强迫症患者的防御机制、父母教养方式及个性特征的调查分析

目的　探讨强迫症患者的防御机制、父母教养方式及其个性特征。方法　采用防御方式问卷 (DSQ)、父母养育方式评价量表 (EMBU)及艾森克个性问卷 (EPQ)对 36例强迫症患者进行了问卷调查 ,并与 36例正常受试者加以比较。结果　①强迫症组中间型和不成熟防御机制因子分均明显高于正常对照组 (P <0 0 1) ,而成熟防御机制因子分则明显低于正常对照组 (P <0 0 5 ) ;②强迫症组父母的情感温暖因子分低 ,而父母的惩罚、拒绝因子分和母亲的偏爱被试因子分高 ,同正常对照组比较 ,差别均具有显著性或非常显著性意义 (P <0 0 1或P <0 0 5 ) ;③强迫症组EPQ的N因子分明显高于正常对照组 ,而E因子分则明显低于正常对照组 (P <0 0 1)。结论　强迫症患者的防御机制、父母教养方式及个性特征与正常人有着明显的不同 ,它为今后开展分析性心理治疗 ,实施心理干预措施提供了依据。     

社交恐怖症患者父母教养方式的对照研究

目的 探讨社交恐怖症患者父母教养方式的特异性因素。方法 采用父母教养方式评价量表(EM—BU)对符合ICD—10诊断标准的36例社交恐怖症患者进行了评定，并与31例强迫症及35例健康人作为对照者加以比较。结果 同健康对照组相比，社交恐怖症患者在父母惩罚及过分拒绝因子上的评分较高，而父母情感温暖因子上的评分较低，差别有非常显著性意义(P＜0.01)。同强迫症组相比，社交恐怖症患者在母亲惩罚因子上的评分较高，而母亲情感温暖因子上的评分较低，差别有显著性意义(P＜0．05)。结论 父母惩罚、缺少父母的情感温暖及父母的过分拒绝在社交恐怖症的发生发展中起着非常重要的作用，其中父母的惩罚可能是社交恐怖症患者的一个特异性因素。     

社交恐怖症患者父母教养方式与强迫症等的对照研究

目的探讨社交恐怖症患者父母教养方式的特异性因素。方法使用父母教养方式问卷的中文版，对符合美国精神疾病诊断与统计手册第３版修订本、国际疾病分类第１０版及中国精神疾病分类方案与诊断标准第２版的３５例社交恐怖症患者进行调查，并分别与２５例强迫症组、３０例非社交恐怖症和强迫症的神经症组和３５例正常对照组进行比较。结果与正常对照组相比，社交恐怖症患者评价其父母对他们惩罚较多（Ｐ＜０．０５～０．０１）。其他两组神经症患者仅母亲惩罚因子分高（Ｐ＜０．０５），而社交恐怖症患者的母亲惩罚因子分高于其他两组神经症患者（Ｐ＜０．０５），仅与强迫症组间的差异无显著性（Ｐ＞０．０５）。结论父母的惩罚在社交恐怖症的发生发展中起着重要作用。     

强迫症患者的防御方式及其家庭因素研究

目的 探讨强迫症患者的防御方式、家庭环境及其父母教养方式的特点。方法 采用防御方式问卷（DSQ）、家庭环境量表（FES—CV）及父母教养方式评价量表（EMBU）对36例强迫症患者（强迫症组）进行了问卷调查，并与36例正常受试者（对照组）加以比较。结果 ①强迫症组不成熟和中间防御机制因子评分均明显高于对照组，而成熟防御机制因子评分则明显低于对照组（P〈0．05或P〈0．01）；②强迫症组家庭亲密度、情感表达及娱乐性评分均明显低于对照组，而矛盾性及控制性评分则明显高于对照组（P〈0．05或P〈0．01）；③强迫症组父母惩罚及过分拒绝因子评分均明显高于对照组（P〈0．05或P〈0．01）；另外患者父亲的情感温暖因子评分极明显低于对照组（P〈0．01），而过度保护因子评分则明显高于对照组（P〈0．05）。结论 强迫症患者的防御方式、家庭环境及父母教养方式与正常人相比有其特点，可以针对其特点进行相应的心理干预。     

独生子女情感障碍患者心理防御机制与人格特征及父母教养方式的研究

目的为探讨独生子女情感障碍患者人格、心理防御机制及父母教养方式的关系。方法采用艾森克个性问卷（EPQ）、防御方式问卷（DSQ）、父母教养方式评价量表（EMBU）对住院的100例独生子女情感障碍患者和正常独生子女进行测评,其中患者在自知力恢复以后测评。结果独生子女情感障碍患者更多地使用投射、抱怨、幻想、退缩、躯体化等不成熟的防御机制,EPQ得分精神质、神经质、内外倾性高于正常独生子女（P〈0．01）,相关分析发现,精神质、神经质与不成熟防御机制、中间防御机制呈正相关,内外倾性与成熟防御机制呈正相关,独生子女情感障碍患者的父母惩罚、父母拒绝、父亲保护、母亲干涉因子分高于正常独生子女（P〈0．01）,而父亲温暖因子低于正常独生子女,相关分析发现,父母惩罚、父母拒绝、父母干涉、父亲保护与不成熟防御机制正相关,而父母温暖与不成熟防御机制负相关。结论独生子女情感障碍患者多使用不成熟防御机制、不良的父母教养方式,存在个性缺陷,且三者之间密切相关。     

强迫症患者认知功能特点的研究

目的了解强迫症患者的认知功能特点。方法以52例停药或首诊的强迫症患者为研究对象,均符合美国精神障碍诊断与统计手册第4版和中国精神障碍分类与诊断标准第3版强迫症诊断标准,以年龄、性别、受教育年限与强迫症组匹配的53名健康人作为正常对照组,采用神经心理测验分别对两组进行评定。结果强迫症患者的知识[(1996±502)分]、算术[(1405±231)分]、数字符号[(5730±1241)个]、木块图形[(3548±875)分]、逻辑即时记忆[(930±412)个]、逻辑延迟记忆[(667±437)个]、词语流畅性[(2201±691)个]、划痕[(6756±2723)s]、威斯康星卡片分类测验[(3288±636)个]、汉诺塔测验成绩[(5517±971)分]均差于正常对照组,分别为知识(2193±322)分、算术(1505±186)分、数字符号(6462±1058)个、木块图形(3862±709)分、逻辑即时记忆(1311±379)个、逻辑延迟记忆(1105±481)个、词语流畅性(2650±607)个、划痕(5412±1849)s、威斯康星卡片分类测验(3615±346)个、汉诺塔测验成绩(6194±919)分,均P<005和P<001;强迫症组和正常对照组的STCW正确数分别为(9024±2007)个和(9326±1592)个,STC和STCW的纠正数均为(0)个和(1)个,均P<005。结论强迫症患者存在广泛的认知功能损害,涉及注意、记忆、执行功能、语言和非语言表达等方面     

强迫症、抑郁症及焦虑症患者血小板5-羟色胺浓度的对照研究

目的　研究 5 羟色胺 ( 5 HT)在强迫症发病中的作用及强迫思维与强迫动作亚组、抑郁症及焦虑症患者间血小板 5 HT含量的差异。方法　采用高效液相色谱法 ,分别测定 2 9例强迫症患者 [(强迫症组 ,根据Y BOCS强迫量表因子得分将其分为强迫思维 ( 16例 )、强迫动作 ( 7例 )和混合性( 6例 ) 3组 ]、2 0例抑郁障碍患者 (抑郁症组 )、17例焦虑障碍患者 (焦虑症组 )和 2 8名正常人 (正常人组 )的血小板 5 HT含量。结果　强迫症组血小板 5 HT水平 [( 139± 172 ) μg/L]低于正常人组 [( 2 4 8±2 15 ) μg/L]及焦虑症组 [( 397± 4 0 1) μg/L],差异具有显著性 (P =0 0 39;P =0 0 2 0 ) ;与抑郁症组 [( 2 0 2± 16 2 ) μg/L]的差异无显著性 ( P >0 0 5 ) ;强迫思维 [( 85± 6 6 ) μg/L]与强迫动作组 [( 16 9± 10 0 ) μg/L]间血小板 5 HT含量的差异有显著性 (P =0 0 2 5 )。结论　强迫症患者 5 HT浓度变化与抑郁障碍患者趋同 ,与焦虑障碍患者的差异有显著性 ;单纯强迫思维者的 5 HT浓度与单纯强迫动作患者的差异有显著性     

精神分裂症患者心理防御机制与人格特征的相关性分析

目的　探讨精神分裂症患者心理防御方式和人格特片的特点及二者的相关性。方法　分别运用防御方式问卷 (DSQ)和艾森克个性问卷 (EPQ)对 10 1名精神分裂症患者和 30例正常人群进行防御方式评定和人格测定。结果　与正常对照组相比 ,精神分裂症患者更多采用不成熟和中间型防御方式 (P <0 0 5 )。防御方式与人格特征存在着一定的关联性 (P <0 0 5 )。不成熟型防御方式和中间型防御机制与EPQ的精神质 (P)得分和神经质 (N)得分呈显著正相关 (P <0 0 1) ,成熟防御机制与内外向(E)得分呈显著正相关 (P <0 0 5 )。结论　精神分裂症患者更多地使用不成熟防御机制 ,存在病态人格 ,且者之间存在明显相关性 ,有关结果 ,对于探讨精神分裂症患者的病理心理机制和开展心理治疗有指导意义。     

伴与不伴敏感性关系妄想的社交恐怖症及强迫症患者人格及症状特征的比较

目的:通过与强迫症患者比较,探讨伴与不伴敏感性关系妄想的社交恐怖症患者的人格特征及症状特点方法:对83例伴与不伴敏感性关系妄想的社交恐怖症、强迫症患者进行艾森克人格问卷(EPQ)、症状自评量表(SCL-90)的检测评定。对3组患者间的人格以及症状进行比较。结果:SCL-90结果中,总分、躯体化因子、强迫因子、人际敏感因子、焦虑因子、精神病因子在3组之间的差异有统计学意义(P均0.05),其余因子间的差异无统计学意义(P0.05)。EPQ结果中,3组间内外向因子分差异有统计学意义(P0.05),但精神病性、神经质及掩饰因子分差异无统计学意义(P0.05)。结论:与不伴有敏感性关系妄想的社交恐怖症患者相比,伴有敏感性关系妄想的社交恐怖症患者与强迫症患者有更加相似的人格特征,并且在症状的严重程度方面,也更有相似性。     

强迫症患者完美主义程度在父母教养方式和道德判断能力之间的中介效应

目的 探讨强迫症患者父母教养方式、道德判断能力与完美主义程度之间的关系，并比 较 3 者在患者与健康人群中的差异。方法 采用方便抽样法，随机选取 2021 年 1— 10 月在北京市某 三甲医院心理科门诊就诊的 100 例强迫症患者为研究组，同时招募 100 名健康对照者为对照组。使用 道德判断测验（MJT）中文标准版、父母教养方式评价量表（EMBU）以及 Frost 多维完美主义量表中文版 （FMPS-C）比较两组患者的道德判断能力、父母教养方式及完美主义程度的差异。采用 Pearson 相关和 多重线性回归分析强迫症患者父母教养方式、完美主义、道德判断能力 3 者之间的关系。结果 研究 组 FMPS-C 非适应性维度得分高于对照组［（76.2±7.3）分比（58.3±12.6）分］，FMPS-C 适应性维度得分、 MJT 中文标准版 C 分数低于对照组［（18.5±3.1）分比（23.8±4.7）分、（9.5±1.7）分比（14.7±6.3）分］，差异 有统计学意义（P＜ 0.01）。研究组 EMBU 中的父亲惩罚、严厉，过分干涉，拒绝、否认，过度保护因子得 分高于对照组，差异有统计学意义（P＜ 0.05）；母亲过度干涉和保护，拒绝、否认，惩罚、严厉因子得分高 于对照组，差异有统计学意义（P＜ 0.05）。强迫症患者母亲过度干涉和保护，拒绝、否认，惩罚、严厉与 非适应性完美主义程度呈正相关（r=0.954、0.412、0.419；P＜ 0.01），与道德判断能力呈负相关（r=-0.853、 -0.244、-0.358；P＜ 0.05）。强迫症患者父亲惩罚、严厉，过分干涉，拒绝、否认，过度保护与非适应性完 美主义程度呈正相关（r=0.304、0.240、0.690、0.248；P＜ 0.05）；父亲拒绝、否认与道德判断能力呈负相关 （r=-0.717，P＜ 0.01）。强迫症患者母亲过度干涉和保护，拒绝、否认，惩罚、严厉与父亲拒绝、否认通过 非适应性完美主义程度对道德判断能力起部分中介作用（均P＜ 0.05）。结论 强迫症患者道德判断能 力低于健康人群；父母过度控制、否认，惩罚等教养方式与非适应性完美主义程度高于健康人群。父母 教养方式通过非适应性完美主义程度部分作用于强迫症患者的道德判断能力。     

Noise-enhanced balance control in patients with diabetes and patients with stroke

OBJECTIVE: Somatosensory function declines with diabetic neuropathy and often with stroke, resulting in diminished motor performance. Recently, it has been shown that input noise can enhance human sensorimotor function. The goal of this study was to investigate whether subsensory mechanical noise applied to the soles of the feet via vibrating insoles can be used to improve quiet-standing balance control in 15 patients with diabetic neuropathy and 15 patients with stroke. Sway data of 12 healthy elderly subjects from a previous study on vibrating insoles were added for comparison. METHODS: Five traditional sway parameters and three sway parameters from random-walk analysis were computed for each trial (no noise or noise). RESULTS: Application of noise resulted in a statistically significant reduction in each of the eight sway parameters in the subjects with diabetic neuropathy, the subjects with stroke, and the elderly subjects. We also found that higher levels of baseline postural sway in sensory-impaired individuals was correlated with greater improvements in balance control with input noise. INTERPRETATION: This work indicates that noise-based devices could ameliorate diabetic and stroke impairments in balance control.     

Cortical folding difference between patients with early-onset and patients with intermediate-onset bipolar disorder

Objectives:  Cerebral abnormalities have been detected in patients with bipolar disorder (BD). In comparison to BD with a later onset, early-onset BD has been found to have a poorer outcome. However, it is yet unknown whether neuroanatomical abnormalities differ between age-at-onset subgroups of the illness. We searched for cortical folding differences between early-onset (before 25 years) and intermediate-onset (between 25 and 45 years) BD patients.
Methods:  Magnetic resonance images of 22 early-onset BD patients, 14 intermediate-onset BD patients, and 50 healthy participants were analyzed using a fully automated method to extract, label, and measure the sulcal area in the whole cortex. Cortical folding was assessed by computing global sulcal indices (the ratio between total sulcal area and total outer cortex area) for each hemisphere, and local sulcal indices for 12 predefined regions in both hemispheres.
Results:  Intermediate-onset BD patients had a significantly reduced local sulcal index in the right dorsolateral prefrontal cortex in comparison to both early-onset BD patients and healthy subjects, and lower global sulcal indices in both hemispheres in comparison to healthy subjects (p < 0.05, Bonferroni corrected). Brain tissue volumes did not differ between groups.
Conclusions:  This study provided the first evidence of a neuroanatomic difference between intermediate-onset and early-onset BD, which lends further support to the existence of different age-at-onset subgroups of BD.     

Serum nitric oxide concentrations in patients with multiple sclerosis and patients with epilepsy

Nitric oxide (NO), a neurotransmitter and a free radical, has been purported to be involved in numerous neurological diseases. We investigated the serum nitric oxide concentration in 30 patients with multiple sclerosis (MS), in 30 patients with epilepsy and in 30 control subjects. The aim was also to determine whether a statistically significant difference in serum NO concentrations exists between the groups of interest. The total serum nitric oxide concentration was measured using the Griess reaction after reducing nitrates to nitrites with elemental zinc. In the group multiple sclerosis, the mean NO concentrations were X ± SEM = 31.02 ± 1.79 μmol/l, in the control group X ± SEM = 25.31 ± 1.44 μmol/l and in the group epilepsy X ± SEM = 22.51 ± 1.28 μmol/l. Student’s t test showed a statistically significant difference between subjects with multiple sclerosis and the control group (p = 0.013), as well as between the groups multiple sclerosis and epilepsy (p = 0.0002). This data confirms that NO may play an important role in the pathogenesis of multiple sclerosis, whereas its role in epilepsy still remains unclear.     

Background factors in patients with schizoaffective disorder as compared with patients with diabetes and healthy individuals

Family history and psychosocial background factors were studied in married patients with a DSM-III diagnosis of schizoaffective disorder (n=17, partnersn=16), married patients with diabetes (n=10, partnersn=10) and married healthy individuals (n=8, partnersn=8). The two latter groups were comparison control groups matched for gender and age to the patients with schizoaffective disorder. Affective disorder, not particularly schizoaffective disorder, was more common in first- and tended to be more common in second-degree relatives of patients with schizoaffective disorder as compared with controls. Poor parental relations, especially to the father, during the formative years were prominent in patients with schizoaffective disorder as compared with the controls. The same patients also more often than others gave a report of sexual enroachment, inside or outside the family, and corporal punishment during the growing-up years.     

Impulsivity and compulsivity in patients with trichotillomania or skin picking compared with patients with obsessive-compulsive disorder

To compare impulsivity and compulsivity, we performed a case control study comparing a group of 20 patients with obsessive-compulsive disorder with a group of 20 patients with skin picking and/or trichotillomania (SP/T). The instruments used were Structured Clinical Interview for DSM-IV Axis I Diagnosis, Yale-Brown Obsessive-Compulsive Scale, Schalling Impulsivity Scale, and Hamilton Anxiety and Depression Inventories. A Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument was designed for this particular study. The Yale-Brown Obsessive-Compulsive Scale scores were significantly higher in patients with obsessive-compulsive disorder, compared with patients with SP/T (F = 90.29; P < .001). The Hamilton Inventories and Schalling Impulsivity Scale revealed no significant intergroup differences. The Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument allowed us to find 6 statistically significant differences between groups: the ability or inability to delay an impulse, quick response or action planning, feelings of pleasure or guilt during or after an act, ritualization, and whether the patient believes he/she has losses or benefits if prevented from acting. In conclusion, SP/T should deserve further attention about their classification in future versions of diagnostic manuals because, as in International Classification of Diseases, Tenth Revision, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition includes these disorders in the same chapter as pathological gambling, kleptomania, pyromania and others. Despite their resemblance to compulsions, their classification under the Obsessive-Compulsive Spectrum needs particular phenomenological and neurobiologic investigation.     

Diffusion tensor imaging in patients with primary cervical dystonia and in patients with blepharospasm

Diffusion tensor imaging (DTI) analyses the movement of water molecules within the cerebral white matter thus providing information on ultrastructural brain changes. We studied 18 patients with cervical dystonia (CD), 16 with blepharospasm (BSP) and 35 years age-matched healthy controls. DTI data were obtained with a Philips 1.5 Tesla scanner and then processed to obtain maps of fractional anisotropy (FA) and mean diffusivity (MD). Twenty-three square regions of interest of uniform size were positioned on the FA maps and then automatically transferred to the MD maps. FA and MD values in the corpus callosum, left and right putamen, right caudate, left and right pre-frontal cortical area and left supplementary motor area in CD patients differed significantly from those in healthy controls. No significant regional differences were found between patients with BSP and healthy controls. In the CD group, age, duration and severity of dystonia did not correlate with regional FA/MD values, whereas the duration of botulinum toxin treatment correlated significantly with the MD value in the right-pre-frontal cortex. The abnormal DTI findings in patients with CD suggest the presence of brain ultrastructural changes in adult-onset primary CD.     

Inferential reasoning: comparison of patients with schizophrenia and patients with traumatic brain injury

We investigated the cognitive processes underlying inferential reasoning, comparing performance of patients suffering from schizophrenia with that of patients with brain injury in an attempt to understand the nature of the social impairments in schizophrenia. Inferential reasoning on mental and physical states and second-order false belief attribution were assessed in healthy controls, in patients with schizophrenia and in brain trauma patients with predominantly ventromedial prefrontal cortex or dosolateral prefrontal cortex lesions. Our finding that ventromedial prefrontal areas are involved in general inferential reasoning casts further light on the neural structures implicated in socio-cognitive impairments in schizophrenia.     

Comparison of schizophrenic patients with formal thought disorder and neurologically impaired patients with aphasia

This study compares the speech and language of 14 schizophrenic patients having a formal thought disorder with 13 neurologically impaired patients with aphasia. Transcribed interviews with these patients were blindly assessed by five specialists for classification as schizophrenic or aphasic. Three of the five specialists performed better than chance but only one achieved high discriminating ability. Interrater reliability was poor. Five of 14 language abnormalities assessed differentiated the diagnostic groups. These findings suggest that schizophrenic patients share many language abnormalities with aphasic patients but do not exhibit a classic aphasic syndrome.     

Comparison of patients with bulimia nervosa, obese patients with binge eating disorder, and nonobese patients with binge eating disorder

This study compared patients with bulimia nervosa (BN), obese patients with binge eating disorder (BED), and nonobese patients with BED. One hundred sixty-two adult women consecutively evaluated for outpatient clinical trials who met DSM-IV criteria for BN, purging type (N = 46) or for BED (N = 79 obese and N = 37 nonobese) were compared using the Eating Disorder Inventory (EDI). The three groups differed significantly on two (drive for thinness and body dissatisfaction) of the three eating-related scales and on all five of the general personality scales of the EDI. When age and depression level were controlled, findings for the eating-related scales did not change, whereas four of the five general personality scales were no longer significant. Post hoc analyses revealed that the BN group and the nonobese BED group had significantly higher drive for thinness than the obese BED group. The nonobese and the obese BED groups did not differ from each other in any area (other than drive for thinness), including body dissatisfaction. The nonobese and the obese BED groups had significantly lower maturity features than the BN group. Our findings suggest that when the effects of age and depression levels are controlled, treatment-seeking women with BN and BED are generally similar. Certain differences that do exist between women with BN and BED are associated with obesity status (drive for thinness), whereas others are associated with diagnosis (body dissatisfaction, maturity fears).