抑郁症诱发电位波形变异与自杀行为史的关联性研究

目的 探讨抑郁症患者脑诱发电位(BEP)波幅下降与自杀行为史的关系以及临床意义.方法 应用美国尼高力公司Spirit脑诱发电位仪,记录了39例抑郁相、22例躁狂相患者和33名正常对照者的3种诱发电位.结果 1.与正常对照组相比,抑郁相和躁狂相组均出现诱发电位主成分波幅降低,抑郁相VEP/P2潜伏期延迟(正常对照组(194±19)ms,自杀史阳性组(211±21)ms,自杀史阴性组(209±17)ms, P＜0.01).2.两组患者的SEPs改变主要与患者有无自杀行为史有关.结论 诱发电位临床应用价值得到了初步证实,与自杀行为相关的生物学指标研究中需进一步重视.     

抑郁症患者脑诱发电位(P300)变化与自杀行为的相关性研究

目的 探讨抑郁症患者脑诱发电位(P300)变化与自杀行为的关系.方法 应用国产脑诱发电位仪,记录了48例抑郁症患者和40名正常对照者的P300.结果 与正常对照组相比,抑郁症组均出现P300主成分波幅降低,抑郁症组P3潜伏期延迟(P<0.01);抑郁症组的P300改变主要与有无自杀行为史有关.结论 P300变化与自杀行为的相关性需进一步追踪随访.     

抑郁症患者失匹性负波变异与自杀行为的关联性研究

目的 探讨抑郁症患者失匹性负波(MMN)变化与自杀行为的关系.方法 应用国产脑诱发电位仪,记录了48例抑郁症患者和40名正常对照者的MMN.结果 与正常对照组相比,抑郁症组出现MMN主成分波幅降低,MMN潜伏期延迟.有无自杀行为史与抑郁症患者的MMN改变有关.结论 MMN临床应用价值得到了初步证实,与自杀行为相关的生物学指标研究中需进一步回访.     

抑郁症患者自杀行为与血清脑源性神经营养因子水平的关系

目的:探讨血清脑源性神经营养因子(BDNF)水平与抑郁症患者自杀行为之间的关系.方法:采用酶联吸附反应方法对有自杀行为的21例抑郁症患者(自杀组)、无自杀行为的52例抑郁症患者(非自杀组)以及80例正常人(对照组)血清的BDNF进行检测,应用汉密尔顿抑郁量表(HAMD)对抑郁症患者的抑郁症状进行评定. 结果:抑郁症患者...     

血清总胆固醇及其低、高密度脂蛋白胆固醇的水平下降与抑郁症患者自杀行为的关系

目的 本文对抑郁症患者的血清胆固醇(TC)及高密度脂蛋白胆固醇(HDI)及低密度脂蛋白胆固醇(LDL)的水平与自杀行为的关系进行了探讨。方法 对107例样本进行了上述测定，其中病例组67例，抑郁症伴自杀行为者33例，无自杀行为者34例，正常对照组40例。结果 抑郁症伴有自杀行为者TC及LDL明显低于无自杀行为者和正常对照组，而HDI与无自杀行为者和正常对照组无明显差异。TC及LDL水平与自杀的严重程度呈明显相关。结论 我们认为TC和LDL水平的降低可增加抑郁症患者自杀的风险。     

情感性精神障碍感觉性诱发电位变异与自杀行为史的关联性研究

目的　探讨情感性精神障碍患者感觉性诱发电位 (SEP)变异与自杀行为史的关系及其临床意义。方法　应用美国尼高力公司Spirit脑诱发电位仪 ,检测 39例抑郁症 (抑郁症组 )患者、2 2例躁狂症 (躁狂症组 )患者和 33名正常对照者 (对照组 )的视觉诱发电位 (VEP)、听觉诱发电位 (AEP)和体感诱发电位 (SSEP) ,并对两患者组中有无自杀史者的测定结果进行比较。结果　 (1 )抑郁症组在VEP中的P2 潜伏期 [有自杀史者为 (2 1 1± 2 1 )ms,无自杀史者为 (2 0 9± 1 7)ms]长于正常对照组 [(1 94±1 9)ms;P <0 0 1和P <0 0 5]。 (2 )抑郁症组和躁狂症组SEP主成分的波幅均低于对照组。 (3)在VEP中 ,抑郁症组中有自杀史者的P3波幅 [(2 7± 1 8) μV]低于无自杀史者 [(5 5± 2 3) μV] ;躁狂症组中有自杀史者的P2 波幅 [(2 9± 1 8) μV]低于无自杀史者 [(5 5± 2 3) μV] ;在AEP中 ,躁狂症组中有自杀史者的P2 波幅 [(3 7± 1 9) μV]低于无自杀史者 [(5 1± 2 3) μV] ,差异有显著性和非常显著性 (P <0 0 5和P <0 0 1 )。结论　感觉性诱发电位是辅助评价自杀倾向的客观方法之一     

低血清胆固醇与女性抑郁症的自杀行为

目的　本文对女性抑郁症患者的血清胆固醇水平与自杀行为的关系进行了探讨。方法　对 116例样本进行血清胆固醇水平测定 ,其中抑郁症伴自杀行为的 40例 ,抑郁症不伴自杀行为的 3 6例 ,正常人 40例。结果　抑郁症伴有自杀行为组血清胆固醇水平明显低于无自杀行为组和正常对照组。血清胆固醇水平与自杀的严重程度呈明显相关。结论　我们认为低血清胆固醇水平可增加女性抑郁症自杀的风险。推测低血清胆固醇导致的自杀行为可能与中枢 5 羟色胺 ( 5 HT)功能降低有关。     

抑郁症自杀未遂患者血清脑源性神经营养因子水平的变化

目的探讨血清脑源性神经营养因子（BDNF）水平与抑郁症患者自杀行为的关系。方法采用酶联免疫分析实验测定抑郁症自杀未遂患者（36例）、无自杀行为患者（55例）及36名正常对照血清BDNF水平,对抑郁症患者以汉密尔顿抑郁量表（HAMD）评定抑郁症状,以自杀意念自评量表（SIOSS）评定自杀意念的强烈程度。结果抑郁症患者组血清BDNF水平低于正常对照组（P〈0．01）。自杀未遂组血清BDNF水平低于无自杀组及正常对照组（P〈0．01）。自杀未遂组HAMD总分和SIOSS总分高于无自杀组。抑郁症患者血清BDNF水平与SIOSS总分呈负相关。结论抑郁症患者存在血清BDNF降低,BDNF水平可能是自杀倾向行为的生物学标志。     

抑郁症自杀未遂患者血清总胆固醇水平研究

目的:对抑郁症自杀未遂患者的血清胆固醇水平与自杀行为的关系进行研究。方法:对抑郁症患者进行血清胆固醇水平测定,其中伴自杀未遂行为者26例,不伴自杀行为者32例,以正常健康者30名为对照。结果:抑郁症伴自杀未遂行为组血清胆固醇水平明显低于无自杀行为组和正常对照组。血清胆固醇水平与自杀的严重程度呈明显负相关。结论:低血清胆固醇水平可增加抑郁症自杀的风险。推测低血清胆固醇导致的自杀行为可能与中枢5-羟色胺(5-HT)功能降低有关。     

小组工作模式在抑郁症患者自杀预警管理中的临床应用

目的探讨小组工作模式在抑郁症患者自杀预警管理中的临床应用。方法选取2013年4月-2014年3月苏州广济医院开放病房有自杀意念的住院抑郁症患者350例,按随机数字表法分为干预组和对照组各175例。对照组按抑郁症护理常规进行护理,干预组采用小组工作模式实施自杀预警管理6周。采用汉密顿抑郁量表(HAMD)、自杀意念自评量表(SIOSS)和简明健康测量量表(SF-36)分别在入院时和干预6周末进行评定,并比较两组患者自杀行为的发生情况。结果两组患者6周末HAMD、SIOSS、SF-36评分较干预前差异均有统计学意义(P0.01);6周末干预组HAMD[(8.20±1.71)分]、SIOSS[(9.18±1.61)分]、SF-36[(613.02±90.07)分]评分较对照组差异均有统计学意义(P0.01),干预组的自杀行为发生率低于对照组(P0.01)。结论开放病房采用小组工作模式对抑郁症患者实施自杀预警管理,能有效降低抑郁症患者住院期间自杀行为的发生,改善患者抑郁症状,提高生活质量。     

Serotonergic Dysfunction in Patients with Bipolar Disorder Assessed by the Loudness Dependence of the Auditory Evoked Potential

Objective

The loudness dependence of the auditory evoked potential (LDAEP) is suggested to be a marker of serotonin system function. This study explored the LDAEP of multiple mood statuses (depression, mania, and euthymia) and its clinical implication in bipolar disorder patients.

Methods

A total of 89 subjects, comprising 35 patients with bipolar disorder, 32 patients with schizophrenia, and 22 healthy controls were evaluated. The bipolar disorder cases comprised 10 depressed patients, 15 patients with mania, and 10 euthymic patients. The N1/P2 peak-to-peak amplitudes were measured at 5 stimulus intensities, and the LDAEP was calculated as the slope of the linear regression. Both cortical and source LDAEP values were calculated.

Results

LDAEP varied according to mood statuses, and was significantly stronger in cases of euthymia, depression, and mania. Cortical LDAEP was significantly stronger in patients with bipolar euthymia compared with schizophrenia, stronger in bipolar depression than in schizophrenia, stronger in healthy controls than in schizophrenia patients, and stronger in healthy controls than in patients with bipolar mania. Source LDAEP was significantly stronger in patients with bipolar euthymia, bipolar depression, and bipolar mania compared with schizophrenia, stronger in bipolar euthymia than in bipolar mania. Psychotic features weakened the source LDAEP relative to nonpsychotic features. The severity of the depressive symptom was negatively correlated with source LDAEP.

Conclusion

These findings suggest that the serotonin activity of patients with bipolar disorder may vary according to mood status. A longitudinal follow-up study should be pursued using drug-naive subjects.     

Clinical Usefulness of Loudness Dependence of Auditory Evoked Potentials (LDAEP) in Patients with Bipolar Disorder

While it has been reported previously that the loudness dependence of auditory evoked potentials (LDAEP) is a putative biological marker or a predictor of treatment response, there have been few studies of LDAEP in bipolar disorder. However, a recent study by Park and colleagues raised the possibility that the LDAEP could be useful as a biological marker of bipolar disorder. They found that the LDAEP was significantly higher in normal controls than in patients with either bipolar disorder or schizophrenia. Lee and colleagues also examined the LDAEP in bipolar disorder and normal controls, and found that it differed according to the bipolar phase, being significantly higher in cases of euthymic bipolar disorder, bipolar depression, and bipolar mania. With regard to treatment response, early clinical findings were that a higher LDAEP and a stronger intensity dependence of visual evoked potentials were related to a favorable response to lithium treatment. Juckel and colleagues recently demonstrated that the pretreatment LDAEP could be a predictor of successful prophylactic lithium treatment. The present article reviews the literature in order to determine whether the LDAEP can be used as a biological marker or a predictor of treatment response in patients with bipolar disorder and of manic switch or treatment resistance in patients with major depressive episode(s).     

Preparatory brain potentials in major depressive disorder.

1. Psychomotor slowing in depression is frequently reflected by delayed reaction times (RT). 2. The role of central arousal mechanisms in response slowing was examined by comparing scalp-recorded slow negative potentials of depressed patients with normal controls in two separate studies. 3. Varying fore-warned RT conditions elicited contingent negative variation (CNV) waveforms and the resultant mid-point amplitudes of these waveforms together with orienting (O-wave), expectancy (E-wave) and post-imperative negative variation (PINV) component amplitudes and sensory evoked responses (N1, P2) were compared between groups. 4. RTs were significantly slowed in depressed patients and the patient group exhibited consistently larger PINV amplitudes. Depending on the RT condition, patients also exhibited larger mid-point CNV amplitudes and smaller N1 and P2 amplitudes.     

心理健康测查表对某些精神疾病的测试分析

目的：研究心理健康测查表（psychological health inventory,PHI)在精神科临床中的适用性。方法：采用宋维真等编制修订的PHI问卷，对325例精神分裂症、躁狂症及抑郁症患者进行测查，并以全国常模作对照分析。结果：各组患者PHI的绝大多数量表原始分均明显高于常模组；精神分裂症、躁狂症及抑郁症各组PHI测图结果与临床诊断基本符合率分别为67．00％、71．74％、93．98％。结论：PHI及其常模对精神正常与否具有较高的鉴别力，对抑郁症的临床辅助诊断更具参考价值，但就精神分裂症与躁狂症两组间的测图结果分辨力欠佳，有待于进一步探讨。     

Motor and occipital cortex excitability in migraine patients

OBJECTIVE: We evaluated motor and occipital cortex excitability in migraine patients using transcranial magnetic stimulation. METHODS: In this study, we included 15 migraine patients with aura (MwA), 15 patients without aura (MwoA) between attacks, and 31 normal healthy controls. Motor thresholds at rest, amplitudes of motor evoked potentials, central motor conduction time and cortical silent period were measured by stimulation of the motor cortex by using 13.5 cm circular coil and recording from abductor digiti minimi muscle. Additionally, phosphene production and the threshold of phosphene production was determined by stimulation of the visual cortex with the same coil. RESULTS: No significant differences were observed between the groups with respect to the motor thresholds, Motor evoked potential max/compound muscle action potential max (MEPmax/Mmax) amplitudes, central motor conduction times and duration of cortical silent period. Although not statistically significant, the proportion of the migraineurs with phosphene generation (90%) was found to be higher than that of normal controls (71%). Phosphene threshold levels in migraine patients, however, were significantly lower than those of the controls with MwA patients having the lowest levels. CONCLUSION: Our findings indicate that the occipital cortex, but not the motor cortex, is hyperexcitable in migraine patients.     

情感性精神障碍患者的睡眠脑电图试验研究

目的 探讨情感性精神障碍患者睡眠脑电图的特点。方法 对１０例躁狂中层得、１０例抑郁症患者的睡眠脑电图进行全夜测试,并与１６名正常受试者进行对照。结果 与对组相比,抑郁症组睡眠脑电图改变主要有快动（ＲＥＭ）睡眠潜伏期缩短等;躁狂症组实际睡眠时间秒,睡眠效率下降。两组比较,抑郁症组比躁狂症组ＲＥＭ潜伏期更短。而躁狂症组比抑郁症组实际睡眠时间更少。结论 睡眠脑电图中的ＲＥＭ指标有可能是情感性精神障碍患者     

抑郁症、焦虑症患者事件相关电位对照研究

目的:探讨抑郁症、焦虑症患者脑诱发电位的变异特点及临床应用价值.方法:共有46例抑郁症患者(抑郁症组)、41例焦虑症患者(焦虑症组)及42名健康志愿者(正常组),使用美国Nicolet Bravo脑电生理仪进行事件相关电位P300(P300)和关联性负变化(CNV)的检测.并于治疗2个月时对两患者组进行相同项目的随访.结果:与治疗前比较,抑郁症组P300靶N2、P3潜伏期缩短(P＜0.05),靶P3波幅升高(P＜0.01),CNV潜伏期M1缩短(P＜0.01),波幅M1、M2升高(P均＜0.05).焦虑症组P300靶P3潜伏期缩短(P＜0.05),CNV波幅M1下降(P＜0.05),指令信号后负变化(PINV)的出现率下降(P＜0.05).治疗后与正常组比较,抑郁症组P300非靶P2波幅偏低(P＜0.01),P300的双峰P2波和CNV的PINV出现率均偏高(P＜0.05～0.01);焦虑症组CNV的潜伏期M2缩短(P＜0.01).抑郁症组与焦虑症组治疗后比较在P300非靶P2波幅、双峰P2波出现率,CNV潜伏期M2和PINV出现率等指标之间差异有显著性(P均＜0.01).结论:抑郁症、焦虑症患者脑诱发电位有自己的变异特点,在诊断和鉴别诊断方面有一定的价值.     

Shame-proneness in attempted suicide patients

ABSTRACT: BACKGROUND: It has been suggested that shame may be an important feature in suicidal behaviors. The disposition to react with shame, "shame-proneness", has previously not been investigated in groups of attempted suicide patients. We examined shame-proneness in two groups of attempted suicide patients, one group of non-suicidal patients and one group of healthy controls. We hypothesized that the attempted suicide patients would be more shame-prone than non-suicidal patients and healthy controls. METHOD: The Test of Self-Conscious Affect (TOSCA), which is the most used measure of shame-proneness, was completed by attempted suicide patients (n = 175: 105 women and 3 men with borderline personality disorder [BPD], 45 women and 22 men without BPD), non-suicidal psychiatric patients (n = 162), and healthy controls (n = 161). The participants were convenience samples, with patients from three clinical research projects and healthy controls from a fourth research project. The relationship between shame-proneness and attempted suicide was studied with group comparisons and multiple regressions. Men and women were analyzed separately. RESULTS: Women were generally more shame-prone than men of the same participant group. Female suicide attempters with BPD were significantly more shame-prone than both female suicide attempters without BPD and female non-suicidal patients and controls. Male suicide attempters without BPD were significantly less shame-prone than non-suicidal male patients. In multiple regressions, shame-proneness was predicted by level of depression and BPD (but not by attempted suicide) in female patients, and level of depression and non-suicidality in male patients. CONCLUSION: Contrary to our hypothesis and related previous research, there was no general relationship between shame-proneness and attempted suicide. Shame-proneness was differentially related to attempted suicide in different groups of suicide attempters, with significantly high shame-proneness among female suicide attempters with BPD and a negative relationship between shame-proneness and attempted suicide among male patients. More research on state and trait shame in different groups of suicidal individuals seems clinically relevant.     

Biological correlates of deliberate self-harm behaviour: a study of electroencephalographic,biochemical and psychological variables in parasuicide

Clinical, electroencephalographic and biochemical variables were measured in 40 patients who attempted suicide and 27 age-matched controls. Patients had significantly higher scores for depression, hopelessness, neuroticism and psychoticism and lower scores for extraversion than controls. They also had significantly lower contingent negative variation (CNV), higher postimperative negative variation and lower whole blood serotonin values than controls. Within the patient group, vulnerability to parasuicide, as determined by previous or repeated acts of deliberate self-harm, was associated with higher scores for hopelessness and suicide intent, lower scores for extraversion and decreased CNV. Factor analysis revealed significant correlations between psychological variables and auditory evoked potential amplitudes for the vulnerable group. A profile of variables associated with increased risk of self-harm in patients presenting with attempted suicide is proposed from our data.