慢性失眠及安眠藥物的使用ppt-wenkub
2023-03-24 10:45:02 本頁面
【正文】 in Psychiatry. 2023。28:10491057. Comorbidities ? Seldom appears without one or more other disorders ? Common orbidities: depression, generalized anxiety, substance abuse, attention deficit, and a variety of physical problems Public Health Burden ? Difficult to evaluate because literature is not developed ? Focus is on populations rather than people Comorbid Psychiatric Disorders With Insomnia 2 3 . 9 %1 4 . 0 %8 . 6 %7 . 0 %4 . 2 %5 . 1 %0% 5% 10% 15% 20% 25% 30%A n x i e t y D i s ord e rM a j or D e p re s s i onD y s t h y m i aA l c oh ol A b u s eD ru g A b u s eO t h e r P s y c h i a t ri cD i s ord e rs*P.001 pared with those with no sleep plaint. ?P.05 pared with those with no sleep plaint. Ford DE et al. JAMA. 1989。28:10491057. Insomnia is the most mon sleep plaint across all stages of adulthood, and for millions, the problem is chronic Insomnia can be a symptom of other disorders, like depression, or it can be a primary disorder in itself The Majority of Insomniacs is Chronically Ill 59835375690102030405060708090 Mild insomnia Severe insomnia Insomnia (DSMIIIR) Elderly, difficulty falling asleep Elderly, disturbed sleep continuity % % % % % Mean 68% % Isomniacs with Persistence of Complaints in TwoYears FollowUp in Primary Care Surveys Ganguli et al. 1996。後來藥不夠時(shí)她就到另一家醫(yī)院的精神科開藥。到後來每天一天黑就覺得要找一點(diǎn)上床準(zhǔn)備睡覺，但是又覺得害怕、怕那一天又會(huì)睡不好或睡不著 … 。學(xué)校畢業(yè)後因?yàn)榧彝ソ?jīng)濟(jì)因素開始工作，睡眠狀況還是不理想。王先生曾經(jīng)在一般開業(yè)醫(yī)師診所處方過安眠藥，效果還不錯(cuò)。長期下來，白天不但會(huì)常頭暈，而且越來越?jīng)]耐性，常常提不起勁來，感覺自己快要垮了，近半年來已經(jīng)把休假請(qǐng)光，還請(qǐng)了不少病假，最近才由朋友介紹到精神科看門診。雖然有醫(yī)師建議她應(yīng)該要嘗試其他改善睡眠的方法，並且控制使用安眠藥，但是她就是擔(dān)心不吃睡不著，雖然她也知道其實(shí)吃了也不一定睡得好，有時(shí)候就乾脆把安眠藥配著啤酒吃，最近喝酒的量也漸漸多起來。 Hohagen et al. 1993。262:14791484. Percentage * * * * ? ? 1 . 6 1 . 61 . 42 . 20 . 91 . 62 . 51 . 5 1 . 52 . 71 . 81 . 40 . 03 . 0C H F C O P D B a c kp rob l e m sH i pi m p a i rm e n tP e p t i c u l c e r P ros t a t ep rob l e m sM i l d I n s om n i aS e v e re I n s om n i aMedical Conditions Associated With Insomnia *P≤.001。62(suppl 10):1826. Greater Impaired Function Impact of Insomnia on Physical and Emotional Health and Social Functioning 35557595C on t rol I n s om n i aB o d y Pa i nG en er al H eal t hM en t al H eal t hR o l e E m o t i o n alR o l e Ph y s i c alS o c i al F u n c t i o n i n gV i t al i t yPh y s i c al F u n c t i o n i n g*Scale ranges from 0 to 100, with higher scores reflecting greater quality of life. Adapted from Zammit GK et al. Sleep 1999。22(9):133550. Epub 2023 Jul 10 ? BACKGROUND: Hypnotics have a role in the management of acute insomnia。 95% CI: , ). Sleep onset latency assessed by sleep diaries was also improved (BDZ: minutes。 ADP: minutes。56:332–343. AncoliIsrael S, Roth T. Sleep. 1999。ger D, Poursain B. Curr Med Res Opin. 2023。 ? 預(yù)定連續(xù)分析數(shù)年 (2023~2023)健保資料，探討變化趨勢。 ? 因應(yīng) BZD receptor agonists（特別是 ZOLPIDEM）近年大量使用之趨勢，宜有全面性、系統(tǒng)性的評(píng)估，以證實(shí)其療效並瞭
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