121例女性精神分裂症患者生活事件调查分析

１２１例女性精神分裂症患者生活事件调查分析绵阳市精神卫生中心任明权，蒲碧清作者对１９９３．１．１─１９９３．９．２５住院诊断为精神分裂症（ＣＣＭＤ─２标准）的１２１例女患者进行生活事件与发病、家族史、治疗等调查。结果发现以生活事件起病者占４７．９％，...     

利培酮与氯氮平治疗精神分裂症比较

探讨利培酮治疗精神分裂症患者的长期疗效、安全性及依从性,以氯氮平为对照,报告如下。１对象与方法１．１研究对象：共１２０例,系１９９７年２～１０月在我院住院的病人,均符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准。年龄１８～７３岁,其中男性７６例,女性４４例;...     

精神分裂症住院患者的苯二氮类药物使用情况调查

近年来,苯二氮艹卓类（ＢＺＤ）的滥用问题越来越引起了人们的重视。我们调查了本院住院精神分裂症病人中ＢＺＤ的应用情况,现报道如下：１对象与方法查阅我院１９９６年６月～１９９７年５月住院的精神分裂症患者９２３例,诊断皆符合ＣＣＭＤ－２标准。年龄１６～６１...     

社区慢性精神分裂症患者的需求调查

目的：了解社区慢性精神分裂症患者的需求情况。方法：对１２０例符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准的患者完成调查。依据社会功能缺陷量表（ＳＤＳＳ）总分划分轻残组，中残组，重残组。以Ｃａｍｂｅｒｗｅｌｌ需求评定量表（ＣＡＮ），生活质量评定量表（ＱＯＬＳ），以及阳性阴性症状评定量表（ＰＡＮＳＳ）作为评定工具。结果：ＣＡＮ需求项目评定结果：３组间家庭照料，日常生活，解决精神症状，了解疾病和治疗信息，社会     

电抽搐治疗不同电极位置的比较

电抽搐治疗迄今为止仍然是快速有效地治疗某些精神疾病的方法。我们采用不同电极部位施行电抽搐治疗，观察其发作情况及治疗效果，现报道如下。１资料与方法１．１病例选择：系１９９６年８月～１９９７年５月住院患者，符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准，ＢＰＲＳ...     

利培酮替换氟哌啶醇癸酸酯治疗精神分裂症的观察

部分精神分裂症病人因各种原因需要在治疗过程中将氟哌啶醇癸酸酯（ＨＤ）转换为利培酮,现将１７例精神分裂症病人两药转换的有关资料报道如下。１　资料１－１　病例选择：入组条件：①符合ＣＣＭＤⅡＲ精神分裂症各型诊断;②正在使用ＨＤ治疗者;③家属及病人同意换用利培酮;④利培酮治疗持续９０天以上。１－２　一般资料：符合入组条件者１７例,男１０例,女７例。年龄２１～４１岁,平均（２９±５－７）岁。病程３～２２年,平均（７－４±４－６）年。７例门诊治疗,１０例住院１～４次,平均（２－１±１－１）次。１４例精…     

利培酮与氯丙嗪治疗精神分裂症对照研究

以利培酮和氯丙嗪治疗精神分裂症进行双盲对照研究,现将结果报告如下。１对象与方法作者单位：３６１０１２厦门市仙岳医院１．１对象系本院１９９８年１～４月新入院患者,符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准,简明精神症状量表（ＢＰＲＳ）总分（不含附加项目）在...     

未婚精神分裂症女性患者对婚姻的心态

对１９９０年３月～１９９６年６月期间的未婚精神分裂症住院女性患者进行调查，均符合ＣＣＭＤ－２－Ｒ诊断标准。年龄１８～２９岁，平均２２．１±３．８岁；病期４月～６年，平均２１．６±１８．４月；住院１～４次，平均１．３±０．７次。病情均已缓解，共１００例...     

慢性精神分裂症出院患者社区康复情况调查

慢性精神分裂症出院患者社区康复情况调查上海市杨浦安定医院（２０００８２）顾闻本文对我院出院后进行社区康复的慢性精神分裂症４６例作一随访调查，现将结果报道如下。１病例选择与方法本组４６例，均符合ＣＣＭＤ－２中的精神分裂症诊断标准。都曾因精神症状加重，精...     

对社区慢性精神分裂症患者的需求调查

近年来慢性精神分裂症患者的需求日益得到人们的关注，主要涉及通过评价患者对家庭和社区服务机构在需求上能否及时、有效和连续的得到心理与物质上的实际帮助，这对如何合理分配社区服务资源，恰当调整对精神病患者的康复措施以及提高患者的生活质量［１，２］，促进社会安定均具有重要意义。本文对社区中慢性精神分裂症患者的需求进行调查，对影响因素作了初步分析。１对象和方法１．１对象调查样本均来自上海市徐汇区三个街道。入组条件：①符合ＣＣＭＤ－２－Ｒ的精神分裂症诊断标准；②年龄１８～６５岁；③无严重躯体疾病；④ＢＰＲＳ…     

Social class, marriage, and fertility in schizophrenia

The hypothesis is presented that the etiology of schizophrenia is neurodevelopmental: schizophrenia is a disorder occurring in extremely late maturers, whereas manic-depressive psychosis affects early maturers. This hypothesis is related to recent neurobiological findings and also to the following epidemiological and demographic topics covered by the author in her review of social class, marriage, and fertility in schizophrenia: Kretschmer's observations of body type differences between patients with schizophrenia and manic-depressive psychosis; trends in the incidence of schizophrenia and manic-depressive psychosis in industrialized versus developing economies; changing epidemiology of the subtypes of schizophrenia and of manic-depressive psychosis; sex differences in manic-depressive psychosis and schizophrenia; fertility and childlessness in schizophrenia; selection for marriage in schizophrenia; marriage patterns, inbreeding, and schizophrenia; social class, social mobility, and occupation in schizophrenia; social mobility and social selection; excess of schizophrenia in the lowest strata of society; social class, course, and outcome; and social stress and schizophrenia.     

Brief communication: factors affecting rehospitalisation in psychiatric patients in Singapore

OBJECTIVES: To study the patterns of readmission in Singapore using a cohort of first admission schizophrenia patients to the state mental health institute. METHODS: A retrospective analysis of case records was done of first admission schizophrenia patients to the hospital from April 1993 to March 1994. Patients who had only one admission in the five years of follow up were compared to 'revolving door patients'. RESULTS: The cohort comprised 133 males (56.8%) and 101 females (43.2%). Seventy-eight patients (33.3%) had one admission to the hospital while 56 (23.9%) fulfilled the revolving door criteria. On performing a logistic regression we found sex (p = 0.02), shorter duration of illness (p = 0.01) and CPN referral (0.006) were significantly associated with revolving door phenomena. CONCLUSIONS: Our study has identified male gender, history of self-harm and a short duration of illness to be risk factors for 'revolving door' phenomena.     

首发精神分裂症的早期症状调查

目的探讨精神分裂症早期症状的特异性。方法采用自编调查表,通过对42例首发精神分裂症与32例首发情感性精神障碍患者的回顾性调查,比较分析两者早期症状的发生率。结果精神分裂症患者早期多见有轻度阳性症状、某些阴性症状及个性的改变,比情感性精神障碍患者的发生率高且有显著性差异(P<0.05)。神经症性症状、情感性症状、社会功能障碍等发生率高但与情感性精神障碍没有显著性差异(P>0.05)。结论精神分裂症早期症状多种多样,某些轻微阳性和阴性症状发生率高,具有一定的特异性,应针对这些症状应进行早期干预。     

The incidence of schizophrenia in European immigrants to Canada

OBJECTIVE: The risk for schizophrenia in immigrants to Europe is approximately three times that of native-born populations. Discrimination and marginalization may influence the risk for schizophrenia within migrant populations. The primary objective of the present study was to determine whether the risk associated with migration was also evident 100 years ago. A second objective was to determine whether changing social stresses are associated with changes to the incidence of schizophrenia. METHOD: During the first two decades of the twentieth century, the Provincial Mental Hospital was the sole provider of psychiatric services in British Columbia, Canada. Detailed clinical records have been preserved for 99.5% of 2477 patients who had a psychiatric admission between 1902 and 1913. Diagnoses were made after a detailed file review and 807 patients met DSM-IV criteria for first-episode schizophrenia, schizophreniform disorder, schizoaffective disorder, or psychosis not otherwise specified. Diagnoses had high inter-rater reliability. The incidence of schizophrenia in migrants from Britain or Continental Europe was compared with that in the Canadian-born population using indirect standardization and Poisson models. RESULTS: Migration from Britain or Continental Europe to Canada in the early twentieth century was associated with an increased rate of schizophrenia; IRR=1.54, (95% CI=1.33-1.78). Incidence increased over time in immigrants but not in the native-born population and this increase occurred during a period of economic recession. CONCLUSIONS: Migration was a risk factor for schizophrenia a century ago as it is today. This risk occurred in white migrants from Europe and increased during a period of increased social stress.     

云南沧源佤族自治县佤族精神分裂症流行病学调查

目的:调查佤族精神分裂症的患病率及其特点。方法:采用按比例简单随机抽样法,对云南省临沧市沧源佤族自治县11个乡镇共18199人进行了入户调查,收集其人口学资料,并对精神分裂症患者进行阳性和阴性症状量表(PANSS)评分。结果:①临沧市沧源县佤族精神分裂症患病率为1.43‰。②男性精神分裂症现患病率2.05‰,女性精神分裂症现患病率0.71‰,男性患病率高于女性。结论:云南沧源县佤族精神分裂症的患病率低于我国大陆农村地区的患病率,且男性高于女性。     

Who became revolving door patients?

A cohort representing all first-time admissions to Danish psychiatric institutions during the period April 1, 1970 to March 31, 1971 was followed for 10 years in the psychiatric register. The cohort comprised 5,881 males and 6,856 females aged 15 years or above. The revolving door population was delineated as (1) patients with minimum four admissions and no admission or discharge period lasting for more than one fourth of the observation period or (2) patients with minimum four admissions during the first one fourth of the observation period. The incidence rate was 3.14 males and 3.55 females per 1,000. Revolving door patients were younger than others, single or divorced, and lived in larger cities. They were more frequently referred to out-patient aftercare and discharged to their own home. A male diagnostic profile of schizophrenia, demential or organic psychoses, personality disorders and abuse emerged together with a female profile of manic depressive and psychogenic psychosis and neurosis. Twenty-one point nine percent of males and 13.0% of females had more than 10 admissions and 4.5% of males and 3.7% of females spent more than 5 years in hospital. High risk groups were 15-24 years old as 21% and 13% of young males respectively females became revolving door patients, and schizophrenics, as 46% of male and 30% of female schizophrenics became revolving door patients.     

Chinese situation of partnership with families of psychiatric patients]

In order to reduce the relapse rate of schizophrenia and help the patients return to the community, we are doing the research on: 1. social skills training by revised Chinese Module for the inpatients as early as possible 2. community re-entry skills training for the outpatients and encouraging them to get jobs 3. family intervention with Chinese Module 4. methods of integrating family intervention and social skills training program in Beijing. RESULTS: 1. The compliance to drug therapy has increased. 2. The relapse rate of schizophrenia was decreased after 1.5 year follow-up. 3. A part of high EE families was changed to low EE. 4. A part of ex-patients got their jobs. 5. The Beijing Family Association for the families of mentally ill has already been established. CONCLUSION: To integrate family intervention, social skills training and drug therapy is the important strategy for the individuals with schizophrenia to reduce the relapse rate of the illness and help the patients return to the community.     

The use of a psychiatric register in predicting the outcome "revolving door patient". A nation-wide cohort of first time admitted psychiatric patients

A nation-wide cohort of all first admitted patients to all Danish psychiatric institutions over a 1 year period and aged 15 years or more was followed for 10 years in the Danish psychiatric register. Revolving door patients were defined as patients with a minimum of four admissions and 1) no admission or discharge period lasting for more than 1/4 of the observation period or 2) at least four admissions over the first 1/4 of the observation period. The revolving door population comprised 1,397 patients with an incidence rate of 0.42 males and 0.32 females per 1,000. Forty-three point five percent belonged to the same diagnostic group at first and last diagnostic assessment ranging from 28.3% in "organic psychosis" to 57.6% in "neurosis". A multiple contingency analysis showed a number of variables at first admission significantly associated with the outcome "revolving door". Many were conditioned by others and the independent variables were "age group", "main diagnosis" and "sex". Patients aged 15-24 years constituted a high risk group among schizophrenics. The 15-24 age group was further at high risk among females with personality disorder or abuse and males with manic depressive and psychogenic psychosis. Living close to a psychiatric institution was in males associated with the outcome independently of age and diagnosis, in females it was restricted to personality disorder. Revolving door patients were significantly younger than others and more likely to suffer from schizophrenia or alcohol/substance abuse.     

Study of understanding the internalized stigma of schizophrenia in psychiatric nurses in Japan

Aim: ‘Internalized stigma’ is a construct that reflects the degree to which a person accepts beliefs endorsed by society about mental illness. Among people with schizophrenia spectrum disorders, internalized stigma has been found to moderate the associations between insight and social function, hope, and self‐esteem. Among families of patients with schizophrenia, internalized stigma may not only hinder help‐seeking but also result in the families attempting to provide care themselves, without assistance from mental health services. Little is known about internalized stigma among service providers, especially psychiatric nurses in Japan. Therefore, we investigated the correlation between internalized stigma and ‘beliefs about the most appropriate form of hospitalization’ among psychiatric nurses. Methods: The subjects were 215 psychiatric nurses employed in psychiatric hospitals who completed the personal stigma scale, perceived stigma scales, and Difficulty of Community Living Scale (DCLS) with respect to a chronic schizophrenia case vignette. Results: Internalized stigma was positively correlated with greater ‘beliefs about the most appropriate form of hospitalization’ among psychiatric nurses. We also showed that stronger ‘beliefs about the social disadvantages of schizophrenia patients in the community’ was positively correlated with stronger ‘beliefs about the most appropriate form of hospitalization’. Conclusion: The present findings suggest that the psychiatric nurses employed at Japanese psychiatric hospitals have a pessimistic view of the community living of people with schizophrenia and their families. And these psychiatric nurses' beliefs were related to their understanding of the deeply dependent relationship between patients and families, and was related to the Confucian ideal.     

Social functioning of patients with schizophrenia in high-income welfare societies

OBJECTIVE: The study assessed the level of reintegration into the community of patients with schizophrenia in Oslo, Norway, a country with a well-developed social welfare system and low unemployment rates. METHODS: Eighty-one patients with a DSM-III-R diagnosis of schizophrenia treated in 1980 and in 1983 in a short-term ward of a psychiatric hospital were followed up after seven years. Seventy-four of 76 patients alive at follow-up agreed to participate. Social functioning was measured by the Strauss-Carpenter Level of Functioning Scale and the Social Adjustment Scale. RESULTS: At follow-up 78 percent of patients lived independently, 47 percent were socially isolated, and 94 percent were unemployed. Thirty-four percent had lost employment in the follow-up period. A poor outcome in terms of social functioning and community reintegration was associated with loss of employment. A good outcome was predicted by short periods of inpatient hospitalization, high levels of education, being married, male gender, and not having a late onset of psychosis. CONCLUSIONS: The level of homelessness among these patients with schizophrenia was encouragingly low, which may have been expected in a high-income welfare society. However, insufficient efforts were aimed at social and instrumental rehabilitation, and the level of unemployment was alarmingly high.