精神医学61巻4号

2019年04月発行

特集 統合失調症の治療ゴールをめぐって

身体的健康の視点から

著者： 菅原典夫¹

所属機関： ¹国立研究開発法人国立精神・神経医療研究センター，トランスレーショナル・メディカルセンター情報管理・解析部

ページ範囲：P.403 - P.410

抄録　統合失調症の治療において，身体的健康を伴わない治療ゴールは存在し得ない。しかし，統合失調症の罹患者における身体的併存疾患の有病割合は，一般人口に比べて高い上，生命を脅かす疾患についてすら，適切に十分に診断されていないと報告されている。一般人口と比べた統合失調症の平均余命について，近年のメタ解析は14.5年ほど短いと報告しており，その対策が求められている。本稿では統合失調症患者のいくつかの身体的併存疾患と健康習慣について述べる。精神科医には，身体的併存疾患に対する適切な身体モニタリングだけでなく抗精神病薬の多剤併用や高用量処方を避けることが求められている。さらに，統合失調症罹患者の不健康な生活習慣を改善するために，多職種チームの非薬物的なアプローチが必須である。

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