社区综合干预对慢性精神分裂症患者生活质量的影响

目的：探讨社区综合干预对慢性精神分裂症患者生活质量和服药依从性的影响。方法：120例慢性精神分裂症患者,随机分成研究组和对照组,各60例。研究组进行社区综合干预,对照组只进行药物治疗。入组前后实施简明精神病评定量表（BPRS）、生活质量综合评定问卷74（GQOLI-74）以及自知力与治疗态度问卷（ITAQ）评定。结果：治疗12个月研究组BPRS评分显著低于对照组（P〈0．05）;研究组GQOLI-74心理健康因子评分和社会功能因子评分显著高于对照组（P〈0．05）;研究组ITAQ评分显著高于对照组（P〈0．05）。结论：社区综合干预能改善慢性精神分裂症患者的生活质量,提高服药依从性。     

工娱治疗对慢性精神分裂症患者康复效果的对照研究

目的探讨工娱治疗对慢性精神分裂症患者康复效果的影响。方法选取符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)慢性精神分裂症诊断标准的患者,共100例。采用随机数字表法分为研究组和对照组,各50例。两组均使用抗精神病药物,研究组辅以12周的工娱治疗。分别于治疗前后采用阴性症状量表(SANS)、护士用住院病人观察量表(NOSIE)及世界卫生组织生活质量表(WHOQOL-100)对两组进行评定。结果治疗后研究组SANS总分及各因子分均下降(P均0.01);NOSIE总分及消极因素分下降而积极因素分上升(P均0.01);生活质量表评定除心理领域、精神支柱外,其它各领域评分均明显提高(P均0.01);而对照组各项评分均无明显变化。结论工娱治疗对慢性精神分裂症有明显疗效,有利于改善精神分裂症患者的生活质量,有利于患者重返社会。     

生活技能训练对住院慢性精神分裂症患者生活质量的影响

目的探讨生活技能训练对住院精神分裂症患者生活质量的影响。方法将120倒患者随机分为训练组和对照组,用护士观察量表（NOSIE）、阴性症状量表（SANS）和生活质量综合评定问卷（GQOLI-74）进行评定。结果训练组NOSIE总积极因素、总消极因素与对照组有明显的差异（P〈0．01）,GQOLI-74中躯体功能、心理功能和社会功能显著高于对照组（P〈0．05）。结论生活技能训练能最大程度地改善患者的社会功能,提高患者生活质量。     

不同干预方式对慢性精神分裂症患者生活质量和康复影响的研究

目的探讨不同干预方式对慢性精神分裂症患者生活质量和康复的影响。方法将180例慢性精神分裂症患者随机分成研究组和对照组各90例。对照组进行药物干预,研究组在药物干预基础上进行社区随访干预。所有患者均评定简明精神量表(BPRS)、生活质量综合评定问卷-74(GQOLI-74)和自知力与治疗态度问卷(ITAQ),并评定康复效果和冲动暴力行为发生率。结果 12个月后,研究组BPRS评分低于对照组(P<0.01);研究组GQOLI-74心理健康和社会功能因子评分高于对照组(P<0.01);研究组ITAQ评分高于对照组(P<0.05)。结论社区随访干预能显著改善慢性精神分裂症患者的生活质量和康复效果。     

康复训练对女性慢性精神分裂症患者疗效观察

目的探讨康复训练对女性慢性精神分裂症患者的疗效。方法将52例女性慢性精神分裂症患者分为研究组和对照组,在常规药物治疗的基础上,对研究组病人进行12周的康复训练,对照组采用传统的医疗模式,分别于研究前,研究12周后运用阳性和阴性症状量表(PANSS)和生活质量综合评定问卷(GQOLI-74)进行评定。结果训练前2组各量表评分差异均无显著性(P>0.05),训练后研究组PANSS阴性因子分,一般精神病理量表分,总分较训练前明显下降(P<0.01)。研究组的生活质量综合评定问卷总分及各维度评分均高于对照组(P<0.01)。结论康复训练可改善女性慢性精神分裂症患者的临床症状和生活质量。     

综合性心理行为干预对慢性精神分裂症的康复效果

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。     

激励机制对长期住院精神分裂症患者阴性症状的影响

目的 探讨激励机制对慢性精神分裂症长期住院患者阴性症状的影响.方法 选择100例慢性精神分裂症住院患者随机分为研究组和对照组,每组50例;在维持原治疗和护理的同时对研究组患者实施为期12周的激励护理干预措施;在实施激励措施前及实施激励措施后第4、12周末分别用阴性症状量表(SANS)和护士用住院观察量表(NOSIE-30)进行疗效评定.结果 两组患者在实施激励措施前SANS、NOSIE-30评分间差异无显著性意义(P均>0.05);实施激励措施前后研究组患者的SANS、NOSIE-30各评分间差异均存在显著性意义(P<0.05),而对照组患者的SANS、NOSIE-30各评分间差异仍无显著性意义(P>0.05).结论 激励可改善慢性精神分裂症长期住院患者的阴性症状,同时提高患者生活质量.     

职业劳动技能训练对慢性精神分裂症患者生活质量的影响

目的 探讨职业劳动技能训练对慢性精神分裂症患者生活质量的影响.方法 142例住院慢性精神分裂症患者随机分为研究组和对照组各71例,共脱落15例.两组患者均在药物治疗的基础上,参加简单工娱治疗,研究组增加职业劳动技能训练项目.实验前后采用护士用住院病人观察量表(NOSIE)、阳性与阴性症状量表(PANSS)、生活质量评定综合问卷(GQOLI — 74)评估临床疗效和生活质量.结果 入组时NOSIE、PANSS、GQOLI — 74评分两组间比较差异无统计学意义(P＞0.05);结束时NOSIE总积极因素、总消极因素及病情总估计分值改善程度大于对照组,差异有统计学意义(P＜0.01);PANSS总分、阴性症状分、一般精神病理量表分改善程度大于对照组,差异有统计学意义(P＜0.01);GQOLI评分中心理功能、社会功能2个功能维度分改善程度大于对照组,差异有统计学意义(P＜0.01).结论 职业劳动技能训练可以改善慢性精神分裂症患者的社会功能,从而提高生活质量.     

阿立哌唑联用利培酮对精神分裂症患者认知功能及生活质量的影响

目的观察阿立哌唑联用利培酮对精神分裂症患者认知功能以及生活质量的影响。方法选取2014年12月至2015年12月期间于我院接受治疗并确诊为精神分裂症的患者共86例,按照随机数表法分为治疗组和对照组,每组43例。对照组患者采取利培酮治疗8周,治疗组患者则应用阿立哌唑联合利培酮治疗8周。比较两组患者治疗后临床治疗效果、认知功能以及生活质量综合评定问卷(GQOLI-74)评分变化情况。结果两组患者治疗前阳性与阴性症状量表(PANSS),韦氏成人记忆测检(WMS)、智能状况检查(MMSE)以及GQOLI-74评分组间无明显差异(P0.05)。治疗后,两组患者PANSS评分较治疗前降低,WMS,MMSE和GQOLI-74各项评分较治疗前均升高,上述差异均有统计学意义(P0.05)。且治疗组患者WMS以及MMSE评分,GQOLI-74总分及各项评分与对照组患者评分比较均较高,且差异有统计学意义(P0.05)。)但两组患者治疗后PANSS评分,组间差异不大(P0.05。结论阿立哌唑联合利培酮对精神分裂症患者的临床治疗效果同单用利培酮治疗的效果相当,但联合阿立哌唑治疗对患者认知功能具有良好的改善作用,且能够有效提高患者生活质量,安全有效。     

工娱疗合并舒必利治疗精神分裂症阴性症状的对照研究

目的 探讨工娱疗合并舒必利对精神分裂症阴性症状的治疗康复作用。方法 将60例以阴性症状为主的精神分裂症患者随机分成两组,进行为期8周的对照研究,分别用工娱疗合并舒必利（研究组）和舒必利（对照组）治疗;采用BPRS、SANS、SAPS和临床疗效评定标准进行评定。结果 研究组在治疗后4周、8周末SANS评分较治疗前均有显著性差异。对照组仅在治疗后8周时SANS评分较疗前显著性差异。两组在治疗后4周,8周时SANS减分均数比较均有非常显著性差异（P＜0．01）。结论 工娱疗合并舒必利对精神分裂症阴性症状的疗效优于单用舒必利,且起效快。     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.