利培酮治疗儿童精神疾病的临床初探

对１６例儿童精神疾病患者给予利培酮治疗，以临床总体印象量表等评定疗效及药物不良反应，治疗结果显示：儿童精神分裂症１０例中有效７例，Ｔｏｕｒｅｔｔｅ综合征（ＴＳ）４例有效３例，孤独症２例中有效１例，显效时间为２周，有效日剂量儿童精神分裂症和孤独症为２～３ｍｇ，ＴＳ为１～１．５ｍｇ，５６．３％的患儿出现药物副反应，提示得培酮儿童精神分裂症，ＴＳ和孤独症部分症状有效，对阳性症状的改善更较阴性症状为好。     

口服利培酮治疗精神分裂症

为验证利培酮治疗精神分裂症的疗效和安全性，对２０例精神分裂症住院患者给予利培酮４～８ｍｇ／ｄ治疗，疗程８周，以阳性和阴性症状量表（ＰＡＮＳＳ）、大体评定量表（ＧＡＳ）和临床总体印象量表（ＣＧＩ）评定疗效，以锥体外系副反应量表（ＥＳＲＳ）和不良反应量表（ＴＥＳＳ）评定药物不良反应。结果显示，治疗结束时显效率为９０％。利培酮的起效时间在１０天左右，仅有轻度的锥体外系副反应和失眠。提示利培酮对精神分裂症的阳性和阴性症状都有良好的疗效，且安全性较高     

利培酮治疗精神分裂症的临床验证

为验证利培酮治疗精神分裂症的有效性和安全性，对２０例按ＤＳＭ—Ⅳ诊断的精神分裂症住院患者进行治疗，剂量２～６ｍｇ／ｄ，疗程８周。以阳性症状和阴性症状量表（ＰＡＮＳＳ）评定疗效，以锥体外系症状评定量表（ＥＳＲＳ）评定锥体外系反应（ＥＰＳ）。治疗结束时，显效率（痊愈＋显著进步）为７０％，有效率９０％，利培酮治疗起效时间为１周。提示利培酮是一种对精神分裂症阳性症状和阴性症状均有一定疗效的抗精神病药物。     

利培酮治疗首发精神分裂症的临床观察

为了解利培酮对门诊治疗首发精神分裂症患者的情况，对３０例患者进行开放性研究，均符合ＣＣＭＤ—２—Ｒ的诊断标准。利培酮剂量为２～６ｍｇ／ｄ，平均３．５±０．７ｍｇ／ｄ，疗程８周。以简明精神病评定量表（ＢＰＲＳ）减分率评定疗效，以不良反应症状量表（ＴＥＳＳ）观察副反应。结果发现，有效率８７％，显效率７０％。副作用有困倦，失眠，口干，头晕，静坐不能等，症状多为轻度和中度，多能耐受，且部分症状可自行缓解。作者认为，在门诊应用利培酮治疗首发精神分裂症是可行的，安全性较高。利培酮起效时间早，可明显改善患者情绪，副作用少，因而可提高患者的依从性     

利培酮治疗儿童精神分裂症临床观察

目的了解利培酮治疗儿童精神分裂症疗效及安全性。方法对47例年龄≤14岁精神分裂症患儿以利培酮治疗8周，利培酮平均治疗剂量为2mg-2．5mg／d，分别以PANSS量表和TESS量表评定疗效及不良反应。结果总有效率为95．74％，不良反应主要为锥体外系反应。结论利培酮对儿童精神分裂症疗效较好，不良反应少，依从性较好，值得推广使用。     

利培酮治疗首发儿童精神分裂症的临床观察

目的探讨利培酮治疗儿童精神分裂症疗效及不良反应。方法对99例首发儿童精神分裂症患儿给予利培酮治疗8周，分别以PANSS量表和TESS量表评定疗效及不良反应。结果利培酮治疗儿童精神分裂症显效率为72．72％。与治疗前相比，PANSS量表的阳性症状因子分在第1周末有显著性降低，总分和一般病理因子分在第2周末有显著性降低，阴性症状因子分在第4周末有显著性降低，差异均有显著性（P〈0．05）。样本中均无严重不良反应。结论利培酮治疗首发儿童精神分裂症具有安全、疗效可靠、副反应小、依从性高。     

利培酮口服液与利培酮片剂治疗老年期精神分裂症疗效与安全性的对照研究

目的比较利培酮口服液与利培酮片剂治疗老年期精神分裂症的疗效和安全性。方法将68例老年期精神分裂症患者随机分为利培酮口服液组和利培酮片剂组。疗程8周，使用阳性与阴性症状量表评定临床疗效，使用副反应量表评定药物不良反应。结果两组在治疗后的第2周均起效，PANSS分数在两组治疗后的2、4、8周降低与治疗前比较其差异均有显著性（P〈0．01）；利培酮口服液组有效率85．7％，利培酮片剂组有效率87．9％；8周末利培酮口服液与片剂的不良反应主要为肌强直、震颤，约20％～25％，其次为失眠、便秘与食欲差等，约9％～11％，但上述症状发生均较轻，未经特殊处理。两组不良反应发生率比较其差异无显著性（P〉0．01）。结论利培酮口服液与利培酮片剂治疗老年期精神分裂症有相同的疗效，安全性高、耐受性好。与利培酮片剂相比口服液给药途径方便，更适合老年患者使用。     

利培酮治疗64例少儿精神分裂症

目的探讨利培酮治疗儿童精神分裂症疗效及副作用.方法对64例首发儿童精神分裂症的患者给予利培酮观察治疗8周,分别以PANSS量表和TESS量表评定疗效及不良反应.结果利培酮治疗儿童精神分裂症显效率为74.14%,起效时间为2周,有效治疗剂量为2～2.5 mg/d.结论利培酮对精神分裂症阳性、阴性症状均有较好的疗效,副作用小,耐受性好,适合儿童精神分裂症的治疗.     

齐拉西酮与利培酮治疗精神分裂症的对照研究

目的：比较齐拉西酮和利培酮治疗精神分裂症的疗效和安全性。方法：将84例精神分裂症患者随机分为两组,分别给予齐拉西酮和利培酮治疗8周。采用阳性症状与阴性症状量表（PANSS）评定临床疗效,治疗中出现的症状量表（TESS）评定不良反应。结果：齐拉西酮和利培酮治疗8周有效率分别为90．5％和92．9％,二药疗效的差异无显著性（P〉0．05）。齐拉西酮组的不良反应发生率（38．1％）稍低于利培酮组（57．1％）。利培酮组锥体外系反应和内分泌改变的发生率均显著高于齐拉西酮组（P均〈0．05）。但两药引起的不良反应一般为轻度或中度,患者耐受性较好。结论：齐拉西酮和利培酮对精神分裂症的疗效相当,但不良反应有所不同。     

奎硫平与利培酮治疗门诊精神分裂症患者对照研究

目的：探讨奎硫平治疗精神分裂症的疗效及不良反应。方法：50例精神分裂症患者随机分为两组，分别给予奎硫平与利培酮治疗。疗程5周。采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效及不良反应。结果：奎硫平组显效率70．0％；利培酮组显效率73．3％。利培酮组锥体外系反应稍高于奎硫平组。结论：奎硫平与利培酮治疗精神分裂症具有相仿疗效。     

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.     

Bibliography of officers of department of mental hygiene

Psychiatric Quarterly -     

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.     

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.