Ryuji Furihata1, Rei Otsuki2, Naomi Hasegawa3, Takashi Tsuboi4, Shusuke Numata5, Norio Yasui-Furukori6, Hiroko Kashiwagi7, Hikaru Hori8, Shinichiro Ochi9, Hiroyuki Muraoka10, Toshiaki Onitsuka11, Hiroshi Komatsu12, Masahiro Takeshima13, Akitoyo Hishimoto14, Tatsuya Nagasawa15, Yoshikazu Takaesu16, Toshinori Nakamura17, Takeshi Asami14, Kenichiro Miura3, Junya Matsumoto3, Kazutaka Ohi18, Yuka Yasuda19, Hitoshi Iida8, Kazuyoshi Ogasawara20, Naoki Hashimoto21, Kayo Ichihashi22, Hisashi Yamada23, Koichiro Watanabe4, Ken Inada10, Ryota Hashimoto24. 1. Kyoto University Health Service, Japan. 2. Department of Psychiatry, Nihon University School of Medicine, Japan. 3. Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan. 4. Department of Neuropsychiatry, Kyorin University School of Medicine, Japan. 5. Department of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Japan. 6. Department of Psychiatry, Dokkyo Medical University School of Medicine, Japan. 7. Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; Department of Forensic Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Japan. 8. Department of Psychiatry, Faculty of Medicine, Fukuoka University, Japan. 9. Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Japan. 10. Department of Psychiatry, Tokyo Women's Medical University, Japan. 11. Department of Neuroimaging Psychiatry, Graduate School of Medical Sciences, Kyushu University, Japan. 12. Department of Psychiatry, Tohoku University Hospital, Japan. 13. Department of Neuropsychiatry, Akita University Graduate School of Medicine, Japan. 14. Department of Psychiatry, Yokohama City University Graduate School of Medicine, Japan. 15. Department of Neuropsychiatry Kanazawa Medical University, Japan. 16. Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Japan. 17. Department of Psychiatry, Shinshu University School of Medicine, Japan. 18. Department of Psychiatry, Gifu University Graduate School of Medicine, Japan. 19. Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; Medical Corporation Foster, Japan. 20. Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Japan. 21. Department of Psychiatry, Hokkaido University Graduate School of Medicine, Japan. 22. Department of Neuropsychiatry, University of Tokyo Hospital, Japan. 23. Department of Neuropsychiatry, Hyogo College of Medicine, Japan; Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan. 24. Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan. Electronic address: ryotahashimoto55@ncnp.go.jp.
Abstract
STUDY OBJECTIVES: To investigate the proportion of inpatients with schizophrenia and major depressive disorder prescribed hypnotic medication, and the association between such medication and the use of other antipsychotic agents. METHODS: This was a nationwide cross-sectional study performed as part of the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment' (EGUIDE) project. Data from 2146 inpatients with schizophrenia and 1031 inpatients with major depressive disorder were analyzed. All types and dosages of psychotropic drugs were recorded and the data at the time of discharge were analyzed. Associations between the use of hypnotic medication and other antipsychotic agents were evaluated using multivariate logistic regression analyses. RESULTS: The proportions of schizophrenia patients who were prescribed any and two or more hypnotic agents were 55.7% and 17.6%, respectively, and the corresponding proportions for patients with major depressive disorder were 63.6% and 22.6%, respectively. In schizophrenia patients, multivariate logistic regression analyses showed that two or more antipsychotics, anticholinergic drugs, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. In patients with major depressive disorder, multivariate logistic regression analyses revealed that two or more antidepressants, two or more antipsychotics, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. CONCLUSIONS: Prescription of hypnotic agents was found to be highly frequent among inpatients with psychiatric disorders. Prescription of two or more main antipsychotic agents was commonly associated with the use of hypnotic medication for both schizophrenia and major depressive disorder.
STUDY OBJECTIVES: To investigate the proportion of inpatients with schizophrenia and major depressive disorder prescribed hypnotic medication, and the association between such medication and the use of other antipsychotic agents. METHODS: This was a nationwide cross-sectional study performed as part of the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment' (EGUIDE) project. Data from 2146 inpatients with schizophrenia and 1031 inpatients with major depressive disorder were analyzed. All types and dosages of psychotropic drugs were recorded and the data at the time of discharge were analyzed. Associations between the use of hypnotic medication and other antipsychotic agents were evaluated using multivariate logistic regression analyses. RESULTS: The proportions of schizophrenia patients who were prescribed any and two or more hypnotic agents were 55.7% and 17.6%, respectively, and the corresponding proportions for patients with major depressive disorder were 63.6% and 22.6%, respectively. In schizophrenia patients, multivariate logistic regression analyses showed that two or more antipsychotics, anticholinergic drugs, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. In patients with major depressive disorder, multivariate logistic regression analyses revealed that two or more antidepressants, two or more antipsychotics, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. CONCLUSIONS: Prescription of hypnotic agents was found to be highly frequent among inpatients with psychiatric disorders. Prescription of two or more main antipsychotic agents was commonly associated with the use of hypnotic medication for both schizophrenia and major depressive disorder.