橄榄体脑桥小脑萎缩听觉P300认知电位的研究

目的 观察P300检查在橄榄体脑桥小脑萎缩中的应用价值及影响因素.方法 应用P300检查和认知能力筛选量表(CASI)对34例橄榄体脑桥小脑萎缩患者和与其年龄、性别相匹配的正常对照组进行检测.结果 患者不同年龄组P300潜伏期较对照组明显延长(t=2.682～4.983,P<0.05～0.01),患者不同年龄组CASI评分比正常对照组明显降低(t=2.486～5.241,P<0.01),患者组P300潜伏期与CASI评分之间呈负相关(r=-0.48,P<0.005),病情轻组[(348.68±21.47) ms]与重组[(363.27±30.15) ms]和脑萎缩明显组[(354.46±26.98) ms]与不明显组[(338.74±23.56) ms]之间P300潜伏期均差异有显著意义 (P<0.01).结论 评价橄榄体脑桥小脑萎缩的认知功能状态,P300检查是一项有价值的客观指标,其异常程度与病情轻、重和脑萎缩程度有关.     

无症状性脑梗死患者血清同型半胱胺酸水平与P300的关系

目的 研究无症状性脑梗死(ACI)患者血清同型半胱胺酸(Hcy)与事件相关电位P300及临床症状之间的关系,探讨叶酸治疗与认知功能改变的关系.方法 采用丹麦KeyPoint型肌电/诱发点位仪对68名首发ACI患者及62名正常对照进行P300测查,酶联免疫吸附法测定血清同型半胱氨酸浓度,蒙特利尔认知评估量表(MoCA)、简易精神状态检查量表(MMSE)评定患者临床症状.结果 与健康对照组相比,患者组血清Hcy水平明显增高,差异有统计学意义(P＜0.01),患者组P300潜伏期明显延长,波幅明显降低,差异有统计学意义(P＜0.01).相关分析显示,患者血清Hcy水平与P300波幅负相关,与P300潜伏期正相关,与MoCA量表评分负相关,未发现与MMSE评分存在相关性;MoCA量表评分与P300波幅负相关,与P300潜伏期正相关,未发现与MMSE评分存在相关性;患者组经过8周叶酸和维生素岛B12治疗,血清Hcy水平明显降低(P＜0.01),P300潜伏期和波幅及MoCA评分均无明显变化;经过12周的治疗,P300波幅明显增加(P＜0.01),P300潜伏期无明显变化(P＞0.05),MoCA量表评分无明显变化(P＞0.05).结论 ACI患者Hcy水平升高,其认知功能损害可能与血清Hcy增高相关,叶酸和维生素B12治疗可能会改善患者认知功能;P300和MoCA可作为评价认知功能的敏感指标.     

P300和MoCA评估丙戊酸钠治疗后癫痫患者认知功能的短期变化对比

目的应用P300和MoCA量表观察症状性癫痫患者接受单药丙戊酸钠治疗前后认知功能的改变。方法对30例首诊的拟行丙戊酸钠单药治疗的症状性癫痫患者(实验组)和30例正常健康体检者(对照组)分别进行事件相关电位P300、MoCA量表测定,并对实验组单药口服丙戊酸钠3个月后、6个月后再次进行P300、MoCA量表复查。结果治疗前实验组MoCA评分为(26.00±1.17)分,对照组为(28.60±1.33)分,实验组MoCA评分较对照组低,差异有统计学意义(P0.05)。治疗前实验组P300潜伏期(424.03±45.98)ms,对照组P300潜伏期(319.83±12.70)ms,实验组P300潜伏期较对照组长,差异有统计学意义(P0.05)。经丙戊酸钠单药治疗3个月后,实验组MoCA评分(26.40±1.17)分,与治疗前比较差异无统计学意义(P0.05);实验组P300潜伏期为(397.87±42.87)ms,与治疗前比较差异有统计学意义(P0.05)。经丙戊酸钠治疗6个月后,实验组MoCA评分为(27.33±1.03)分,与治疗前比较差异有统计学意义(P 0.01);实验组P300潜伏期为(367.50±33.80)ms,与治疗前比较差异有统计学意义(P0.01)。结论症状性癫痫患者存在认知功能障碍,口服丙戊酸钠可改善认知功能,且P300潜伏期较MoCA量表能更早反映癫痫患者短期认知功能变化。     

艾司西酞普兰对躯体形式障碍患者认知功能的影响

目的:探讨艾司西酞普兰对躯体形式障碍患者认知功能的影响。方法:60例躯体形式障碍患者(病例组)接受艾司西酞普兰治疗6周;治疗前后分别行瑞文标准推理测验、成人韦氏智力测验中数字广度及数字符号测验、以及事件相关电位P300检测;结果与60名健康者(对照组)比较。结果:病例组治疗前瑞文、数字广度及符号测验评分(84.78±13.85、11.22±1.61、10.95±2.45)明显低于对照组(96.52±18.18,12.63±2.66,12.83±1.49;P均0.01),P300 N1潜伏期[(101.96±9.38)ms]明显长于对照组[(90.17±7.99)ms](P0.001);治疗后瑞文及数字广度评分(91.25±14.87,11.98±1.89)明显增加,P300 P2及N2潜伏期[(194.64±65.31)ms,(240.60±41.41)ms]明显延长(P0.05或P0.01)。结论:艾司西酞普兰可改善躯体形式障碍患者的认知功能。     

老年慢性脑供血不足认知障碍的研究

目的 分析老年性慢性脑供血不足(CCCI)蒙特利尔认知评估量表(MoCA)及P300改变的特点,以期提高对CCCI认知功能受损的诊断水平.方法 使用MoCA对22例住院老年CCCl患者及16例对照组进行认知功能测定.使用肌电-诱发电位仪的oddball程序检测患者及对照组的P300.结果 老年CCCI组MoCA评定总分低于对照组,差异显著(18.23±1.8 vs 22.19±5.96,P＜0.05)对各项得分分析显示,主要表现在视空间与执行功能和记忆两项差异显著(2.18±0.66 vs 2.62±1.15,P＜0.05;2.64±0.66 vs 3.44±1.15,P＜0.05).老年CCCI组P300峰潜伏期较对照组明显延长(445.45±37.5)ms vs(336.38±16.50)ms,P＜0.01.结论 老年CCCI患者认知功能受损,主要表现在视空间与执行功能和记忆受损较为突出,老年CCCl患者P300峰潜伏期延长反映认知功能受损.MoCA和P300是评估老年CCCI患者认知功能简单有效的方法.     

精神分裂症患者注意网络功能与情绪认知障碍的相关性研究

目的 探讨精神分裂症患者的注意网络功能和面孔情绪认知功能障碍及两者间的关系.方法 采用注意网络测验(ANT)和中国人面孔情绪测验(CFET)对50例未用抗精神病药的精神分裂症患者(患者组)进行评估,并与53名正常健康者(对照组)进行比较.结果 (1)ANT:患者组的平均反应时间[(743.0±97.0)ms]长于对照组[(668.9±95.8)ms,P＜0.01],定向网络效率[(30.1±30.7)ms]低于对照组[(49.6±21.3)ms,P＜0.01].(2)CFET:患者组和对照组的总分[分别为(75.46±13.28)分和(105.64±4.82)分]及对六种基本情绪的认知评分[分别为:喜(18.82±0.52)分和(19.81±0.39)分、怒(15.10±4.63)分和(18.23±1.37)分、悲(12.96±5.11)分和(18.17±1.52)分、惊(13.24±5.03)分和(18.77±1.12)分、怕(5.96±3.99)分和(15.11±2.15)分、厌(9.38±5.47)分和(15.47±2.18)分]差异均有统计学意义(P＜0.01).(3)Spearman相关分析:患者组ANT正确率与CFET总分呈正相关(r=0.285),ANT平均反应时间与CFET总分(r=-0.302)和对情绪怒的认知评分(r=-0.296)呈负相关,而ANT警觉效率评分与对情绪厌的认知评分(r=0.401)呈正相关(均P＜0.05).结论 精神分裂症患者存在注意定向功能障碍和广泛的情绪认知缺陷,注意功能与情绪认知总体水平存在相关.     

P300和总脑小血管病评分对脑小血管病患者认知 障碍评估的临床价值

目的 本研究旨在评估 P300、总脑小血管病（CSVD）评分对 CSVD 患者认知障碍程度的 检测作用，并探讨认知功能筛查量表与之匹配程度。方法 纳入 2018 年 10 月至 2020 年 6 月就诊于 连云港东方医院神经内科并诊断CSVD的患者72例，同时纳入同期评价的年龄、性别与之匹配的34名 健康体检者设为对照组。所有纳入者均在一周内检查简易智力状态检查量表（MMSE）和蒙特利尔 认知评估量表（MoCA）和 P300、总 CSVD 评分。CSVD 患者根据认知功能筛查量表（MMSE、MoCA）分 为认知障碍组和非认知障碍组，分析 3 组间 MMSE、MoCA 评分与 P300 潜伏期、P300 波幅、总 CSVD 评分的关系。结果 认知障碍组和非认知障碍组在中央点（Cz）记录的P300 潜伏期均长于对照组 （P＜ 0.001），认知障碍组P300 潜伏期长于非认知障碍组［（397.471±35.911）ms比（342.584±14.502）ms， P＜ 0.001］。认知障碍组和非认知障碍组的总 CSVD 评分高于对照组（P＜ 0.001），认知障碍组总 CSVD 评 分 高 于 非 认 知 障 碍 组（P＜ 0.001）。 相 关 分 析 显 示 MMSE、MoCA 评 分 与 P300 潜 伏 期（r=-0.768， P＜ 0.001；r=-0.824，P＜ 0.001）、总 CSVD 评 分 之 间（r=-0.816，P＜ 0.001；r=-0.896，P＜ 0.001）存 在 强负相关关系。当 P300-Cz 潜伏期为 348.4 ms 时，CSVD 患者诊断认知障碍的敏感度为 94.3%，特异 度为 83.1%。当总 CSVD 评分为 2 分时，CSVD 患者诊断认知障碍的敏感度为 82.9%，特异度 97.2%。 结论 P300 潜伏期、总 CSVD 评分可能是 CSVD 患者认知功能障碍的早期预测指标，且较 MMSE、MoCA 量表可能更客观地反映认知功能     

帕金森病患者血清人软骨糖蛋白39水平的改变及其与病情和认知功能的相关性

目的探讨帕金森病(PD)患者血清人软骨糖蛋白39(YKL-40)水平的改变及其与病情和认知功能的相关性。方法用ELISA法给63例PD患者和60名正常对照者进行血清YKL-40水平检测,以及蒙特利尔认知评估(Mo CA)量表评分。并给PD患者进行统一PD评定量表(UPDRS)Ⅰ、Ⅱ、Ⅲ评分,评定病情。对PD患者的血清YKL-40水平与UPDRSⅠ、Ⅱ、Ⅲ评分、病程及Mo CA量表进行相关性分析。结果 PD组的血清YKL-40水平[(3.717±0.1015)ng/ml]明显高于正常对照组[(2.919±0.1827)ng/ml](P0.001)。PD患者的血清YKL-40水平与UPDRSⅠ无相关性(r=0.21,P0.05),与UPDRSⅡ、Ⅲ评分呈正相关(r=0.9251,r=0.7767;均P0.0001),与PD患者的病程亦呈正相关(r=0.4323,P0.01),与Mo CA量表评分呈负相关(r=-0.6985,P0.0001)。结论 PD患者的血清YKL-40水平显著增高,并与病情和认知功能密切相关。YKL-40可成为PD诊断和病情判断的生物学指标。     

老年卒中后抑郁患者血清细胞因子的研究

目的 探讨老年卒中后抑郁患者(PSD)血清细胞因子白细胞介素-1β(II-1β)、白细胞介素-6(IL-6)以及肿瘤坏死因子(TNF-α)的水平.方法 采用酶联免疫吸附法检测PSD组(36例)及卒中后无抑郁患者(对照组;32例)的血清IL-1β、IL-6及TNF-α水平,并以汉密尔顿抑郁量表(HAMD)评分将PSD组分为轻度组(8～16分;9例)、中度组(17～23分;17例)及重度组(≥24分;10例),比较各组血清IL-1β、IL-6及TNF-α水平的差异.结果 (1)PSD组血清IL-1β[(35.2±4.2)ng/L]、IL-6[(11.3±4.3)ng/L]及TNF-α[(32.4±6.9)ng/L]水平,均高于对照组[分别为(18.1±3.3)ng/L、(6.1±1.9)ng/L及(21.6±4.8)ng/L;P＜0.01];(2)卒中后重度抑郁组血清IL-1β[(41.8±3.2)ng/L]、IL-6[(17.5±5.7)ng/L]及,TNF-α[(38.8±5.8)ng/L]水平,均高于轻度抑郁组[分别为(29.1±2.3)ng/L、(6.6 ±1.7)ng/L及(25.9 ±3.3)ng/L;P＜0.05]、中度抑郁组[分别为(34.6±2.6)ng/L、(10.2 ±3.5)ng/L及(32.1±3.6)ng/L;P＜0.05],中度抑郁组亦高于轻度抑郁组(P＜0.05);(3)血清IL-1β(r=0.637)、IL-6(r=0.698)、TNF-α(r=0.722)水平均与抑郁的严重程度显著相关(P＜0.01).结论 IL-1β、IL-6及TNF-α可能在卒中后抑郁的发生发展中起重要作用.     

后循环TIA患者临床认知功能与P300相关性研究

目的探讨后循环(posterior circulation,PI)-短暂性脑缺血发作(transient ischemic attack,TIA)患者大脑认知功能的临床表现,了解PI-TIA患者大脑认知功能状态。方法选择2011年7月-2012年8月在新疆石河子市人民医院神经内科住院的PI-TIA患者30例,对照组50例。两组患者使用简易精神状态量表(MMSE)、蒙特利尔认知评估中文版(M0CA)和事件相关电位P300(ERP/P300)进行认知功能评定。结果 PI-TIA组MoCA和MMSE评分较对照组减低(P 0. 01); P300潜伏期较对照组延长(P 0. 01)。PI-TIA组MoCA子项目中执行功能/视空间、命名、记忆评分较对照组低(P 0. 01,0. 05)。PI-TIA组MMSE子项目时间定向力、语言即刻记忆、计算能力、短程记忆、语言表达、图形描画评分较对照组低(P 0. 01,0. 05)。MMSE和MoCA正相关(r=0. 811,P 0. 01)。MMSE和P300潜伏期负相关(r=-0. 745,P 0. 01)。结论 PI-TIA患者存在一定的认知功能损害。MoCA和P300潜伏期可识别PI-TIA患者早期认知功能损害。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Relationship Between Sluggish Cognitive Tempo and Age and IQ in Preschool and School-Age Children and Adolescents with Autism and with ADHD

Journal of Autism and Developmental Disorders - Relationships between sluggish cognitive tempo (SCT) and age and IQ were investigated in children with autism and/or ADHD covering broader age and IQ...     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.