30例学校恐惧症人格和情绪特征研究

目的：探讨学校恐惧症的临床特征。方法：对30例学校恐惧症患儿（研究组）和30名正常对照儿童（对照组）进行艾森克个性问卷（EPQ）,儿童焦虑性情绪障碍筛选量表（SCARED）,焦虑自评量表（SAS）及抑郁自评量表（SDS）评估。结果：研究组患儿EPQ结果显示神经质得分显著高于对照组,掩饰程度得分显著低于对照组（P均〈0.05）;SCARED、SAS、SDS的评估显示,与对照组相比,研究组存在明显焦虑和抑郁症状（P〈0.05）。结论：学校恐惧症患儿可能具有神经症的个性特点,普遍存在焦虑和抑郁症状。     

难治性抑郁症患者心理社会因素分析

目的探讨心理社会危险因素在难治性抑郁症发病中的相关机制。方法难治性抑郁症患者、非难治性抑郁症患者和正常对照者各30例。被试者完成一般情况问卷、艾森克个性问卷（EPQ）、生活事件量表（LES）、社会支持评定量表（SSRS）,汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定。采用t检验、χ2检验、Pearson相关性分析、多元逐步回归分析方法,应用SPSS10.0软件完成数据统计。结果①难治性抑郁症组EPQ内外向因子分显著低于非难治性抑郁症组和正常对照组,神经质因子分显著高于非难治性抑郁症组和正常对照组。负性事件总分、社交及其他问题因子分显著高于非难治性抑郁症组和正常对照组,社会支持总分、客观支持分显著低于非难治性抑郁症组和正常对照组。②HAMD总分与负性事件总分、EPQ精神质因子分、神经质因子分呈正相关,与社会支持总分、主观支持因子分、客观支持因子分、支持利用度因子分呈负相关,HAMA总分与EPQ神经质因子、负性事件总分呈正相关,与EPQ内外向因子分、社会支持总分、支持利用度因子分呈负相关。③多因素分析结果：负性事件和低社会支持是抑郁的危险因素,EPQ神经质因子是焦虑的危险因素。结论性格内向,情绪不稳定,体验较多的负性生活事件,社会支持低下是难治性抑郁症的危险因素。应激、社会支持影响难治性抑郁症的严重程度和预后。     

产后抑郁症患者与人格、社会支持的相关研究

目的 探讨产后抑郁症与人格、社会支持的关系.方法 共计1 292例初产妇,诊断为产后抑郁症的232例为研究组,而无抑郁症状的1060例为对照组,问卷评定采用爱丁堡产后抑郁量表、艾森克个性问卷及社会支持评定量表.结果 产后抑郁症的检出率为17.96%.研究组的E维度、L维度因子分评分显著低于对照组(P<0.05),而研究组的N维度因子分评分显著高于对照组(P<0.05).研究组的客观支持、主观支持、利用度因子评分显著低于对照组(P<0.05).结论 产后抑郁症与患者的人格特征及社会支持等因素有关.     

短暂性脑缺血发作患者抑郁症状及其相关因素研究

目的探讨短暂性脑缺血发作患者的抑郁症状的相关因素。方法共计102名短暂性脑缺血发作患者，存在抑郁症状的41名患者为研究组，而无抑郁症状的61名为对照组，问卷评定采用汉密顿抑郁量表、艾森克个性问卷及社会支持评定量表。结果短暂性脑缺血发作患者的抑郁症状检出率为40.20%。汉密顿抑郁量表总分与艾森克个性问卷的N维度呈正相关（r=0.27，P〈0.05），与E维度呈负相关（r=-0.23，P〈0.05）。研究组的客观支持、主观支持因子分显著低于对照组（t=-2.50--10.62，P〈0.05）。结论短暂性脑缺血发作部分患者存在较明显的抑郁症状，其与个性特征及社会支持等因素有关。     

重性抑郁障碍临床痊愈患者心理社会功能特征研究

目的:研究重性抑郁障碍患者在达到临床痊愈标准后心理社会功能的特点。方法:采用生活质量综合评定问卷(GQOLI-74)的躯体、心理、社会功能分量表、17项汉密顿抑郁量表(HAMD)、社会支持评定量表(SSS)和生活事件量表(LES),对32例经住院治疗后达到临床痊愈的重性抑郁障碍患者和32名正常人进行调查分析。结果:协变量方差分析显示,以客观社会支持或负性生活事件为协变量时;研究组躯体功能维度(F=5.75,P<0.05)及躯体不适感因子得分(F=5.51,P<0.05)显著低于对照组;研究组心理功能维度中的正性情感因子得分(F=4.75,P<0.05)显著高于对照组;研究组社会功能维度中的工作学习(t=-3.80,P<0.01)和婚姻家庭因子得分(t=-3.30,P<0.01)显著低于对照组,该维度中的社会支持因子(F=4.94,P<0.05)和业余娱乐生活因子得分(F=9.30,P<0.01)显著高于对照组;研究组总体生活质量因子得分(F=4.14,P<0.05)显著低于对照组。结论:临床痊愈的重性抑郁障碍患者心理功能可能已恢复至正常水平,躯体、社会功能可能尚未完全恢复。     

老年恶性肿瘤患者抑郁症状与个性及社会支持的关系

目的 探讨老年恶性肿瘤患者抑郁症状的相关因素.方法 共计92例老年恶性肿瘤患者,存在抑郁症状的32例患者为研究组,而无抑郁症状的60例为对照组,问卷评定采用汉密顿抑郁量表、艾森克个性问卷及社会支持评定量表.结果 老年恶性肿瘤患者的抑郁症状检出率为34.78%.研究组的E维度、L维度因子分评分显著低于对照组(t=-2.54～-2.40,P＜0.05),而研究组的N维度因子分评分显著高于对照组(t=3.02,P＜0.05).研究组的客观支持、主观支持、利用度因子评分显著低于对照组(t=-6.33～-4.36,P＜0.05).结论 老年恶性肿瘤患者存在较明显的抑郁症状,其与个性特征及社会支持等因素有关.     

精神分裂症患者子女青少年期心理状况的调查分析

目的 探讨精神分裂症患者子女与健康人群子女的青少年期心理状况及性格特征差异.方法 对上海市嘉定区33例精神分裂症患者子女青少年期（研究组）和33例健康人群子女（对照组）,采用艾森克个性问卷（少年版）（EPQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、自尊量表（SES）、一般自我效能感量表（GSES）进行测试,比较两组间的差异.结果 研究组EPQ的精神质、神经质评分显著高于对照组,内外向评分显著低于对照组（P＜0.05）.研究组SAS、SDS显著高于对照组,SES、GSES评分显著低于对照组,差异均有统计学意义（P＜0.01）.结论 精神分裂症患者子女较正常人群子女在青少年期更易出现焦虑、抑郁、自卑等心理问题,精神分裂症患者子女青少年期的心理健康值得关注.     

应激有关因素与缓解期精神分裂症患者应对方式的相关研究

目的探讨应激有关因素与缓解期精神分裂症患者应对方式的相关性。方法选取142例缓解期精神分裂症患者为研究组,85例正常人为对照组,采用应对方式问卷对研究组和对照组进行评定,对研究组患者单独评定症状自评量表（SCL-90）、领悟社会支持量表（PSSS）、自动思维问卷（ATQ）及艾森克人格问卷（EPQ）。结果研究组解决问题分低于对照组,自责、回避、合理化分高于对照组,成熟应对方式得分明显低于对照组,不成熟应对方式得分明显高于对照组（P〈0.05）。研究组中,ATQ与应付方式问卷中除合理化外各因子均有相关性（P〈0.05）,PSSS量表中的家庭外社会支持和社会支持总分与解决问题、求助、成熟应对方式有相关性（P〈0.05）,SCL-90与所有应对方式因子均有相关性（P〈0.05）,EPQ中的内外向与解决问题、自责、求助、成熟应对方式有相关性（P〈0.01）,神经质与除解决问题外各因子均有相关性（P〈0.01）,精神质与除回避外各因子均有相关性（P〈0.05）,掩饰与所有因子均有相关性（P〈0.05）。多元逐步回归分析结果显示,与成熟应对相关的因子包括内外向、家庭外支持、家庭内支持、精神质,与不成熟应对相关的有ATQ、掩饰因子,与混合型应对方式相关的有SCL-90总分。结论缓解期精神分裂症患者存在不成熟应对方式,其与应激因素相关。     

脑梗死患者的生活质量与其焦虑、抑郁情绪的相关性研究

目的 探讨脑梗死患者的生活质量与其焦虑、抑郁情绪的关系。方法 采用Zung焦虑自评量表（SAS）、Zung抑郁自评量表（SDS）及生活质量综合评定问卷（GQOLI）对80例脑梗死患者（脑梗死组）及80名健康人（对照组）进行问卷调查，并对生活质量与其焦虑、抑郁情绪作相关分析。结果 脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均明显低于对照组（P〈0．01），而SAS及SDS评分均明显高于对照组（P〈0．01）。脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均与SAS及SDS评分呈显著性负相关。结论 脑梗死患者的生活质量较差，焦虑、抑郁情绪明显；其生活质量与焦虑、抑郁情绪密切相关。     

产后抑郁症患者的心理社会因素分析

目的研究产后抑郁症患者的人格特征、生活事件及社会支持影响因素。方法对93例产后抑郁症患者及135名正常产妇分别应用艾森克人格问卷、生活事件量表及社会支持评定量表进行评估。结果与正常产妇相比较,产后抑郁症在人格方面具有内倾及神经质倾向,且常经历较多的负性生活事件;产后抑郁症组的社会支持总分及其各分量表得分均显著低于正常组。结论产后抑郁症的发生与人格、生活事件及社会支持等心理社会因素有关。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -