidence interval = 1.76 - 2.55, p ＜ 0.01), older age (OR = 1.02, 95% CI = 1.76 - 2.55, p ＜ 0.01), greater symptom severity (OR = 1.03, 95% CI = 1.01 - 1.04, p ＜ 0.01), and comorbid medical diseases (OR = 1.99, 95% CI = 1.65 - 2.40, p ＜ 0.01) were found to be all significantly positive factors related to the constipation. We also found that the use of second-generation antipsychotic drugs (OR = 1.75, 95% CI =1.24- 2.48, p ＜ 0.01), and the use of SGAs combined with first-generation antipsychotic drugs (OR = 3.78, 95% CI = 2.70 - 5.28, p ＜ 0.01) were significantly more likely to cause constipation than the use of FGAs alone. Conclusion: Those findings suggest that clinicians need greater vigilance and active evaluation of constipation in patients with schizophrenia, to ensure appropriate clinical management and to prevent associated complications.

關鍵字

constipation ； schizophrenia ； antipsychotics ； prevalence

參考文獻

Tiihonen J, Lönnqvist J, and Wahlbeck K, et al.: 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009; 374: 620-7.

Bai YM: Pharmacological studies on patients with schizophrenia in Taiwan: a compilation of literature. Taiwanese Journal of Psychiatry (Taipei) 2012; 26: 10-1.

Freudenreich O, Goff DC: Colon perforation and peritonitis associated with clozapine. J Clin Psychiatry 2000; 61: 950-1.

Antonacci D, de Groot C: Clozapine treatment in a population of adults with mental retardation. J Clin Psychiatry 2000; 61: 22-5.

Wampers M, De Hert M, Van Eyck D, and Peuskens J: Somatic medication in hospitalised schizophrenic patients in Belgium. Schizophr Res 2004; 1: 152-3.