上海市浦东新区精神疾病患者期望寿命回顾性分析

目的了解上海市浦东新区精神疾病患者的期望寿命,以探讨精神疾病对期望寿命的影响。方法将浦东新区1999—2008年精神疾病患者与该区普通人群进行比对,采用标准化死亡率,期望寿命等指标进行分析。结果 1999—2008年浦东新区精神疾病患者累计死亡率为13.26‰,标化死亡率为12.57‰,15岁后的各年龄组的标化死亡率均高于普通人群;性别对精神疾病患者的标化死亡率的无影响;10岁组精神疾病患者期望寿命为63.0岁,低于浦东新区普通人群的期望寿命（72.1岁）。结论人群罹患精神疾病后期望寿命较普通人群低。     

精神疾病患者自杀流行病学调查

目的：了解普通人群和精神疾病患者的自杀死亡率，自杀诱因和方式。方法：采用回顾性研究方法，普查1997-1999年上海宝山区疾病预防控制中心人口总数及死亡报告卡，区公安分局的自杀案例和区精神病防治办公室的精神疾病患者死亡报告卡。结果：普通人群年平均自杀死亡率9.43/10万。精神疾病患者为274.45/10万。结论：精神疾病患者是自杀的高危人群，应予重视。     

开展社区干预对重性精神疾病患者早期治疗的影响

目的分析开展社区干预对重性精神疾病患者早期治疗的影响。方法2008年在新会区多个社区和人群开展社区干预后,比较2008与2007年首次入住我院的新会区重性精神疾病患者的病程、治疗效果、住院日及住院费。结果2008年我院新会区病程为1年内重性精神疾病患者比例（40．56％）高于2007年（20．23％）;2008年我院新会区首次住院重性精神疾病患者临床治愈率（45．99％）高于2007（29．17％）年,住院日及住院费低于2007年。结论新会区社区干预模式值得推广和深入开展。     

河北省承德地区精神疾病流行病学调查

目的：了解河北省承德地区18岁及以上人群各类精神疾病的时点患病率和分布特点。方法：2004年10月至2004年11月采用多阶段分层整群随机抽样方法，抽取≥18岁者为调查对象。用一般健康问卷（CHQ-12）将调查对象分为高、中、低危险组，以美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）轴Ⅰ用定式临床检查患者版进行调查，用DSM-Ⅳ对精神障碍进行诊断。结果：3025人完成调查，精神疾病总时点患病率为177．19‰，终生患病率为216．86‰。除精神发育迟滞和痴呆外，各类精神疾病时点患病率为175．86‰，终生患病率为215．54‰。时点患病率农村为（176．65‰），城市为（180．08‰）；女性（182．05‰）高于男性（171．94‰）。重性抑郁障碍患病率最高（51.57‰）。结论：本调查基本掌握了河北省承德地区18岁及以上人群各类精神障碍的患病水平和分布特点。     

二、关于自杀的研究(三) 精神疾病患者自杀流行病学调查

目的 :了解普通人群和精神疾病患者的自杀死亡率、自杀诱因和方式。　方法 :采用回顾性研究方法 ,普查 1997～ 1999年上海宝山区疾病预防控制中心人口总数及死亡报告卡、区公安分局的自杀案例和区精神病防治办公室的精神疾病患者死亡报告卡。　结果 :普通人群年平均自杀死亡率 9 4 3/10万 ,精神疾病患者为 2 74 4 5 / 10万。　结论 :精神疾病患者是自杀的高危人群 ,应予重视。     

住院精神疾病患者合并糖尿病的调查

目的：调查住院精神疾病患者合并糖尿病的情况，探索相关因素。方法：自制一般情况调查表，回顾性调查住院精神疾病患者的糖尿病患病情况，检测空腹血糖、餐后2小时血糖、血脂，计算体重指数。结果：2647例住院精神疾病患者中，213例合并糖尿病，患病率8．05％，为正常人群的3．22倍。213例中体重超重的占44．13％，肥胖的占40．38％，有28．63％的患者空腹血糖控制不佳，85．92％的患者餐后2小时血糖控制不佳。合并糖尿病与超重、肥胖、高血脂、高血压等因素相关。结论：精神疾病患者中糖尿病的患病率远高于普通人群，临床上应予以关注。     

218例服刑罪犯精神疾病鉴定分析

作者对218例劳改服刑罪犯的精神疾病鉴定资料进行了分析、讨论。感到罪犯中的精神疾病分布不同于一般人群精神疾病的分类比例,认为服刑作为生活事件对精神疾病尤其是精神分裂症的发生、发展及复发均有一定影响。强调早期发现及心理治疗对此类患者的作用尤为重要。     

抽动秽语综合征共患注意缺陷多动障碍的 临床特征分析

目的 调查影响抽动秽语综合征（TS）共患注意缺陷多动障碍（ADHD）患者的临床特征。 方法 本研究包括回顾性研究和横断面调查研究两部分，回顾2005—2007 年在北京安定医院就诊并登 记入库的TS 患者的人口学资料和病例特征，并对TS 患者及家长进行横断面调查研究；由临床医生对患 者进行简明儿童少年神经精神访谈问卷（MINI-Kid）、DSM-5 诊断评估以及斯诺佩评估量表（SNAP- Ⅳ）评 估，由家长完成Conners父母症状问卷评估，由患者本人完成Conners自评量表和儿童自我意识量表评 估，并由临床医生对患者采用耶鲁布朗大体抽动严重程度量表（YGTSS）进行抽动症状严重程度评估并 记录其是否规律治疗TS，以及是否服用治疗ADHD药物。结果 221例患者纳入分析，其中138例（62.4%） 为TS 共患ADHD 患者，TS 共患ADHD组患者在围产期不良事件、发病年龄、首次诊断年龄、首次治疗年 龄、是否规律治疗及精神疾病家族史方面与TS 未共患ADHD 组差异有统计学意义，其症状严重程度与 围产期不良事件、是否规律治疗、是否接受ADHD 药物治疗及精神疾病家族史有关。明显症状组患者 接受ADHD 治疗比例低于轻微症状组。结论 TS 共患ADHD 治疗效果与围产期不良事件、是否规律治 疗、是否接受ADHD治疗以及精神疾病家族史有关。     

1986～2001年某部新兵精神疾病调查

目的；探讨入伍新兵精神疾病的患病率及相关因素。方法：应用新兵精神疾病调查的工具，对1986－2001年某部入伍的所有集训期新兵进行精神疾病的流行病学调查。结果：15年共调查入伍新兵656540名，检查出各类精神疾病共539名，总检出率（时点患病率）为0．82‰。新兵各类精神疾病的时点患病率以精神分裂症（0．29‰）、神经症（0．20‰）和精神发育迟滞（0．10‰）为高。入伍前已患病者占83．1％，入伍后新发病者占16．9％。有明显精神疾病家族史者占28．4％。结论：开展新兵精神疾病调查，在集训期内把患有精神疾病者作退兵处理，对提高兵员质量具有重要意义。     

精神疾病患者弓形虫感染的调查

报道以弓形虫的玻片为抗原，进行免疫酶染色试验（ＩＥＳＴ），检测精神疾病患者７５４例，弓形虫感染率为２４．１４％，明显高于当地一般人群５．８６％（Ｐ＜０．０１）；各种精神疾病的弓形虫感染率以精神分裂症为最高（２６．２１％），其次是脑器质性精神障碍。精神病人家中养描并经常与猫逗玩者感染率为３３．１９％，显著高于不养猫者（２１．３８％），井观察了弓形虫感染与患者性别、年龄、职业、病期及城乡关系。     

The relationship between sleep disturbance and morale in Japanese elderly people

BACKGROUND: Complaints of sleep disturbance are common in elderly individuals. The quality of life (QOL) for people who have insomnia is thought to be worse than for those who do not have insomnia. In this study we investigated the influence of disturbed sleep on morale in elderly people who live independently. METHODS: A survey of the necessity of public nursing care for all those aged over 65 years was performed in Kumamoto city, Japan. Three hundred subjects from the elderly population living at home without special care were sampled at random and they filled out a questionnaire regarding sleep, psychiatric symptoms and attitudes towards their own aging. RESULTS: A logistic regression analysis found psychiatric symptoms and problems keeping awake to be independently related to a negative attitude towards one's own aging. Neither sleep, sex nor age demonstrated any relationship with the negative attitudes of elderly individuals. CONCLUSION: Excessive daytime sleepiness is related to poor morale regardless of both the quality and quantity of sleep and psychiatric symptoms.     

Beliefs about medications: measurement and relationship to adherence in patients with severe mental disorders

Objective: To determine if the Beliefs about Medicines Questionnaire (BMQ) has satisfactory psychometric properties in patients with severe mental disorders and if their scores differ from those of patients with severe medical disorders. To investigate if the scores are related to medication adherence. Method: Two hundred and eighty psychiatric patients completed the BMQ and reported how much of their medication they had taken the past week. Serum concentrations of medications were analyzed. BMQ scores were compared with those of patients with chronic medical disorders. Results: Cronbach’s alpha was satisfactory for all subscales. The psychiatric group scored lower on the necessity of taking medication than the medical group. Non‐adherent patients felt medication to be less necessary and were more concerned about it than adherent patients. The necessity subscale predicted adherence fairly well. Conclusion: The BMQ has satisfactory psychometric properties for use in patients with severe mental disorders. The constructs measured by the BMQ are related to adherence in these patients.     

Using a hybrid model to investigate the comorbidity and symptom overlap between social phobia and the other anxiety disorders and unipolar mood disorders

New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.     

Investigating the relationship between challenging behavior, co-morbid psychopathology and social skills in adults with moderate to severe intellectual disabilities in Ireland

Researchers suggest that social skill deficits and psychiatric issues may be affected by the presence of maladaptive behaviors in people with intellectual disabilities. A sample of 39 participants with intellectual disability was surveyed for the presence of psychiatric symptoms and social skills deficits. Outcomes indicated that individuals with severe challenging behaviors scored significantly higher than those without problem behaviors in terms of presence of psychiatric symptoms in ten of the thirteen subscales of the DASH-II. Results also showed that individuals with severe problem behaviors scored significantly lower on social skills measures, using the MESSIER, than those without. A significant difference was observed between participants presenting with psychiatric symptoms and those who did not in terms of social skills, with the former scoring significantly lower than the latter. Results of the study provide weight to current research supporting the relationships between problem behaviors, co-morbid psychopathology and social skill deficits. This information could be used to further develop positive supports for adults with intellectual disability and challenging behaviors in order to improve their quality of life, community inclusion and social networks.     

Psychosis and pregnancy: five cases of severely ill women

An increasing number of patients with chronic mental disease are now integrated in society. As a consequence, women with severe psychiatric illness may become pregnant and wish to complete the pregnancy and to give birth to a child. The lack of sensation of reality in these patients and their social situation may result in particular problems in their treatment, and it may be necessary to admit them to a psychiatric ward before delivery. In this paper five cases of pregnant women with severe and chronic psychosis are described. These patients had many problems in common. Thus, they were all schizophrenics with very severe psychopathology, had poor understanding of their own situation, and lacked social networks. All the fathers were non-Danish. Coercion was used in all cases. To help women with severe mental illness to go through pregnancy and childbirth requires close collaboration between psychiatric and obstetric staff and social workers, and this should be organized in an institution with experience in the treatment of this type of patient.     

The treatment and security needs of patients in special hospitals

The treatment and security needs of a 20% cross-section of patients in the three maximum-security hospitals of England and Wales are described. Data were collected from case notes and interviews with each patient and with the clinical team. Patients were described in term.s of their diagnosis, source of admission and reasons for admission, past psychiatric treatment, present clinical features and estimated needs for psychiatric treatment and secure containment. The sample consisted of 296 cases. Most patients had been admitted from prison, although only 10% were serving a sentence; 21% were detained under non-criminal treatment orders. The most common diagnosis was schizophrenia (55%) and 14% suffered from other psychoses. Most patients had long histories of psychiatric treatment and 39% were inpatients at the time of the behaviour which lead to their admission. The problem mentioned most often in admission reports was repeated assaults (56%), with the most frequent victims being other patients or hospital staff. Both the research and clinical teams rated over 80% as needing medium or higher security, with the research team identifying a need for maximum security in 37%, whilst the clinical team put this figure at 50%. A similar range of diagnoses and clinical problems was identified in patients rated as needing medium or maximum security, suggesting differences in severity only, with many patients on the borderline between these categories. The most common clinical problems were lack of insight, difficulty relating to other people and failure to respond to medication. Absconding risk was identified as an obstacle to transfer to lesser security in only 9% of patients. Only 2% of patients were expected to show any improvement in their clinical condition over the next year and only 5% were expected to improve in the next 5 years. These predictions are consistent with the long histories of hospitalisation in many patients. Between one- and two-thirds of patients rated as needing medium security would require this level of security for more than 2 years, making them unsuitable for most units. Many special hospital patients’ do not require all aspects of maximum security but most have a high level of chronic psychiatric disability and extensive treatment needs. The success of any attempt to move them out of the special hospitals will depend on providing care elsewhere, particularly long-term medium secure care, which is lacking at present. The quality of life and chances of transfer of many special hospital patients could be improved by a greater emphasis on treatment and rehabilitation within the hospitals. This has important resource implications.     

Psychosis and pregnancy: Five cases of severely ill women

An increasing number of patients with chronic mental disease are now integrated in society. As a consequence, women with severe psychiatric illness may become pregnant and wish to complete the pregnancy and to give birth to a child. The lack of sensation of reality in these patients and their social situation may result in particular problems in their treatment, and it may be necessary to admit them to a psychiatric ward before delivery. In this paper five cases of pregnant women with severe and chronic psychosis are described. These patients had many problems in common. Thus, they were all schizophrenics with very severe psychopathology, had poor understanding of their own situation, and lacked social networks. All the fathers were non-Danish. Coercion was used in all cases. To help women with severe mental illness to go through pregnancy and childbirth requires close collaboration between psychiatric and obstetric staff and social workers, and this should be organized in an institution with experience in the treatment of this type of patient.     

Age-specific characteristics of attempted suicide in adolescence

A total of 422 suicide attempts of adolescents (15 to 19 years of age) were investigated and compared with 327 suicide attempts of young adults. Adolescents had more serious social problems than young adults. Their adaptive problems became worse while growing older until the age of 20. Adolescents made suicide attempts with serious intent more often than young adults, but their suicide attempts were not as often lethal as in young adults. Although repeated suicide attempts were relatively common in both groups, only 10 people were part of both materials. Adolescents were as often psychotic when attempting suicide as young adults were. Twenty-four percent of adolescents and 26% of young adults were admitted to a psychiatric hospital as treatment.     

Perceived stigmatization of mentally ill people and its consequences for the quality of life in a Swiss population

The awareness of social conceptions of mental illness is essential in understanding the social realities of people with mental illness. Labeling due to psychiatric hospitalization can have a powerful influence on people's life chances. Little is known about subjective perceptions of stigmatization and discrimination and the influence of these beliefs on the quality of life of mentally ill people. We used a psychiatric inpatient sample and a community sample to analyze and compare perception of stigmatization and discrimination. Both patients and community members believed that most people rejected former mental patients. Thus, attitudes toward mental illness have their source in the socialization of the individual and his or her cultural context rather than in the currently pathological state of those affected. In a multiple regression analysis, we showed that even if controlled for demographic and clinical factors, perceived devaluation and discrimination had a significant negative effect on the quality of life of the mentally ill people. For planning and implementing psychiatric treatment programs, it is important to be aware of social conceptions of mental disorder.     

Relating Axes IV and V of DSM-III to clinical severity of psychiatric disorders

This study examined DSM-III Axes IV and V scores and their ratio among patients in different psychiatric treatment settings. Inpatients' scores and ratios were worse than those of outpatients; longer-term inpatients' scores and ratios were worse than those of shorter-term ones; and chronically ill state hospital inpatients' were the worst.