摘要目的 了解精神科医生抗精神病药物处方行为现状,并探讨其影响因素.方法 采用抗精神病药物处方行为调查问卷,对山东省3家精神卫生机构的151名精神科医生进行调查.结果 (1)精神分裂症单一用药的比例:<5%者3.3%(5例);5%～25%者9.3%(14例);25%～50%者15.9%(24例);50%～75%者28.5%(43例);>75%者43%(65例).(2)新型抗精神病药物在精神分裂症和双相障碍的处方率均远多于传统抗精神病药物[(84.9±13.3)%,(15.0±13.3)%,t ＝32.41,P ＝0.000;(86.4±14.3)%,(13.6±14.3)%,t ＝31.28,P ＝0.000].(3)抗精神病药物处方决策原则排序:阳性症状疗效>临床经验>药物安全性>药物费用报销与否、阴性症状疗效.(4)抗精神病药物处方策决影响排序:同事、专家>专业医学期刊文献>医药销售代表.结论 精神分裂症的用药符合<中国精神分裂症防治指南>的用药原则,但应加强对阴性症状治疗的重视,新型抗精神病药物成为精神分裂症和双相障碍治疗的一线用药,精神科处方行为受多种因素的影响.

abstractsObjectives To understand the current status of psychiatrist's prescribing behaviors on antipsychotic drugs in the treatment of the patients with schizophrenia and bipolar mood disorder in Shandong Province, and to explore the principles and influential factors of the prescribing behaviors. Methods 151 psychiatrists from three psychiatric hospitals in Shandong Province were conducted an questionnaire on prescribing behaviors on antipsychotic drugs. Results (1) Of all the participants, 43% (65 cases) reported that more than 75% of all the patients with schizophrenia that he/she saw within the last three months could be classified into the single antipsychotic drugs treatment group, 28.5% (43 cases) reported 50%'75%, 15.9% (24 cases) reported 25%'50%, 9.3% (14 cases) reported 5%'25%, and 3.3% (5 cases) reported less than 5%. (2) The usage rates of atypical antipsychotic drugs were significant higher than those of typical antipsychotic drugs in the treatments of schizophrenia and bipolar mood disorder (84.9±13.3: 15.0±13.3,t ＝32.41,P ＝0.000;86.4±14.3: 13.6±14.3,t ＝31.28,P ＝0.000). (3) The order of importance on the prescribing behavior decision was: the effectiveness on positive symptoms of antipsychotic drugs, the experience of the psychiatrists, the safety of antipsychotic drugs, the effectiveness on negative symptoms and the costs of antipsychotic. (4) The order of importance of influential factors on the prescribing behavior decision was:colleagues and expert opinions, the medical journal article and the sales representatives.Conclusion Atypical antipsychotic drugs have been the first fine choice of the patients with schizophrenia and bipolar mood disorder. The psychiatry should pay more attention to nagative symptoms of patient with schizophrenia. The prescribing behavior decision was influenced by a lot of factors, such as colleagues, expert opinions, medical journal article, sale representatives, and so on.