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1.
精神分裂症的强迫症状   总被引:4,自引:1,他引:3  
目的:探讨精神分裂症的强迫症状的发生率与特征,方法:对43例伴有强迫症状的精神分裂症患者进行观察分析。结果:强迫症状发生率为5.32%,其中药物所致强迫症状为1.34%。结论:精神分裂症的强迫症状为精神分裂症症状的组成部分。强迫症状繁杂、变化多,有的荒谬怪异,疗效不佳。其发生机制可能与5-羟色胺及多巴胺功能失调有关。  相似文献   

2.
目的比较强迫症、精神分裂症伴有的强迫症状和精神分裂症经氯氮平治疗导致的强迫症状等3组不同患者在症状学和全血5-羟色胺(5-HT)浓度方面的差异,探讨强迫症状与5-HT异常间的关系。方法对强迫症、伴强迫症状的及氯氮平治疗导致强迫症状的精神分裂症各15例,不伴强迫症状的(19例)以及氯氮平治疗未导致强迫症状的精神分裂症组(15例)使用Yale-Brown强迫量表(YBOCS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)及阳性和阴性症状量表(PANSS)进行临床症状评定;采用高效液相色谱法检测上述5组和正常组(15例)的全血5-HT浓度。结果强迫症和精神分裂症伴有的强迫症状中强迫思维和行为均多见,而氯氮平导致的强迫症状则以强迫行为为主。有无强迫症状的精神分裂症组比较,后者的PANSS阳性量表分低,HAMA评分高(P<0.05)。有强迫症状的3组患者的全血5-HT浓度均低于无强迫症状的3组(正常组,精神分裂症不伴强迫症状组和氯氮平治疗未导致强迫症状组)(P<0.05),并且全血5-HT浓度和这3组的YBOCS分,强迫思维评分及强迫行为评分均无显著相关性。结论强迫症状在强迫症和精神分裂症中存在着症状学差异;5-HT功能低下可能是这三种强迫症状产生的共同生化机制之一。  相似文献   

3.
精神分裂症与抑郁症中强迫症状对照研究   总被引:2,自引:0,他引:2  
目的:探讨精神分裂症和抑郁症伴有的强迫症状的临床特征。方法:收集1996年1月~1997年1月住我院的有强迫症状的精神分裂症患者31例有强迫症状的抑郁症患者34例,用强迫症状调查表及Yale-Brown强迫量表进行调查评定。结果:两组在强迫行为的发生率、强迫行为分及强迫症状总分上有显著差异。结论:精神分裂症和抑郁症伴有的强迫症状临床特征上有差异,可能有助于两者的鉴别。  相似文献   

4.
临床工作中发现一些具有强迫症状的精神分裂症患者,对于强迫症状与精神分裂症病程的关系,具有强迫症状的精神分裂症就其治疗和预后问题,精神分裂症的强迫症状与强迫症的区别,文献报道较少。且各学者意见不一。本文就50例诊断为精神分裂症并具有强迫症状患者材料,针对上述问题,进行探讨。  相似文献   

5.
氯硝安定治疗强迫性神经症疗效显著,但对精神分裂症的强迫症状疗效如何,为此,作者进行了氯硝安定合并氯丙嗪,氯丙咪嗪合并氯丙嗪治疗精神分裂症伴发强迫症状的随机对照观察。结果报告如下。1资料和方法11病例选择研究病例均为住院病人。入组条件:(1)符合CC...  相似文献   

6.
具强迫症状的精神分裂症61例对照研究   总被引:2,自引:0,他引:2  
对61例具有强迫症状与70例无强迫症状的精神分裂症患者作治疗及随访的对照研究,发现两者疗效及随访结果均有极显著性差异,进一步证实有强迫症状的精神分裂症预后差。  相似文献   

7.
帕罗西汀合并利培酮治疗强迫症临床观察   总被引:2,自引:0,他引:2  
近年来发现利培酮治疗精神分裂症伴发强迫症状有效。我们现对单用帕罗西汀效果差的强迫症患者合并利培酮治疗,取得很好效果,报告如下。  相似文献   

8.
精神分裂症伴强迫症状的临床研究   总被引:1,自引:0,他引:1  
目的 分析伴强迫症状的精神分裂症临床特点及治疗效果,为临床诊断及治疗提供参考。方法 对伴强迫症状的精神分裂症与不伴强迫症状的精神分裂症各38例进行对照分析,使用维思通抗精神病药物治疗,采用阳性及阴性症状量表(PANSS)、强迫症状量表(Y—BOCS)、Hamilton抑郁量表(HAMD)、Hamilton焦虑量表(HAMA)评定疗效。结果 伴强迫症状的精神分裂症起痛年龄早,起病隐袭,病程迁延,以阴性症状为主,住院时间长,治疗效果差,Y—BOCS、HAMD、HAMA等量表评分明显高于不伴强迫症状的精神分裂症,有显著性差异。结论 伴强迫症状的精神分裂症,具有一定的异质性,单一使用抗精神病药物疗效差。  相似文献   

9.
抗精神病药物与强迫症状   总被引:2,自引:0,他引:2  
目的探讨抗精神病药与强迫症状的关系。方法采用自编调查表对659例门诊精神分裂症病人做问卷调查并对病史资料进行统计分析。结果(1)精神分裂症伴强迫症状者122例,占18.5%(122/659),其中63例强迫症状在服用抗精神病药后出现,占9.6%(63/659);(2)非典型抗精神病药诱发强迫症状的比率依次为氯氮平14.2%,利培酮5.1%,奥氮平1.9%,经典抗精神病药诱发强迫症状的比率共计2.8%;(3)氯氮平高剂量者强迫症状的发生率高于低剂量者,约1/3的病人强迫症状出现在服用氯氮平1年以内,半数以上出现在服氯氮平3年以内。结论抗精神病药诱发的强迫症状并不少见,氯氮平是其中的常见药物,强迫症状的发生与用药剂量和时间有关。  相似文献   

10.
伴强迫症状的精神分裂症75例临床分析   总被引:1,自引:0,他引:1  
目的:探讨伴强迫症状的精神分裂症的特点。方法:对75例伴强迫症状的精神分裂症与不伴强迫症状的精神分裂症75例进行对照,采用阳性与阴性症状量表(PANSS)评定疗效。结果:伴强迫症状的精神分裂症患者有以下情况者较多:男性,起病年龄早,病前性格内向,起病隐袭,病程迁延,情感不协调,紧张焦虑,意志减退及残留有阴性症状等较多;而幻听,被害妄想较少,疗效较差。联用氟西汀可明显提高疗效。结论:伴与不伴强迫症状的精神分裂症具有一定异质性。  相似文献   

11.
1980年12月至1993年12月,我科经前方入路治疗颈椎病并获随访183例,其中37例(20.2%)术后恢复不满意,JOA恢复率小于60%。根据主诉与症状,我们把这些病人分成4组。(1)术后症状立即加重,1年内仍无改善者4例。(2)术后症状无明显改善,1年后仍无进步者11例。(3)术后症状减轻,但经过一段时间后,原症状又复出现者8例。(4)双下肢症状好转,但又出现新的上肢症状或上肢原症状加重者14例。结合术后X线、CT、MRI和椎管造影等检查所见,我们将发现的主要问题归纳为手术操作、病情发展演变、原有胸腰椎病和脊髓受压变性等情况。本文对以上发生的问题进行了分析,提出在以后的手术中应特别注意的事项。  相似文献   

12.
Few studies have investigated the long-term course of patients with acute polymorphic psychotic disorder, despite the clinical relevance. The present study focused on the frequency of acute polymorphic psychotic disorder without symptoms of schizophrenia (F23.0) and the prognosis of patients with the disorder over a long period. A total of 388 inpatients with nonaffective psychosis were examined and cases with F23.0 were retrospectively investigated regarding clinical course over 12 years with reference to clinical charts. A total of 16 cases were diagnosed with F23.0 according to first episode. After 12 years, five cases were rediagnosed with schizophrenia, and one case with borderline-type emotionally unstable personality disorder, although the diagnosis of F23.0 was not changed in 10 older patients. Of the four cases with >2 repeated episodes of F23.0, the same clinical picture as in the first episode was observed in three, while one case showed continuous residual symptoms. F23.0 does not represent a homogeneous clinical entity. In some cases, diagnosis changes to schizophrenia, but others display repeated episodes of F23.0.  相似文献   

13.
We recognized that several traumatized individuals re-lived the danger associated with trauma on recollecting the original traumatic event; moreover, some of them experienced a similar traumatic event. In this article, we report these cases and show that this tendency is exhibited more frequently in victims of sexual abuse. Van der Kolk, who treated veteran soldiers who served in Vietnam, became aware of the compulsion of patients to repeat their trauma through treatment. He expressed this repetition compulsion as re-enactment or re-victimization of past traumatic experiences, showing how the trauma was repeated at a behavioral level in his article. After their treatment, he published his research on traumatized people as Post-Traumatic Stress Disorder in the 1980's. Nowadays, generally, this repetition compulsion behavior is not included as a symptom of PTSD in Japan. Van der Kolk insisted that these repetition compulsions caused further suffering for victims and their relations. We also thought that these repetition compulsions can disturb rehabilitation. In our article, we expressed the condition as active compulsion repetition. We considered that it should be distinguished from passive conditions including instructive symptoms such as repetitive nightmare and flashback. We also represented how active compulsion was repeated in our cases, which was not consistent with the concept of PTSD on DSM-IV. When the active repetition compulsion was acted, we noticed that patients showed depersonalization. We thought that an understanding of the depersonalization following reenactment and re-vicitimization was important in order to comprehend the mechanism of PTSD.  相似文献   

14.
Although ToM deficit in schizophrenia is widely accepted, findings regarding remitted schizophrenia patients are contradictory. Because residual symptoms are present out of psychotic exacerbation periods, the differences between definition of remission may be important to interpret these findings. The purpose of this study was to investigate the relationship between performance of 2 different aspects of theory of mind (ToM) and residual clinical symptoms and other cognitive deficits in schizophrenia. Ninety-one stable outpatients with schizophrenia and 55 healthy controls were assessed with a neuropsychological battery. Both social-cognitive and social-perceptual aspects of ToM were impaired in schizophrenia, even in patients who were totally free of residual symptoms. Still, the results showed that ToM deficit is related to residual symptoms of schizophrenia. Social-cognitive ToM abilities seem to be related to both positive and negative symptoms. The ToM deficits of fully remitted patients without persistent negative symptoms may be secondary to a more general cognitive dysfunction in schizophrenia.  相似文献   

15.
16.
Eating Disorder and Schizophrenia   总被引:1,自引:1,他引:0  
Abstract: Five cases with eating disorders (one case with anorexia nervosa alone, 4 cases with anorexia nervosa and bulimia nervosa) complicated with schizophrenia and 3 cases of bulimia nervosa complicated with schizophrenia were reported. The eating disorders and schizophrenia were diagnosed according to the diagnostic criteria of DSM-III-R. As to the type of schizophrenia, 4 patients were of an undifferentiated type and 4 cases were of a disorganized type. Regarding the prepsychotic personality, 6 of the 8 cases showed schizothyme personality traits. All the patients showed depressive symptoms which are relatively common in eating disorders. In all the patients, significant social or school life difflculties persisted and a resumption of premorbid functioning was not seen. The possibility of an afflnity between anorexia nervosa and schizophrenia was discussed.  相似文献   

17.
OBJECTIVE: Clinical scales have become established as tools to quantify phenomenological features of schizophrenia. The goal of this study was to examine relations among the following: the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the deficit-nondeficit classification. METHOD: Forty-seven patients with schizophrenia were recruited according to specific inclusion and exclusion criteria. The standardized assessment procedures were administered by a trained psychiatric research team. RESULTS: Examination of the BPRS showed that the patients had highest scores on the thought disorder factor and the symptoms specific to schizophrenia. Classification of patients as having the positive, negative, or mixed type of schizophrenia resulted in a finding of seven with the positive, seven with the negative, and 33 with the mixed type. The division of patients into those with the deficit syndrome (N = 29) and those without (N = 18) was related to symptom specificity and to positive and negative symptoms. Deficit syndrome patients had more symptoms specific to schizophrenia, fewer nonspecific symptoms, and, as expected, greater severity of negative symptoms. Cluster analysis revealed three clusters of patients: those with low negative symptom scores and high scores on specific symptoms (the majority were without the deficit syndrome); those with high scores on negative, positive, and specific symptoms (the majority had the deficit syndrome); and those with lower scores on specific symptoms and high scores on negative and positive symptoms (the majority had the deficit syndrome). CONCLUSIONS: The scales showed some overlap but also seemed to measure complementary aspects of the phenomenology of schizophrenia. Subtypes of patients identified by the combined use of these scales may differ in underlying pathology.  相似文献   

18.

Objective

We investigated the neurocognitive deficits in schizophrenic patients with and without obsessive-compulsive disorder (OCD).

Methods

We grouped 27 patients as either obsessive-compulsive or non-obsessive-compulsive based on the presence of OCD. The two groups completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Positive and Negative Symptom Scale (PANSS), and Hamilton Depression Scale. The intelligence quotient (IQ) was tested using the Korean Wechsler Adult Intelligence Scale. The memory quotient (MQ) was tested using the Korean-Auditory Verbal Learning and Korean-Complex Figure Test. The executive intelligence quotient (EIQ) was determined using the Kims executive intelligence test (EXIT).

Results

Ten of the 27 patients had OCD. The compulsion score of Y-BOCS was positively correlated with positive symptoms, negative symptoms, and the total scores of PANSS. The OCD-schizophrenia patients had higher IQs. No difference was found in MQ. Although the EIQ did not differ between the two groups, the OCD-schizophrenia patients performed better at the Stroop-interference and verbal fluency tests, which was highly dependent on executive function.

Conclusion

Our findings suggest that OCD may have a protective effect on some cognitive function, at least in relatively early stage of illness. Moreover, based on clinical, neurocognitive features, schizophrenia with OCD could be considered as a distinct subtype of schizophrenia.  相似文献   

19.
目的比较利培酮与氯氮平对精神分裂症阴性症状的疗效和不良反应。方法应用利培酮和氯氮平治疗精神分裂症各20例,其阴性症状评定量表评分≥65分者入组。用阴性症状评定量表(SANS)评定疗效,用副反应量表(TESS)评定药物不良反应。结果利培酮和氯氮平对精神分裂症阴性症状的疗效相当,起效时间为2周。两药的副反应不同,利培酮多见锥体外系反应,而氯氮平多见心动过速、嗜睡、流涎、便秘等。结论利培酮对精神分裂症阴性症状有效、疗效与氯氮平相当。  相似文献   

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