分裂样精神病与精神分裂症

分裂样精神病与精神分裂症四川省攀枝花市第三人民医院（６１７０６１）杜海英①王耀华戎建铁ＤＳＭ－ＩＶ和ＣＣＭＤ－２－Ｒ诊断标准中，均把病程的长短作为区别分裂样精神病和精神分裂症的主要尺度，其科学性和正确性有待进一步验证，本文仅对我院收治的现已确诊为精神...     

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。     

76例分裂样精神病临床比较分析

作者对76例分裂样精神病的临床特征与精神分裂症、躁狂症作了比较分析。结果发现,多数患者的病前性格、遗传素质及临床症状等均近似于精神分裂症,但其中也包含有部分情感性疾病。     

分裂样精神病45例临床分析

分裂样精神病４５例临床分析郑士全，王兆梅，刘方礼临床上，有一组起病急、病程短、分裂性症状突出、被命名为分裂样精神病（ＳＦＤ）的患者，一般归为精神分裂症（Ｓｃ）的一个诊断亚型［１，２］。为探讨两者之间的区别，及ＳＦＤ诊断亚型的临床应用价值，笔者对ＳＦＤ...     

精神分裂症与分裂样精神病前躯症状对照分析

为探讨精神分裂症和分裂样精神病前躯症状诊断价值,对80例首次诊断为分裂样精神病,复发后改诊为精神分裂症病人(SC组)与60例维持诊断分裂样精神病的病人(SCF组)的前躯症状进行了比较分析。结果显示：前躯症状的发生率,尤其是不恰当行为、性格改变、讲话离题、躲避亲人或与人疏远、敏感、多疑、怪异想法、无端恐惧、强迫症状等发生率SC组显高于SCF组。提示精神分裂症一分裂样精神病的前躯症状确有差异。     

分裂样精神病与精神分裂症阴,阳性症状对比分析

分裂样精神病与精神分裂症阴、阳性症状对比分析大庆市第三医院（１６３７１２）于希洋侯兆香邵影关于分裂样精神病（简称ＳＦＰ，下同）的临床症状分析、研究，国内外已有许多报导，但其结果不一。本文就ＳＦＰ者的阴、阳性症状与精神分裂症作一比较分析，报告如下。１资...     

分裂样精神病37例患者的预后观察

通过对一组分裂样精神病患者的前瞻性观察，以DMS－Ⅲ－R所注明“预后良好特点”相对照，表明分裂样精神病的预后良好。     

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。     

Negative symptoms in first episode non-affective psychosis

OBJECTIVE: To determine the prevalence of negative symptoms and to examine secondary sources of influence on negative symptoms and the role of specific negative symptoms in delay associated with seeking treatment in first episode non-affective psychosis. METHOD: One hundred and ten patients who met Diagnostic Statistical Manual-IV (DSM-IV) criteria for a first episode of schizophrenia spectrum psychoses were rated for assessment of negative, positive, depressive and extrapyramidal symptoms, the premorbid adjustment scale and assessment of demographic and clinical characteristics including duration of untreated psychosis (DUP). RESULTS: Alogia/flat affect and avolition/anhedonia were strongly influenced by parkinsonian and depressive symptoms, respectively. A substantial proportion (26.8%) of patients showed at a least moderate level of negative symptoms not confounded by depression and Parkinsonism. DUP was related only to avolition/anhedonia while flat affect/alogia was related to male gender, diagnosis of schizophrenia, age of onset and the length of the prodrome. CONCLUSION: Negative symptoms that are independent of the influence of positive symptoms, depression and extra pyramidal symptoms (EPS) are present in a substantial proportion of first episode psychosis patients and delay in seeking treatment is associated mainly with avolition and anhedonia.     

Illicit substance use and its correlates in first episode psychosis

Mazzoncini R, Donoghue K, Hart J, Morgan C, Doody GA, Dazzan P, Jones PB, Morgan K, Murray RM, Fearon P. Illicit substance use and its correlates in first episode psychosis. Objective: To determine if substance use (particularly cannabis) is more frequent among first episode psychosis patients and associated with a more problematic clinical presentation. Method: All first episode psychosis (FEP) patients presenting to secondary services were recruited from London and Nottingham, over 2 years, in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study broad framework. Clinical and sociodemographic variables were assessed using a set of standardized instruments. A schedule was created to retrospectively collate substance use data from patients, relatives and clinicians. Results: Five hundred and eleven FEP were identified. They used three to five times more substances than general population. Substance use was associated with poorer social adjustment and a more acute mode of onset. Cannabis use did not affect social adjustment, but was associated with a more acute mode of onset. Conclusion: Cannabis has a different impact on FEP than other substances. Large epidemiological studies are needed to disentangle cannabis effect.     

EEG abnormalities and 3-year outcome in first episode psychosis

Objective: This study assesses the relationship of EEG to several aspects of 3 year symptomatic and functional outcome in first episode psychosis. Method: A total of 117 patients with first episode psychosis had their baseline EEG classified by modified Mayo Clinic criteria as normal, essentially normal or dysrhythmia. Socio‐demographic variables, duration of illness and of untreated psychosis and premorbid adjustment were also recorded. Positive and negative symptoms of psychoses, depression, anxiety and global functioning were rated on entry and after 3 years of treatment. Results: Patients with a dysrhythmic EEG at entry into treatment showed significantly greater persistence in both positive and negative symptoms of psychoses as well as anxiety and depression over 3 years. These findings were independent of duration of untreated illness or premorbid adjustment. Conclusion: An abnormal baseline EEG in patients with first episode psychosis is associated with a poorer symptomatic outcome at 3‐year follow‐up.     

The first episode of psychosis: the experience of relatives

OBJECTIVE: The aim was to determine the extent of and the correlates of the distress and impact of care families of patients with first episode psychosis were experiencing when they first came for treatment. METHOD: Subjects were 238 individuals who had presented with a first episode of psychosis and their family members. Family members were assessed with the Psychological General Well-Being Scale, and the Experience of Caregiving Inventory. Patient data included assessment of positive and negative symptoms, depression, quality of life, and substance use. RESULTS: Family members of these first-episode patients were experiencing distress and difficulties. It was the family's appraisal of the impact of the illness that was associated with their psychological well-being. CONCLUSION: As the majority of these first episode families are keen to be involved early and have engaged in an intervention programme, the next step should be an evaluation of their involvement to determine if it is effective.     

Criminal offending and distinguishing features of offenders among persons experiencing a first episode of psychosis

Aims: Persons with severe mental illness (SMI) are at increased risk of criminal offending, particularly violent offending, as compared with the general population. Most offenders with SMI acquire convictions prior to contact with mental health services. This study examined offending among 301 individuals experiencing their first episode of psychosis. Methods: Patients provided information on sociodemographic and clinical variables and completed a neurological soft sign examination and neuropsychological tests. Additional information was extracted from clinical files and official criminal records. Results: The results show that 33.9% of the men and 10.0% of the women had a record of criminal convictions, and 19.9% of the men and 4.6% of the women had been convicted of at least one violent crime. Proportionately more male and female patients than men and women in the general UK population had prior convictions for violent crimes. In a multivariate model including background and clinical variables, only one variable distinguished the male offenders. African‐Caribbean ethnicity was associated with a threefold increase in the odds of offending (odds ratio = 3.84, 95% confidence interval 1.03–14.37). Offenders, as compared with non‐offenders, obtained significantly lower premorbid and current intelligence quotient scores and similar scores on tests of neurological soft signs, working memory and executive functions. Conclusions: At contact with mental health services for a first episode of psychosis, significant numbers of patients have records of criminal convictions and thereby a high risk for future violent behaviour. These patients require specific interventions, in addition to medication, to reduce offending and aggressive behaviour.     

EEG abnormalities and two year outcome in first episode psychosis

OBJECTIVE: This study examines the relationship of EEG to 2 year symptomatic outcome, duration of illness and untreated psychosis and gender. METHOD: A total of 122 patients presenting for treatment of first episode psychosis had their baseline EEG classified by modified Mayo Clinic system criteria as normal, essentially normal or dysrhythmia. Positive and negative symptoms of psychoses were rated on entry and after 2 years of treatment. The socio-demographic variables and duration of illness and of untreated psychosis were also recorded. RESULTS: Patients with a normal EEG showed significantly more reduction in both positive and negative symptoms of psychoses over 2 years and were more likely to be in 'remission' as compared with the essentially normal or dysrhythmia group. The dysrhythmic group had significantly higher duration of illness than either the normal or essentially normal groups. There were no gender differences in the distribution of EEGs. CONCLUSION: An abnormal EEG in patients with first episode psychosis is associated with a poorer prognosis and a longer duration of untreated illness.