癫性类分裂样精神病的临床对照分析

目的为探讨癫性类分裂样精神病的临床特征。方法本文对36例癫性类分裂样精神病患者与36例精神分裂症患者进行了临床对照分析。结果癫性类分裂样精神病患者发病年龄大、思维粘滞、病理性赘述、情绪不稳、易激惹显著高于精神分裂症患者;而在思维贫乏、情感淡漠、意志活动减退则显著低于精神分裂症患者,且病前内、外向性格有显著差异。结论癫性类分裂样精神病是多因素综合作用的结果。     

癫癎性类分裂样精神病的临床对照分析

目的为探讨癫癎性类分裂样精神病的临床特征.方法本文对36例癫癎性类分裂样精神病患者与36例精神分裂症患者进行了临床对照分析.结果癫癎性类分裂样精神病患者发病年龄大,思维粘滞、病理性赘述、情绪不稳、易激惹显著高于精神分裂症患者;而在思维贫乏、情感淡漠、意志活动减退显著低于精神分裂症患者,且病前内、外向性格有显著差异.结论癫癎性类分裂样精神病是多因素综合作用的结果.     

癫癎性类分裂样精神病的临床对照分析

目的 为探讨癫癎性类分裂样精神病的临床特征.方法 本文对36例癫癎性类分裂样精神病患者与36例精神分裂症患者进行了临床对照分析.结果 癫癎性类分裂样精神病患者发病年龄大,思维粘滞、病理性赘述、情绪不稳、易激惹显著高于精神分裂症患者;而在思维贫乏、情感淡漠、意志活动减退显著低于精神分裂症患者,且病前内、外向性格有显著差异.结论 癫癎性类分裂样精神病是多因素综合作用的结果.     

分裂样精神病和首发精神分裂症长期随访对照研究

目的 探讨分裂样精神病与首发精神分裂症的症状结构及远期预后有无差异。方法 对164例分裂样精神病或首发精神分裂症患随机给予氯丙嗪或氯氮平治疗；按DSM-IV标准划分诊断；于治疗前分别作韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、利手测验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验及言语流利性测验10项神经心理测查各1次，并作BRPS、SANS、CGI、功能总体评定量表、Simpson/Minidotes副反应量表、迟发性运动障碍评定量表（TD）各1项，于治疗12周末及治疗52周末再分别评定1次上述各项测查。结果 在治疗前及治疗12周末、治疗52周末分裂样精神病与首发精神分裂症状患在阳性症状、阴性症状、认知功能水平及迟发性运动障碍方面的差异均有显性，前阳性症状较重，阴性症状少，认知功能及社会功能恢复较好。TD发生少。结论 分裂样精神病具有独特临床特征。应在疾病分类学中保留其独立的位置。     

分裂样精神病与精神分裂症阴性、阳性症状比较

目的：探讨分裂样精神病与精神分裂症阴性和阳性症状的特点。方法：对49例分裂样精神病与70例精神分裂症患者的阴性和阳性症状作对照研究。结果：两组患者阳性和阴性症状的发生率差异无显著性（P〉0.05）;分裂样精神病组中有妄想症状者明显多于精神分裂症组;而精神分裂症组中情感平淡、思维贫乏等阴性症状者明显多于分裂样精神病（P〈0.01）。结论：分裂样精神病与精神分裂症在阴性、阳性症状方面存在差异。     

分裂样精神病与精神分裂症的血液流变学研究

为探讨分裂样精神病与精神分裂症的血液流变学改变,对25例分裂样精神病、115例精神分裂症及60例健康人做血液流变学检测的前瞻性研究。结果,无论分裂样精神病与精神分裂症的全血粘度、刚性指数、低切还原粘度、纤维蛋白原、电泳率都显高于正常人。分裂样精神病与精神分裂症比较,除全血粘度（101/s）、血浆压积的改变存在一定程度上的差异,以及前的血小板粘附率高于后外,其余各项指征相似,说明分裂样精神病与精神分裂症具有相似的血液流变学改变,从一个侧面提示两可能是同源性疾病。     

慢性癫痫性分裂样精神病临床分析

慢性癫痫性分裂样精神病是癫痫病人在意识清醒状态下发生联想障碍、强制性思维、被害妄想和幻听等类似偏执型精神分裂症的临床征象[1]。在临床上易误诊为精神分裂症。为了进一步探讨慢性癫痫性分裂样精神病的临床特征,作者对我院收治的31例慢性癫痫性分裂样精神病作一回顾性分析,现报告如下。1　资料1.1　临床资料:病例选自1990年6月至1998年7月首次住本院的慢性癫痫性分裂样精神病患者。入组标准为:①符合中国精神疾病分类方案与诊断标准第二版修订本癫痫性精神障碍诊断标准;②精神障碍类型以精神病性症状为主要特征,且为持续性精神障碍。…     

利培酮治疗首发儿童精神分裂症的临床观察

目的了解利培酮治疗儿童少年期首发精神分裂症或分裂样精神病的临床疗效、安全性和药物剂量。方法用利培酮对62例年龄<14岁的儿童精神分裂症患者治疗8周,采用简明精神病评定量表(BPRS)评定疗效,副反应量表(TESS)及实验室相应检查评定安全性及副反应。结果总有效率85%。不良反应主要为锥体外系反应及失眠,平均治疗剂量(3.26±0.88)mg/d。结论利培酮对于首发儿童少年期精神分裂症或分裂样精神病的治疗,用药安全、疗效可靠、副反应小、依从性高。     

分裂样精神病前驱症状的调查分析

本研究探讨前驱症状对分裂样精神病和精神分裂症的诊断价值。对３０例首次诊断分裂样精神病，复发后改诊为精神分裂症的病人（改诊组）与５０例维持诊断分裂样精神病的病人（维持组）的前驱症状进行比较分析。结果显示，前驱症状的发生率，尤其是不恰当行为，工作学习能力下降。孤僻退缩、讲话离题模糊，不寻常感觉，及怪异想法等的发生率在改诊组显著高于维持组，预示真正的分裂样精神病与精神分裂症的前驱症状有所差别。     

气功所致精神病与精神分裂症的临床特征对照研究

目的　比较气功所致精神病与精神分裂症的临床特征。方法　比较分析按CCMD - 2诊断为气功所致精神病 84例、气功所致精神分裂样障碍 4 4例和精神分裂症 37例的临床特征。结果　气功所致精神病平均发病年龄大于精神分裂症。三组BPRS总分均值比较 ,说明初次精神病发作时症状严重程度没有差别。抗精神病药平均日剂量 ,气精组 <分裂样组 <分裂症组 ,而显效率分别为 88.1%、75 .0 %、32 .4 %。结论　气功所致的精神病初次发作严重程度与分裂症没有明显差异 ,且抗精神病药物能有效地控制其精神病发作 ;短期治疗效果比分裂症要好 ;发病有独特的文化基础与病因。如果属于气功诱发精神分裂样精神障碍 ,而短期内又不能确诊者 ,笔者倾向于诊断为精神分裂症 ,而临床表现和精神障碍内容是气功所致精神障碍和精神分裂症的早期诊断参考指标     

气功所致精神障碍与分裂样精神病对照研究

目的：对气功所致精神障碍和分裂样精神病的异同进行探讨。方法：收集连续住院患者中符合中国精神疾病分类方案与诊断标准第2版修订本气功所致精神障碍诊断标准的病例22例，分裂样精神病66例，进行对照分析，并作3年随访。结果：气功所致精神障碍组19例、分裂样精神病组38例维持原诊断。两组在性别、发病年龄、婚姻、职业、人格特征、智能及精神症状方面差异有显著性。结论：气功所致精神障碍与分裂样精神病有明显差异，是两种性质不同的精神疾病。     

Are Black Caribbean patients more likely to receive an incorrect diagnosis of very-late-onset schizophrenia-like psychosis than their white British counterparts?

OBJECTIVE: Increased rates of schizophrenia and schizophrenia-like psychoses are repeatedly reported within migrant populations. The authors investigated whether some or all of an observed increase in service contact rates for very-late-onset schizophrenia-like psychosis in older black people of Caribbean origin could be explained by underdiagnosis of affective psychosis. METHODS: The case-notes of 47 patients with very-late-onset schizophrenia-like psychosis were rated with a 44-point psychopathology checklist. RESULTS: Black Caribbean patients with very-late-onset schizophrenia-like psychosis were younger and more likely to be male than their white British counterparts. Although there were some differences in symptoms between the groups, these did not reach levels of statistical significance. CONCLUSION: Further studies will be required to establish the diagnostic stability and outcome of very-late-onset schizophrenia-like psychosis in older black Caribbean migrants.     

Initial diagnosis and treatment in first‐episode psychosis: can an operationalized diagnostic classification system enhance treating clinicians' diagnosis and the treatment chosen?

Aim: Diagnosis during the initial stages of first‐episode psychosis is particularly challenging but crucial in deciding on treatment. This is compounded by important differences in the two major classification systems, International Classification of Diseases, 10th revision (ICD‐10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV). We aimed to compare the concordance between an operationalized diagnosis using Operational Criteria Checklist (OPCRIT) and treating clinician‐generated diagnosis in first‐episode psychosis diagnosis and its correlation with treatment prescribed. Methods: Operationalized polydiagnostic assessments were conducted on 150 first‐episode psychosis patients using OPCRIT. OPCRIT‐generated ICD‐10, DSM‐IV and treating clinician diagnoses were compared. The association between these diagnoses and choice of treatment was evaluated. Results: General agreement between the three classification systems was moderate to good, with kappa values between 0.460 and 0.674. There was a higher frequency of schizophrenia diagnosis in ICD‐10 (n = 85) comparing to DSM‐IV (n = 45) and similar in clinical diagnosis (n = 76), with moderate to good agreement between classifications (kappa between 0.602 and 0.731). No significant differences were found for ratings of psychotic depressive and manic/bipolar disorders with psychosis, with affective disorders having the higher agreement. Heterogeneous group of ‘other disorders’ achieved a kappa value from 0.250 (DSM‐IV/ICD‐10) to 0.566 (DSM‐IV/clinical diagnosis). Conclusion: Despite the challenges in first‐episode psychosis diagnosis, it is possible to have a good agreement between OPCRIT‐generated (DSM‐IV and ICD‐10) diagnoses and clinician‐based diagnoses, although some differences exist. The choice of psychopharmacological treatment prescribed matches well with these operationalized diagnoses.     

First rank symptoms in first episode psychosis and their relationship to the duration of untreated illness

Most studies of First Rank Symptoms (FRS) are based on cross-sectional inpatient samples of people with schizophrenia at various stages of illness. We sought to examine the prevalence of FRS in a representative sample of first episode psychosis patients and compare those with and without FRS clinically and in terms of duration of untreated illness. Information was gathered from 158 consecutive cases of first episode psychosis presenting in a defined geographical region through semi-structured interview tools. Of this sample, 40.5% of cases received a diagnosis of schizophrenia. The prevalence of FRS among the entire group was 52.5%. After controlling for multiple testing, no FRS contributed significantly to predicting a diagnosis of schizophrenia. There was no significant relationship between the duration of untreated illness and FRS.     

Is schizophrenia associated with narcolepsy?

OBJECTIVE: To determine the nature of the relationship between schizophrenia-like psychosis and narcolepsy. BACKGROUND: A relationship between schizophrenia and narcolepsy has long been postulated due to the association of schizophrenia-like psychosis with narcolepsy and its treatment. METHOD: We report two patients who presented with schizophrenia-like psychosis of narcolepsy and review the literature regarding possible shared neurobiology between the two disorders that might explain their co-occurrence. RESULTS: There appears to be little in the way of common pathology between these two conditions when symptoms, human leukocyte antigen associations, rapid eye movement sleep architecture, D2-dopamine receptor changes, and hypocretinergic function are examined. CONCLUSIONS: The available literature suggests that schizophrenia-like psychosis in narcolepsy is most commonly medication related or a chance co-occurrence, with limited evidence for a separate psychosis of narcolepsy.     

Difference in age of onset of psychosis between epilepsy and schizophrenia

To clarify the nature of psychosis development in epilepsy patients, we studied differences in age of onset of psychosis between epilepsy patients with psychosis (epilepsy-psychosis) and schizophrenia patients. Subjects were 282 patients with epilepsy-psychosis (36 postictal, 224 interictal, and 22 bimodal psychoses) and 612 schizophrenia patients. Age of onset was compared between the schizophrenia group and the whole epilepsy-psychosis group as well as its subgroups. Effects of sex and family history of psychosis on age of onset were also evaluated. Epilepsy patients developed psychosis later (mean age 30.1) than schizophrenia patients (mean age 26.6). Among epilepsy-psychosis subgroups, postictal psychosis and interictal psychosis showed a later onset than schizophrenia. In interictal psychosis, while chronic schizophrenia-like psychosis occurred at similar age compared to schizophrenia, brief episodic psychosis occurred at later age. Epilepsy-psychosis patients showed no sex difference in age of onset, whereas female schizophrenia patients showed a later onset than male schizophrenia patients. Both the epilepsy and schizophrenia patients with family history of psychosis tended to develop psychosis at an earlier age, although this did not reach statistically significant level. The findings of the study suggest that the nature of epilepsy-psychosis is not fully equivalent to that of schizophrenia.     

First self‐perceived signs and symptoms in emerging psychosis compared with depression

Aim: To investigate differences between the early symptoms of schizophrenia and depressive disorders. Methods: Sixty‐one individuals with an at‐risk mental state (ARMS), 17 of whom later made the transition to psychosis, 37 patients with a first episode of psychosis and 16 controls with depressive disorders were interviewed about first self‐perceived signs and symptoms. Results: In ARMS and first episode of psychosis, on average, first self‐perceived signs or symptoms had occurred about 5–6 years before the interview. In ARMS, including transition to psychosis, ‘loss of energy’ and ‘difficulties concentrating’ were the most frequently recalled first signs. There was much overlap for the four most frequently mentioned symptoms in the three groups. As compared with ARMS, controls with depressive disorders significantly more often recalled ‘depression’ and ‘social isolation’ as the very first signs of disease. Conclusions: Clinicians should consider the development of self‐recalled first signs over time carefully when assessing suspected early prodromal stages of schizophrenia and beginning depressive disorder.     

Impact of phase-specific treatment of first episode of psychosis on Wisconsin Quality of Life Index (client version)

OBJECTIVE: The objective of this study was to assess the impact of a phase-specific community-focused treatment program on different dimensions of self-reported quality of life in a representative sample of first episode psychosis patients. Method: Data were collected on patients presenting with a first episode of psychosis on the Wisconsin Quality of Life Index (client version), positive and negative symptoms, and demographic and clinical variables at baseline following clinical stabilization and at 1 year. RESULTS: Complete data on a representative sample of 41 patients showed a significant improvement in most dimensions of the WQOL at 1 year; these changes were generally independent of changes in symptoms and there were no significant differences in the magnitude of improvement in QOL between those with DUP < or >6 months. CONCLUSION: Patients with a first episode of predominantly schizophrenia spectrum psychosis show a highly significant improvement in subjectively assessed quality of life following a year of phase-specific comprehensive treatment.     

Radiological findings in individuals at high risk of psychosis

OBJECTIVE: To assess the prevalence of radiological magnetic resonance imaging (MRI) findings in individuals at high risk of schizophrenia. METHODS: MRI scans from individuals at high risk of schizophrenia (HR; n = 37) were assessed by a radiologist blind to group status and compared with scans from patients with first episode psychosis (FE; n = 30), depressive controls (DC; n = 17), and healthy controls (HC; n = 26). RESULTS: There was a significantly higher proportion of radiological findings in individuals at high risk of schizophrenia (35%) and patients with first-episode psychosis (40%) than in patients with depression (18%) or healthy controls (12%). These differences were specific to findings regarded as potentially clinically significant as opposed to normal variants; however, there was no indication for medical treatment. CONCLUSIONS: The results suggest that a large proportion of those at high risk of psychosis have radiological findings on MRI scanning, and that the prevalence of radiological findings in this group is similar to that in patients with first episode psychosis.     

气功所致精神分裂样障碍随访对照研究

目的：研究气功所致精神分裂样障碍的临床特征和近期疗效。方法：比较分析气功所致精神障碍84例、气功所致精神分裂样障碍44例和精神分裂症37例的近期疗效。结果：精神分裂症的发作次数明显多于气功所致精神障碍。精神分裂症和气功所致精神分裂样障碍者的精神功能减退比气功所致精神障碍者明显。结论：气功所致精神分裂样障碍近期治疗效果比精神分裂症要好，但是，停止治疗和继续练功也可能导致疾病复发。