Comparing psychotropic medication prescribing in personality disorder between general mental health and psychological services: retrospective cohort study.

Autor:	Kadra-Scalzo G; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Garland J; Croydon Personality Disorder Service, South London and Maudsley NHS Foundation Trust, UK., Miller S; Croydon Personality Disorder Service, South London and Maudsley NHS Foundation Trust, UK., Chang CK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Global Health Program, College of Public Health, National Taiwan University, Taiwan; and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan., Fok M; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Waterview Centre, Central and North West London NHS Foundation Trust, UK., Hayes RD; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Moran P; Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK., Shetty H; BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK., Young AH; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Stewart R; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK.
Jazyk:	angličtina
Zdroj:	BJPsych open [BJPsych Open] 2021 Mar 25; Vol. 7 (2), pp. e72. Date of Electronic Publication: 2021 Mar 25.
DOI:	10.1192/bjo.2021.34
Abstrakt:	Background: Although no drugs are licensed for the treatment of personality disorder, pharmacological treatment in clinical practice remains common. Aims: This study aimed to estimate the prevalence of psychotropic drug use and associations with psychological service use among people with personality disorder. Method: Using data from a large, anonymised mental healthcare database, we identified all adult patients with a diagnosis of personality disorder and ascertained psychotropic medication use between 1 August 2015 and 1 February 2016. Multivariable logistic regression models were constructed, adjusting for sociodemographic, clinical and service use factors, to examine the association between psychological services use and psychotropic medication prescribing. Results: Of 3366 identified patients, 2029 (60.3%) were prescribed some form of psychotropic medication. Patients using psychological services were significantly less likely to be prescribed psychotropic medication (adjusted odds ratio 0.48, 95% CI 0.39-0.59, P<0.001) such as antipsychotics, benzodiazepines and antidepressants. This effect was maintained following several sensitivity analyses. We found no difference in the risk for mood stabiliser (adjusted odds ratio 0.79, 95% CI 0.57-1.10, P = 0.169) and multi-class psychotropic use (adjusted odds ratio 0.80, 95% CI 0.60-1.07, P = 0.133) between patients who did and did not use psychological services. Conclusions: Psychotropic medication prescribing is common in patients with personality disorder, but significantly less likely in those who have used psychological services. This does not appear to be explained by differences in demographic, clinical and service use characteristics. There is a need to develop clear prescribing guidelines and conduct research in clinical settings to examine medication effectiveness for this population.
Databáze:	MEDLINE
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