缓解期双相情感障碍I型II型患者及近亲属认知功能对照研究

目的：探讨缓解期双相情感障碍I型、II型患者及其近亲属认知功能的临床特征。方法对50例缓解期双相障碍I型患者（BP‐1组）、50例缓解期双相障碍II型患者（BP‐2组）、50名健康近亲属（亲属组）及50名正常人群（对照组）采用持续操作测验和威斯康星卡片分类测验进行测评分析。结果 BP‐1组、BP‐2组及亲属组持续操作测验的正确数评分显著低于对照组（P＜0．05）,且BP‐1组显著低于BP‐2组和亲属组（P＜0．05）。BP‐1组、BP‐2组和亲属组威斯康星卡片分类测验的错误应答数、非持续性错误数显著高于对照组（P＜0．05或0．01）;BP‐1组、亲属组显著高于BP‐2组（P＜0．01）;BP‐1组和亲属组总应答数、完成分类数、正确率、完成第一个分类数所需要应答数、不能维持完整分类数与对照组及BP‐2组比较差异有显著性（P＜0．05或0．01）。结论缓解期双相情感障碍I型、II型患者及其近亲属存在多维度认知功能损害,I型患者任务管理能力损害较明显,II型患者注意力损害明显。     

首发精神分裂症患者认知功能与阴性症状的相关性

目的:探讨首发精神分裂症患者认知功能与阴性症状的相关性。方法:2004-01/12采用计算机版的Wisconsin卡片分类测验(WCST)对武汉大学人民医院精神卫生中心的首发精神分裂症患者40例评价认知功能,同时采用阴性和阳性量表(PANSS)进行精神症状学评分,分析两者的相关性。结果:40例患者选取WCST10项指标与阴性、阳性症状总分进行相关性分析,差异均无显著性,r=-0.348～0.922,P均>0.05。阴性症状中N3(情感交流障碍)、N6(交谈缺乏自发性和流畅性)两项症状与认知功能损害有显著相关性,r=-0.390～0.643,P<0.05～0.01。结论:首发精神分裂症患者认知功能障碍与阳性、阴性症状关系不大,与阴性症状之间存在一定的联系,其中与交流障碍相关性最密切。     

以阴性症状为主的慢性精神分裂症患者认知功能研究

目的探讨以阴性症状为主的慢性精神分裂症的认知功能变化。方法采用Stroop测验、连线测试(TMT)、范畴流利测验、WMS-III空间广度测验、定步调连续加法任务测验、木块拼图对49例精神分裂症患者,53例健康志愿者进行测评。结果以阴性症状为主的慢性精神分裂症的所有认知功能测验均差于正常对照组(P0.01),精神分裂症患者SANS总分及分量表分与大部分认知量表成绩有相关性(P0.05),注意障碍因子与所有认知量表成绩有相关性(P0.05或0.01)。结论以阴性症状为主的慢性精神分裂症存在普遍的认知功能损害,阴性症状可能与认知功能可能存在共同的病理基础。     

阳性症状为主型精神分裂症和伴有精神病性症状双相障碍患者MMPI对照研究

目的探讨阳性症状为主型精神分裂症和伴有精神病性症状的躁狂或抑郁的双相障碍患者的个性特征,为其鉴别诊断提供线索。方法采用MMPI测试软件,评估24例精神分裂症阳性症状为主型患者(精神分裂症组)和37例伴有精神病性症状的躁狂或抑郁的双相障碍患者(双相障碍组)人格特征,分别计算临床量表10个因子分值。采用SPSS 13.0进行统计处理,比较两组患者之间的差异。结果精神分裂症阳性症状为主型男性患者的社会内向因子分高于女性患者,差异有统计学意义(t=2.186,P=0.040);双相障碍男、女性患者之间的临床量表10个因子分均未见差异。两组患者的临床量表10个因子分差异无统计学意义(P>0.05),但精神分裂症阳性症状为主型患者的精神病态、偏执性人格、精神分裂症、轻躁狂因子分高于中国常模划界的T分,双相障碍患者的偏执性人格因子分高于中国常模划界的T分,其余均低于中国常模标准。结论精神分裂症阳性症状为主型与伴精神病性症状的双相障碍患者存在人格特征改变,两组患者MMPI无明显差异,精神分裂症阳性症状为主型患者的社会内向人格可能存在性别差异。     

首发精神分裂症患者认知功能损害与不同精神症状的相关性研究

目的探讨首发精神分裂症患者认知功能损害与不同精神症状的相关性。方法采用病例对照研究,共选取符合入选标准的首发精神分裂症患者149例、正常对照193例,采用重复性成套神经心理状态测验(RBANS)、威斯康星卡片分类测验(WCST)对两组研究对象进行认知功能测试,比较两组认知功能的差异;采用阳性阴性症状量表(PANSS)评定患者的精神症状并分型,采用美国Niclet Bravo脑诱发电位仪对精神分裂症患者进行认知电位P300检测,分析患者RBANS测验总分与PANSS中不同精神症状的相关性,比较不同亚型患者认知电位P300的差异。结果患者组RBANS测试结果各因子分均显著低于对照组(P<0.05);两组WCST各项测量指标比较均有显著性差异(P<0.05);患者组RBANS测试总分与PANSS阴性症状量表中的交谈缺乏自发性和流畅性、情感交流障碍呈显著正相关(r=0.191、0.192,P<0.05);阴性亚型患者与阳性亚型患者认知电位P300波幅比较呈显著性差异(P<0.05)。结论首发精神分裂症患者存在认知功能的损害,其中认知功能损害程度与阴性症状密切相关。     

首发精神分裂症患者认知功能与阴性症状的相关性

目的：探讨首发精神分裂症患者认知功能与阴性症状的相关性。方法：2004-01／12采用计算机版的Wisconsin卡片分类测验(WCST)对武汉大学人民医院精神卫生中心的首发精神分裂症患者40例评价认知功能，同时采用阴性和阳性量表(PANSS)进行精神症状学评分，分析两者的相关性。结果：40例患者选取WCST 10项指标与阴性，阳性症状总分进行相关性分析，差异均无显著性，r=-0．348～0．922，P均&;gt;0．05。阴性症状中N3(情感交流障碍)、N6(交谈缺乏自发性和流畅性)两项症状与认知功能损害有显著相关性，r=-0．390～0．643，P&;lt;0．05～0．01。结论：首发精神分裂症患者认知功能障碍与阳性，阴性症状关系不大，与阴性症状之间存在一定的联系，其中与交流障碍相关性最密切。     

奥氮平治疗老年精神分裂症患者的临床疗效及对认知功能的改善作用

<正>约85%的精神分裂症患者存在认知功能障碍,主要表现为记忆力衰退、注意力不集中、执行功能损害等[1]。研究[2]表明,精神分裂症认知功能障碍随着年龄的增长呈现持续恶化的趋势,导致许多老年精神分裂症患者呈衰退状态及认知功能缺损,严重影响其生活质量。目前临床上仍主要采用药物治疗老年精神分类症,主要分为典型和非典型类药物[3]。本研究分别给予80例老年精神分裂症患者奥氮平和氟哌啶醇治疗,分析两     

阿立哌唑对晚发性精神分裂症患者认知功能的影响

目的 探讨阿立哌唑对晚发性精神分裂症患者认知功能的影响.方法 将106例晚发性精神分裂症患者随机分为两组,每组53例,分别口服阿立哌唑、氯丙嗪治疗.观察8周.于治疗前后采用阳性与阴性症状量表、威斯康星卡片分类测验评定临床疗效及认知功能.结果 治疗后两组阳性与阴性症状量表评分均较治疗前显著降低（P＜0.01）,阿立哌唑组威斯康星卡片分类测验的总正确数、持续反应数、完成分类数均较治疗前显著升高（P＜0.01）,总错误数、持续错误数均较治疗前显著降低（P＜0.01）,氯丙嗪组仅持续反应数较治疗前显著升高（P＜0.01）.结论 阿立哌唑治疗晚发性精神分裂症疗效显著,能显著改善患者认知功能.     

单相和双相抑郁障碍及精神分裂症患者神经认知功能的对比研究

目的对比分析复发单相抑郁障碍、双相抑郁障碍及精神分裂症患者神经认知功能的特征,为临床早期识别和诊断抑郁障碍和精神分裂症提供参考依据。方法选取精神科2012年1月至2014年3月收治的32例双相I型抑郁障碍患者(A组)、28例复发单相抑郁患者(B组)和38例精神分裂症患者(C组)为研究对象,并选取同期30例健康者为对照组,对比分析4组患者总体认知功能以及在持续注意/警觉、学习、记忆、精细动作、社会认知、执行功能以及信息处理等认知领域方面的表现。结果 C组患者认知变量均为重度损害,A组和B组患者神经认知功能损害多为轻中度;C组在持续注意/警觉、学习、记忆、执行功能、信息处理及总体认知功能等方面得分均低于A、B组(P均<0.05),A组上述指标得分和B组比较差异无统计学意义(P均>0.05),A组和B组在执行功能和计划领域比较差异有统计学意义(P均<0.05)。结论双相抑郁障碍和精神分裂症认知损害模式与程度存在明显差异,而双相抑郁障碍和复发单相抑郁患者神经认知功能模式相似,神经认知功能对临床鉴别抑郁障碍和精神分裂症具有一定的提示意义,但尚不能作为区分单双相抑郁的客观指标。     

重复经颅磁刺激在精神分裂症中的临床研究新进展

正精神分裂症是一组病因未明的难治性精神障碍,临床症状主要表现为阳性症状(妄想、幻觉、思维紊乱、行为异常等)、阴性症状(快感缺失、冷漠、社会退缩等)及认知功能的损害等[1]。精神分裂症患者的认知功能损害主要集中在记忆、注意和执行功能等方面[2]。目前临床上对于精神分裂症的治疗多以药物治疗为主,但药物治疗对精神分裂症患者的阴性症状和认知功能损害的效果不佳,且药物治疗常伴随着大量的副反应,     

The Organization of the Self-Concept in Bipolar Disorders: An Empirical Study and Replication

Two studies are described that used a self-concept card sort task to investigate the structure of the self-concept in individuals with bipolar disorders. Both studies showed in the euthymic state, that such individuals had a modularized self-concept in which key aspects of the self tend to be organized as completely positive or completely negative. The inclusion of a chronic illness control group of individuals with diabetes in the 2nd study demonstrated that these effects were not simply a change in the self-concept that was consequent on the experience of a long-term chronic disorder.     

抑郁症双相情感障碍精神分裂症药物应用状况调查

目的：了解抑郁症、双相情感障碍及精神分裂症患者的药物应用状况。方法采用自制调查表对34例抑郁症、27例双相情感障碍及88例精神分裂症患者的药物应用状况进行统计分析。结果抑郁症以单一用药为主（94．1％）;双相情感障碍在应用情感稳定剂治疗的基础上常联合抗抑郁药物（37．0％）或抗精神病药（37．0％）治疗;精神分裂症单一用药占51．1％,联合用药占48．9％。结论抑郁症、双相情感障碍及精神分裂症患者的临床用药均符合精神药理学规范。     

精神分裂症与急性应激障碍及抑郁症患者血清蛋白质谱初步分析

目的研究精神分裂症、急性应激障碍、抑郁症患者血清蛋白质谱的表达情况，筛选差异表达的标志蛋白并探讨其临床价值。方法采用表面增强激光解吸电离飞行时间质谱技术（SELDI-TOF—MS）对122例精神分裂症、急性应激障碍、抑郁症患者及健康患者血清蛋白质谱图进行检测，用Biomarker Wizard3．1版本软件分析质谱数据，筛选血清差异表达的标志蛋白并评价其临床价值。结果精神分裂症患者与健康者血清有56个差异蛋白质峰，其中5个蛋白质峰作为标志蛋白具有潜在的临床价值；精神分裂症与急性应激障碍者之间差异表达的蛋白质峰有15个；精神分裂症与抑郁症患者血清有21个差异蛋白质峰。结论精神分裂症、急性应激障碍、抑郁症患者血清中具有差异表达的标志蛋白，可能对其鉴别诊断和病因学研究，以及进一步研究蛋白质组学改变及其临床应用具有重要意义。     

The effects of neuregulin1 on brain function in controls and patients with schizophrenia and bipolar disorder

Recent studies have identified neuregulin1 as a probable susceptibility gene for schizophrenia and bipolar disorder. However, little is known about how this gene may affect brain function to increase vulnerability to these disorders. The present investigation examined the impact of neuregulin1 genotype on brain function in patients with schizophrenia, patients with bipolar I disorder and healthy volunteers. We used functional magnetic resonance imaging to measure brain responses during a verbal fluency task in a total of 115 subjects comprising 41 patients with schizophrenia, 29 patients with bipolar disorder and 45 healthy volunteers. We then used statistical parametric mapping to estimate the main effects of diagnostic group, the main effect of genotype and their interaction. We tested the hypothesis that the high-risk variant of neuregulin1 would be associated with altered prefrontal function. In all three diagnostic groups, the high-risk variant of neuregulin1 was associated with greater deactivation in the left precuneus. In addition, there was an interaction between diagnosis and genotype in two regions of the prefrontal cortex. The right inferior frontal gyrus expressed increased activation in individuals with the high-risk variant, but only in patients with schizophrenia. Conversely, the right posterior orbital gyrus expressed increased activation in individuals with the high-risk variant, but only in patients with bipolar disorder. Our results suggest that genetic variation in neuregulin1 has a measurable impact on brain function and provide preliminary evidence for a disease-specific pattern of gene action in different regions of the prefrontal cortex.     

重性精神疾病患者的家庭负担调查

目的探讨重性精神疾病患者的疾病家庭负担。方法采用疾病家庭负担量表(FBS),对148 例符合ICD-10 诊断标准的精神分裂症和双相障碍患者的照顾者进行评定。结果精神分裂症和双相障碍患者的疾病家庭负担普遍存在,涉及多个维度。各维度影响达中度以上的分别为家庭关系(51%)、家庭娱乐活动(50%)、家庭日常活动(45%)、经济负担(43%)、家庭成员心理健康(36%)、家庭成员身体健康(32%)。年轻、自费及无个人收入患者的疾病家庭负担更重。结论提示需制定综合的心理社会干预措施,有效减轻照顾者的家庭负担。     

Effect of CACNA1C rs1006737 on neural correlates of verbal fluency in healthy individuals

BackgroundRecent genetic studies found the A allele of the variant rs1006737 in the alpha 1C subunit of the L-type voltage-gated calcium channel (CACNA1C) gene to be overrepresented in patients suffering from bipolar disorder, schizophrenia or major depression. While the functions underlying the pathophysiology of these psychiatric disorders are yet unknown, impaired performance in verbal fluency tasks is an often replicated finding. We investigated the influence of the rs1006737 single nucleotide polymorphism (SNP) on verbal fluency and its neural correlates.MethodsBrain activation was measured with functional magnetic resonance imaging (fMRI) during a semantic verbal fluency task in 63 healthy male individuals. They additionally performed more demanding verbal fluency tasks outside the scanner. All subjects were genotyped for CACNA1C rs1006737.ResultsFor the behavioral measures outside the scanner, rs1006737genotype had an effect on semantic but not on lexical verbal fluency with decreased performance in risk-allele carriers. In the fMRI experiment, while there were no differences in behavioural performance, increased activation in the left inferior frontal gyrus as well as the left precuneus was found in risk-allele carriers in the semantic verbal fluency task.ConclusionsThe rs1006737 variant does influence language production on a semantic level in conjunction with the underlying neural systems. These findings are in line with results of studies in bipolar disorder, schizophrenia and major depression and may explain some of the cognitive and brain activation variation found in these disorders.     

Gut microbes in neurocognitive and mental health disorders

Abstract

Introduction

As individuals age, the prevalence of neurocognitive and mental health disorders increases. Current biomedical treatments do not completely address the management of these conditions. Despite new pharmacological therapy the challenges of managing these diseases remain.There is increasing evidence that the Gut Microbiome (GM) and microbial dysbiosis contribute to some of the more prevalent mental health and neurocognitive disorders, such as depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), schizophrenia, bipolar disorder (BP), and dementia as well as the behavioural and psychological symptoms of dementia (BPSD) through the microbiota-gut-brain axis.

Methodology: Scoping review about the effect of gut microbiota on neurocognitive and mental health disorders.     

Differential effects of DAAO on regional activation and functional connectivity in schizophrenia, bipolar disorder and controls

Recent studies have identified DAAO as a probable susceptibility gene for schizophrenia and bipolar disorder. However, little is known about how this gene affects brain function to increase vulnerability to these disorders. We examined the impact of DAAO genotype (rs3918346) on brain function in patients with schizophrenia, patients with bipolar I disorder and healthy controls. We tested the hypothesis that a variation in DAAO genotype would be associated with altered prefrontal function and altered functional connectivity in schizophrenia and bipolar disorder. We used functional magnetic resonance imaging to measure brain responses during a verbal fluency task in a total of 121 subjects comprising 40 patients with schizophrenia, 33 patients with bipolar disorder and 48 healthy volunteers. We then used statistical parametric mapping (SPM) and psycho-physiological interaction (PPI) analyses to estimate the main effects of diagnostic group, the main effect of genotype, and their interaction on brain activation and on functional connectivity. Inferences were made at p<0.05, after correction for multiple comparisons across the whole brain. In the schizophrenia group relative to the control group, patients with one or two copies of the T allele showed lower deactivation in the left precuneus and greater activation in the right posterior cingulate gyrus than patients with two copies of the C allele. This diagnosis×genotype interaction was associated with differences in the functional connectivity of these two regions with other cortical and subcortical areas. In contrast, there were no significant effects of diagnosis or of genotype in comparisons involving bipolar patients. Our results suggest that genetic variation in DAAO has a significant impact on both regional activation and functional connectivity, and provide evidence for a diagnosis-dependent pattern of gene action.     

An Untargeted Metabolomics Analysis of Antipsychotic Use in Bipolar Disorder

Background

Second generation antipsychotic (SGA) use in bipolar disorder is common and has proven effective in short‐term trials. There continues to be a lack of understanding of the mechanisms underlying many of their positive and negative effects in bipolar disorder. This study aimed to describe the metabolite profiles of bipolar subjects treated with SGAs by comparing to metabolite profiles of bipolar subjects treated with lithium, and schizophrenia subjects treated with SGAs.

Methods

Cross‐sectional, fasting untargeted serum metabolomic profiling was conducted in 82 subjects diagnosed with bipolar I disorder (n = 30 on SGAs and n = 32 on lithium) or schizophrenia (n = 20). Metabolomic profiles of bipolar subjects treated with SGAs were compared to bipolar subjects treated with lithium and schizophrenia subjects treated with SGAs using multivariate methods.

Results

Partial lease square discriminant analysis (PLS‐DA) plots showed separation between bipolar subjects treated with SGAs, bipolar subjects treated with lithium, or schizophrenia subjects treated with SGAs. Top influential metabolite features were associated with several pathways including that of polyunsaturated fatty acids, pyruvate, glucose, and branched chain amino acids.

Conclusions

The findings from this study require further validation in pre‐ and posttreated bipolar and schizophrenia subjects, but suggest that the pharmacometabolome may be diagnosis specific.