首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 62 毫秒
1.
综合性心理行为干预对慢性精神分裂症的康复效果   总被引:5,自引:0,他引:5  
目的 探讨综合性心理行为干预对慢性精神分裂症的康复效果。方法  6 4例慢性精神分裂症患者根据其意愿被分为对照组和研究组。在精神药物剂量不变的情况下 ,对照组结合简单娱乐活动及支持性心理治疗 ,研究组结合综合性心理行为干预 ,疗程 12周。结果 疗程结束后 ,研究组有效率 6 4.5 % ,而对照组 2 1.2 % ;研究组简明精神病评定量表 (BPRS)、阴性症状量表 (SANS)、社会功能评定量表 (DAS)和生活质量量表 (QOL)评分优于对照组 (P <0 .0 5或 0 .0 1)。结论 综合性心理行为干预能提高临床疗效 ,改善慢性精神分裂症的阴性症状、社会功能及生活质量。  相似文献   

2.
目的观察家庭干预在首发精神分裂症患者康复中的效果。方法选取2017年7月~2019年6月在我院住院治疗后病情稳定且正在服用药物的72例首发精神分裂症患者用随机数字表法将他们分为两组。其中对照组36名患者不采用家庭干预,研究组36例患者采取家庭干预。采用阴性和阳性量表(PANSS)、世界卫生组织生存质量测定量表(WHOQOL-BREF)、个体和社会功能量表(PSP)对两组患者治疗效果以及治疗前后社会功能、生活质量进行比较,并统计两组的复发率。结果家庭干预6月后,研究组36例患者PANSS减分较明显,疗效优于对照组,对比差异有统计学意义(P0.05);研究组患者WHOQOL-BREF评分、PSP评分明显优于对照组,差异有统计学意义(P0.05);研究组复发率明显低于对照组,差异有统计学意义(P0.05)。结论家庭干预能提高首发精神分裂症患者的疗效,可进一步改善患者生活质量及社会功能,降低复发率。  相似文献   

3.
精神分裂症院内康复措施及其疗效的一年随访   总被引:95,自引:1,他引:94  
目的 探讨院内康复措施对精神分裂症患者的作用。方法 将 12 4例精神分裂症住院患者随机分为措施干预组和对照组 ,每组各 6 2例。在抗精神病药治疗的同时 ,对干预组施以小组工作制、院内职业康复的两种技能训练 ,共 10周。出院后随访 1年。用简明精神病评定量表 (BPRS)、住院病人护士观察量表 (NOSIE 30 )、社会功能缺陷筛选量表 (SDSS)和就业率等进行评估。结果  (1)与入组时比较 ,住院期间干预组NOSIE 30各因素的变化值从住院的第 2周开始至第 10周均优于对照组(均P <0 0 1) ,且增分和减分的幅度逐渐增大。 (2 )出院时点与随访最后时点评分差值的比较 ,干预组的SDSS分 [(4 0± 2 7)分 ]、NOSIE 30积极因素分 [(- 2 4 8± 4 9)分 ]和消极因素分 [(8 9± 3 6 )分 ]均显著优于对照组 [分别为 (- 3 9± 1 9)分、(5 2± 5 0 )分和 (- 19 5± 5 9)分 ;均P <0 0 1~P <0 0 0 1];(3)干预组的复发率 (10 %)、再住院率 (3%)和再就业率 (4 1%)皆优于对照组 (分别为 6 9%、5 6 %和 13%,P =0 0 0 0 )。结论 院内康复措施对控制精神分裂症患者的病情、提高社会功能和再就业率 ,以及降低复发率和再住院率具有重要的作用。  相似文献   

4.
目的:探讨个体服务计划(ISP)社区康复管理模式对农村精神分裂症患者康复的影响。方法:按随机数字表法将2个乡镇110例精神分裂症患者分为研究组和对照组各55例,并分别实施ISP社区康复管理模式或现行的社区管理模式6个月。患者入组时、入组后3及6个月给予自知力与治疗态度问卷(ITAQ)、服药依从性量表评定;比较1年后两组的复发率。结果:干预前两组患者ITAQ总分、治疗依从性比较差异均无统计学意义;干预后3及6个月时两组ITAQ总分较基线显著提高(P均0.01);且研究组ITAQ评分及服药依从性明显高于对照组(P均0.01);随访1年研究组复发率(24.53%)显著低于对照组(43.14%)(P0.05)。结论:ISP社区康复管理模式对改善农村精神分裂症患者的自知力、提高治疗依从性、降低复发率有一定的作用。  相似文献   

5.
目的:探讨电子社区管理对出院后恢复期精神分裂症患者康复的影响。方法:将临床"痊愈"出院的精神分裂症患者206例按出院顺序交替分为研究组102例和对照组104例;两组患者均给予抗精神病药维持治疗及常规出院指导,研究组在此基础上实施电子社区管理,观察1年。采用症状自评量表(SCL-90)、Momingside康复状态量表(MRSS)、服药依从性量表在入组时和1年后分别进行测评,评价患者的心理健康、服药依从性及复发率。结果:经电子社区管理1年后,研究组SCL-90各项评分(t=2.31~5.72)、MRSS各项评分(t=2.19~5.15)均明显低于对照组(P0.05或P0.01);服药依从性高于对照组(χ2=12.67,P0.01),复发率(28.43%)低于对照组(42.30%)(χ2=4.33,P0.05)。结论:电子社区管理能显著提高出院后精神分裂症患者的服药依从性、改善社会功能及降低疾病的复发率。  相似文献   

6.
药物自我治疗技能训练对慢性精神分裂症的效果   总被引:3,自引:0,他引:3  
目的 探讨药物自我治疗技能训练 (SelfMedicationManagementSkillTraining)对慢性精神分裂症的效果。方法 将 6 8例服用氯氮平治疗的慢性精神分裂症患者随机分为药物自我治疗技能训练组 (简称训练组 )和对照组。训练组患者进行技能训练 ,共 12周。采用临床大体印象量表 (CGI)、简明精神病评定量表 (BPRS)和阴性症状评定量表 (SANS)进行效果评定 ,同时检测氯氮平和去甲氯氮平血浓度、外周血T细胞亚群与白介素Ⅱ受体 (SIL 2R)。结果 训练组患者阴性症状的改善以及免疫因子CD3 + 、CD4+ 和CD4+ /CD8+ 的增高均优于对照组 (P <0 0 5 ) ,且药物自我治疗技能显著提高 (P <0 0 1)。结论 药物自我治疗技能训练有助于慢性精神分裂症的治疗和康复  相似文献   

7.
阳性强化行为疗法对精神分裂症远期疗效的随访观察   总被引:1,自引:0,他引:1  
目的 探讨阳性强化疗法对精神分裂症远期疗效的影响。方法 对 1996年《阳性强化行为疗法对精神分裂症疗效观察》的研究组和对照组的各 4 5例患者进行追踪观察 ,研究组在药物治疗的同时并实施行为阳性强化训练 ,对照组只用药物治疗 ,采用BPRS、NOSIE等评定疗效。结果 研究组病人BPRS评分较对照组明显低 (P <0 .0 1) ,NOSIE评分较对照组明显高 (P <0 .0 1) ,复发率明显低于对照组 (χ2 =5 .6 1;P <0 .0 1) ,服药依从性明显高于对照组 (χ2 =12 .5 0 ;P <0 .0 0 1) ,劳动能力明显好于对照组 (χ2 =13.5 0 ;P <0 .0 0 1) ,首次复发距出院时间较长、复发次数减少、就诊次数增多。结论 行为阳性强化训练对精神分裂症患者的远期疗效有明显的作用  相似文献   

8.
目的 探讨认知行为干预首发精神分裂症患者的康复作用.方法 将我院精神科首发精神分裂症住院患者80例随机分为两组(研究组与对照组各40例),两组患者均采用常规药物治疗和精神科护理,研究组患者住院两周后增加认知行为干预,康复出院回归社区后每月组织患者集中授课、放松1次,持续2年.采用生活质量综合评定问卷-74(GQOLI-74)、自知力及治疗态度问卷(ITAQ)、治疗依从性及复发率进行评价.结果 回归社区2年后,研究组GQOLI-74量表躯体功能、心理功能、社会功能及总体生活质量评分均显著高于对照组(P<0.01).回归社区2年后,研究组患者自知力明显优于对照组(P<0.05);回归社区1、2年后,研究组患者治疗依从性明显优于对照组(P<0.05,P<0.01);回归社区2年后,研究组患者复发率显著低于对照组(P<0.01).结论 认知行为干预可提高精神分裂症患者的自知力、服药依从性和生活质量,降低复发率.  相似文献   

9.
首发精神分裂症早期干预的康复效果   总被引:4,自引:1,他引:3  
目的 探讨早期干预措施对首发精神分裂症患者的康复效果。方法 将 6 2例首发男性精神分裂症住院患者随机分为干预组 (30例 )和对照组 (32例 ) ,在利培酮治疗的同时 ,对干预组予以心理社会干预措施 ,观察时间为 8周 ,出院后随访 6个月。用阴性、阳性症状评定量表 (PANSS)、住院病人护士观察量表 (NOSIE 30 )和复发率进行评估。结果 入组时与随访最后时点评分差值的比较 ,干预组患者的PANSS总分 (4 6 37± 13 6 5 )、阳性症状分 (18 2 4± 5 83)、阴性症状分 (14 5 5± 5 4 0 )均优于对照组 (分别为 4 1 5 9± 14 6 3、15 30± 6 2 2、19 84± 7 36 ,P <0 0 5~P <0 0 1) ;干预组患者的积极因素分 (- 38 6 5± 9 79)、消极因素分 (31 0 2± 12 5 3)、总评估分 (- 6 6 30± 14 4 5 )皆显著优于对照组 (分别为 - 9 6 7± 11 2 3、3 18± 14 4 7、- 11 6 2± 2 3 75 ,P均 =0 0 0 0 ) ;干预组的复发率 (6 6 7% )低于对照组 (18 75 % ) ,但差异无显著性。结论 对首发精神分裂症患者早期干预措施 ,能较好改善患者的精神症状、提高社会功能、降低复发率 ,故有利于患者重返社会  相似文献   

10.
目的:评价元认知训练(MCT)对慢性精神分裂症的疗效。方法:将80例慢性精神分裂症患者采用随机数字表法分为研究组(n=40)和对照组(n=40),研究组进行MCT、对照组进行文摘讨论,治疗4周。采用阳性与阴性症状量表(PANSS)和精神分裂症认知功能评定量表(SCoRS)分别于治疗前后对入组者进行评定。结果:治疗4周后,两组间PANSS总分及阳性症状比较有显著性差异(P 0. 05);两组间SCoRS各项评分比较差异有统计学意义(P 0. 05)。结论:MCT对慢性精神分裂症患者的阳性症状及认知功能有明显改善作用。  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
Diagnostic Difficulties and Treatment Implications   总被引:1,自引:0,他引:1  
Robert J. Gumnit 《Epilepsia》1987,28(S3):S9-S13
Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.  相似文献   

13.
Cognitive Dysfunction Associated with Antiepileptic Drug Therapy   总被引:7,自引:5,他引:2  
Eileen P.G. Vining 《Epilepsia》1987,28(S2):S18-S22
Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.  相似文献   

14.
B. J. Wilder 《Epilepsia》1987,28(S2):S1-S7
Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.  相似文献   

15.
Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.  相似文献   

16.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

17.
Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.  相似文献   

18.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

19.
Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity   总被引:5,自引:1,他引:4  
G. Trube  R. Netzer 《Epilepsia》1994,35(S5):S62-S67
Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.  相似文献   

20.
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号