リチウム予防療法者に対する外来指導についての考察

The use of lithium carbonate as a prophylactic therapy to affective disorders has now become widespread. The evaluation of the patients' attitudes toward their lithium therapy and affective disorders is very important in the decision to continue therapy. We issued a questionnarie to 41 outpatients in the Psychiatric Clinic of Okayama University Hospital. All patients have continued lithium therapy for at least 3 months because of two or more manic-depressive episodes over the past two years, and all of them were in remmission and had normal intelligence. The patients wanted more information on following questions: possible risk of relapses, heredity of affective disorders, methods for preventing relapses, how to handle theirselves at further psychotic episodes, duration of their nedication, side effects of long-term lithium therapy, the degree of prophylactic effects of lithium, and the combined use of lithium with other drugs. Forty-nine percent of the patients had read about the affective disorder and 59% of the patients wanted to learn about lithium therapy. These results suggest that patients on prophylactic lithium therapy may want more active and easily understandable guidance concerning affective disorders and lithium therapy. Prophylactic lithium therapy is a long-term procedure which requires assistance from the patient's physician and family. We should guide and support patients toward a more effective and safe continuation of lithium therapy.