盐酸氟西汀治疗强迫症临床开放性对照研究

为观察氟西汀对强迫症病人的疗效和不良反应，进行了开放性对照研究，对照药物为氯丙咪嗪，氟西汀组30例，氯丙咪嗪组30例，均符合CCMD－2－R有关强迫症的诊断标准。疗程8周，予临床疗效评定和Y－BOCS则反应量表评定。结果显示，氟西汀治疗强迫症显效率与氯丙咪嗪相近，见效时间4－6周，不良反应明显低于氯丙咪嗪，提示氟西汀对强迫症安全、有效。     

氯硝西泮,氯丙咪嗪治疗强迫症的自身对照研究

目的 探讨氯硝西泮治疗强迫症的疗效。方法 以氯丙咪嗪为抗强迫标准药物与氯硝西泮进行自身交叉对照研究。在治疗前后分别进行Y—BOCS、SDS、SAS量表及临床疗效评定。结果 氯硝西泮疗效显著差于氯丙咪嗪,且治疗前后氯丙咪嗪组SDS、SAS量表评分有显著差异,而氯硝西泮组则否。治疗期间两药副作用发生率未见显著差异(P>0.05)。结论 氯硝西泮治疗强迫症显著差异于氯丙咪嗪。     

氯丙咪嗪合并暴露疗法与单用氯丙咪嗪治疗强迫症的对照研究

目的：探讨药物合并行为治疗强迫症的效果。方法：将符合CCMD－2－R强迫症诊断标准的28例病人，随机分成两组，14例在氯丙咪嗪治疗的基础上联用暴露疗法做为研究组，另14例单用氯丙咪嗪 治疗做为对照组，均系统治疗8周，用耶鲁－布朗强迫症量表（Y－BOCS）减分率评定两组治疗的疗效，结果；氯丙咪嗪合并暴露疗法组的疗效优单用氯丙咪嗪组，尤其是在控制强迫行为方面更为突出。结论：氯丙咪嗪合并暴露疗法尤其适用于以强迫行为为主的强迫症病人。     

氯丙咪嗪联合电休克治疗强迫症24例分析

目的探讨药物与电休克（ECT）治疗强迫症的疗效。方法将符合CCMD-2-R强迫症诊断标准的病人随机分为2组，24例采用氯丙咪嗪联合ECT作为研究组，24例单用氯丙咪嗪作为对照组，均治疗8周，用汉密尔顿抑郁量表（HAMD-24）评定临床疗效，用不良反应症状量表（TESS）评定不良反应。结果氯丙咪嗪联合电休克组疗效明显优于氯丙咪嗪组。结论氯丙咪嗪联合电休克治疗强追症起效快，疗效肯定，且不良反应轻微。     

认知领悟疗法治疗强迫症的随访对照研究

目的　探讨认知领悟疗法在强迫症治疗中的作用及长期疗效。方法　将 5 0例住院强迫症患者分成两组 ,分别用认知领悟疗法合并氯丙咪嗪 ( 30例为研究组 )和单用氯丙咪嗪 ( 2 0例为对照组 )治疗 ;于入组时、治疗 6周后、半年及 1年后分别用Y BOCS量表、HAMA量表评定病人 ,并于出院 1年后用SDSS量表评定病人。结果　研究组治疗 6周后至出院 1年后强迫症状评分显著低于单一用药组 ,治疗半年后研究组焦虑症状评分较低。出院一年后研究组SDSS评分低于单一用药组。结论　认知领悟疗法不仅能减轻强迫症状 ,而且能改善焦虑症状 ,增强社会功能 ,提高生活质量 ,是全面改善强迫症的治疗方法 ,而且长期应用疗效显著     

奥氮平合并氯丙咪嗪治疗精神分裂症强迫症状的对照研究

目的了解国产奥氮平合并氯丙咪嗪治疗伴强迫症状的分裂症的疗效和副反应。方法对伴强迫症状的分裂症随机分为研究组和对照组，研究组用奥氮平合并氯丙咪嗪，对照组单用奥氮平，治疗周期均为8周。用PANSS、Y—BOCS评定疗效，TESS评定副反应。结果治疗8周末两组PANSS总分和各因子分与治疗前比较均明显下降（P〈0．01），且两组治疗2、4、8周末PANSS总分及其因子分的减分率差异无显著性（P〉0．05），但Y—BOCS总分和其因子分减分率研究组显著高于对照组（P〈0．01）。两组治疗后分裂症症状有效率、显效率、痊愈率比较差异无显著性（P〉0．05），但强迫症状有效率、显效率、痊愈率差异有显著性（P〈0．01）。研究组治疗后TESS总分较对照组高（P〈0．05）。结论奥氮平合并氯丙咪嗪治疗伴强迫症状的分裂症疗效肯定，副反应能够耐受，可作为治疗伴强迫症状分裂症的一个较好选择。     

氯丙咪嗪合并利培酮治疗强迫症的对照研究

目的探讨利培酮对于氯丙咪嗪治疗强迫症的增效作用。方法将70例强迫症随机分为2组,氯丙咪嗪同时合并利培酮和单独使用氯丙咪嗪治疗,治疗8周。采用强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评定疗效。结果合并利培酮组有31例完成试验,氯丙咪嗪组有32例完成试验。治疗8周后,两组Y-BOCS平均总分有明显下降,合并利培酮组优于氯丙咪嗪组,两组无显著性差异(P<0.05);HAMA、HAMD的评分均显著下降,两组无显著性差异(P>0.05)。结论合并利培酮对于氯丙咪嗪治疗强迫症有增效作用。     

西酞普兰与氯丙咪嗪治疗强迫症临床对照分析

目的　比较西酞普兰与氯丙咪嗪治疗强迫症的临床疗效及副反应。方法　将 4 6例符合CCMD 3诊断标准的强迫症患者随机分为两组 ,分别用西酞普兰和氯丙咪嗪治疗 8周 ,采用Yale Brown强迫量表(YBOCS)、副反应量表 (TESS)和临床疗效评定标准评定疗效和副反应。结果　西酞普兰与氯丙咪嗪疗效差异无显著性 ,西酞普兰组副反应较氯丙咪嗪组少且轻 ,两组脱落率相似。结论　西酞普兰是治疗强迫症可选药物之一     

帕罗西汀与氯丙咪嗪治疗强迫症对照研究

目的探讨帕罗西汀治疗强迫症的疗效和不良反应。方法应用帕罗西汀和氯丙咪嗪治疗强迫症各30例,应用Yale-Brown强迫量表(Y-BOCS)、汉密顿抑郁量表(HAMD),汉密顿焦虑量表(HAMA)及临床4级标准评定疗效,用副反应量表(TESS)评定副反应。结果帕罗西汀与氯丙咪嗪疗效相似,两组显效率及有效率差异无显著性,帕罗西汀不良反应发生率明显少于氯丙咪嗪。结论帕罗西汀治疗强迫症疗效与氯丙咪嗪相当,不良反应较轻,值得推广。     

利培酮治疗精神分裂症强迫症状的对照研究

目的探索利培酮合并安慰剂与利培酮合并氯丙咪嗪对精神分裂症强迫症状的疗效。方法将合并有强迫症状的住院精神分裂症病人75例随机分为利培酮合并安慰剂组38例与利培酮合并氯丙咪嗪组37例,进行8周的治疗对照研究,治疗前后用MMOCI、Y-BOCS、PANSS、及TESS进行评定。结果治疗前后比较,两组疗效都显著。利培酮合并安慰剂组对强迫症状的总有效率82.9%,显效率为68.6%,利培酮合并氯丙咪嗪组的总有效率为97.3%,显效率为89.2%,两组疗效比较有显著差异。结论利培酮合并安慰剂治疗精神分裂症的强迫症状有效,但合并氯丙咪嗪治疗疗效更好。     

Toxoplasma gondii in individuals with schizophrenia: association with clinical and demographic factors and with mortality

BACKGROUND: Increased rates of exposure to Toxoplasma gondii have been found in individuals with schizophrenia as compared with control groups, but the correlates of Toxoplasma exposure in schizophrenia have not been defined. METHODS: We measured IgG class antibodies to Toxoplasma gondii in 358 individuals with schizophrenia. We correlated Toxoplasma antibody status with clinical and demographic variables and examined the effect of Toxoplasma seropositivity on mortality in a follow-up period of up to 5 years. RESULTS: Individuals with schizophrenia who had serological evidence of Toxoplasma infection were more likely to be female but did not differ in age, race, total symptom score, or other demographic or clinical characteristics. However, we found that serological evidence of Toxoplasma was associated with a significantly increased risk of dying of natural causes during the follow-up period (Cox proportional hazard ratio of 4.70; 95% confidence interval, 1.27-17.31, P = .020) adjusted for age, gender, and other clinical and demographic variables. CONCLUSIONS: Toxoplasma infection may confer an increased risk for mortality from natural causes in schizophrenia. An understanding of the pathogenesis of Toxoplasma infections in individuals with schizophrenia might lead to new approaches to the management of this disorder.     

Children with ADHD and motor dysfunction compared with children with ADHD only

The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixty-three children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.5 mg/kg [corrected], twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.     

Self-esteem and behavioural adjustment in children with epilepsy and children with diabetes

This paper describes a study to investigate the relationship between self-esteem and behavioural adjustment in two groups of children with chronic illness, one with epilepsy and the other diabetes. A total of 62 children with epilepsy and 91 children with diabetes were recruited from the total population of children aged 8–15 attending the epilepsy and diabetic clinics at a children's hospital over a 12 month period. Self-esteem and behavioural adjustment were assessed with the Harter and Achenbach Questionnaires respectively. The results showed the children with epilepsy were consistently more behaviourally disturbed and had lower self-esteem than children with diabetes. The independent completion of the questionnaires, (the Harter by the child and the Achenbach by the parents) increases the validity of the findings. Long duration of illness was the most consistent illness variable associated with poor behavioural adjustment in the two groups. The cross-sectional design of the study did not make it possible to draw any definite conclusions about the causal or temporal relationship between low self-esteem and behavioural disturbance. Once again, the potential value of prospective studies into the psychosocial adjustment of children with chronic illness is highlighted.     

Anxiety associated with hyperlipoproteinemia with and without obesity]

From the literature considered, it appears that the relationship between anxiety and lipoproteinemia is worth being further explored. Taking into account the relative weight of 277 male Belgian-French-speaking and Flemish-speaking subjects (type IV, lipidogram, Fredrickson classification), different levels of anxiety, depression, and modes of anxiety expression, are examined and compared, as a homogeneous sub-sample, to the main larger heterogeneous one. Type IV individuals are hypothesized and indeed observed to be anxious and to show intermediate (in-between) responses to the anxiety questionnaire (Cattell Anxiety Scale). Similarly, relative weights and lipid concentrations exhibit higher values than those observed on the whole sample. Within type IV individuals, psychological self-report scores and relative weight values are highly but negatively related: anxiety and depression are at the lowest by extremely overweighted subjects, and in-between response tendency is at the highest. Extending the conclusions at hand still requires additional comparisons with other lipidic types.     

Delirium with manic and psychotic features associated with amantadine

While clinicians are familiar with psychosis as a complication in the long-term treatment with amantadine, rapid psychiatric complications are of much less concern. In the case presented, severe decompensation in mental status occurred within 48 h of initiation of standard doses of amantadine hydrochloride. Clinicians should be alert not only for delayed complications but also for early-onset mental decompensation in elderly patients with influenza A treated with amantadine.     

Patients with rest-tremor and scans with ipsilateral dopaminergic deficit

Dopamine transporter imaging is typically abnormal in Parkinson’s disease and shows reduced striatal uptake, which is typically greater contralateral to the clinically more affected side. However, tremor-dominant Parkinson’s disease patients may have significantly lower uptake in the striatum ipsilateral to the rest-tremor compared to akinetic-rigid PD patients, implying a possible role of an ipsilateral deficit in the generation of rest-tremor.We report here three patients with rest-tremor and the unexpected finding of an ipsilateral presynaptic dopaminergic deficit with normal uptake contralateral to the rest-tremor in dopamine transporter imaging. We divided them in two groups, with and without a corresponding structural lesion in brain imaging. These data may suggest a role of ipsilateral dopaminergic deficit in the generation of rest-tremor. An explanation of these findings could be damage of crossed dopaminergic fibres from the substantia nigra to thalamus, which can cause motor impairment ipsilateral to dopamine depletion experimentally. This is speculative but there is no doubt that these cases exist and we encourage others to report similar cases, as this may assist in the better understanding of the yet unknown pathophysiology of rest-tremor.