Artikel
Pharmacotherapy of psychiatric inpatients with adjustment disorder – current status and changes between 2000 and 2016
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Autoren
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Timo Greiner
- University Clinic for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
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Beatrice Haack
- University Clinic for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
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Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Renate Grohmann
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
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Martin Heinze
- University Clinic for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
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Michael Schneider
- University Clinic for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| Veröffentlicht: | 19. November 2019 |
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Gliederung
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Background: Adjustment disorder is a temporary change in behaviour or emotion as a reaction to a stress factor. Therapy usually consists of psychotherapy. Pharmacotherapy can be advised, however, data on the real life pharmacological treatment is sparse.
Materials and methods: We analysed prescription data for 4,235 psychiatric inpatients diagnosed with adjustment disorder in the time period 2000 to 2016. The data were obtained from the Drug Safety Programme in Psychiatry (AMSP). Drug prescriptions and demographic data were collected on two reference days per year; prescription patterns and changes over time were analysed.
Results: Of all patients, 82% received some type of psychotropic drug. Mostly antidepressants (60%), antipsychotics (36%), and tranquilizers (23%) were prescribed. Prescription rates for antidepressants decreased slightly over the years, while rates for antipsychotics increased, especially for atypical antipsychotics.
Conclusion: The diagnosis “adjustment disorder” is most likely a working diagnosis that is used for patients in immediate need of psychiatric aid. Overall, pharmacotherapy for inpatients with this diagnosis is mostly symptom-oriented and focuses on depressive moods, agitation and anxiety. Therapy regimes changed over time and show an increased use of atypical antipsychotics with sedative properties (mostly quetiapine). However, for most of the medication, there are neither evidence-based studies nor guidelines regarding adjustment disorder. In addition, some of the drugs might be contraindicated in some cases.
