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1.
目的:验证氟西汀治疗持续的躯体形式疼痛障碍的镇痛疗效。方法:80例持续的躯体形式疼痛障碍患者,随机分为氟西汀组和安慰剂组,观察8周,采用医学结局研究用疼痛量表(MOSPM)和汉密尔顿抑郁量表17项(HAMD17)评估氟西汀镇痛疗效。结果:与安慰剂组相比,治疗8周后氟西汀组MOSPM总分降低显著低于安慰剂组。治疗第2周末氟西汀组与安慰剂组间有统计学差异。氟西汀组患者中,伴有抑郁情绪的患者镇痛疗效较好。结论:氟西汀治疗持续的躯体形式疼痛障碍有效。  相似文献   

2.

Background

Several studies demonstrated that depressed patients had low serum BDNF levels which correlated with the severity of their depression, and antidepressant treatment increases levels of serum BDNF in depressed patients. It was speculated that agents acting on both noradrenergic and serotonergic transporters might have a greater influence on BDNF levels. The aim of our study was to determine effects of venlafaxine vs. fluoxetine on serum BDNF levels in depressive patients.

Methods

Forty-three patients diagnosed as major depressive disorder according to DSM-IV are included in the study. Forty-three patients were randomized to take fluoxetine (22 cases) or venlafaxine (21 cases). Serum levels of BDNF were measured by ELISA at baseline and 6 weeks after the start of treatment.

Results

Baseline levels of BDNF were not significantly different between the patient group and the controls. But male patients and the male controls showed statistical differences with respect to baseline BDNF levels. BDNF levels of the patient group did not change with treatment. Yet, the increase of BDNF levels was close to statistically significant in the fluoxetine group, whereas not significant in the venlafaxine group. There were no significant differences in baseline and 6th week BDNF levels between the responders and the non-responders.

Conclusion

Further studies controlling for a wide variety of confounding variables are needed, which may help to reach a clear conclusion about the potential of BDNF as a biomarker for depression or as a predictor of antidepressant efficacy.  相似文献   

3.

Background

The duration of clinical control of motor symptoms of Parkinson disease (PD) treated with levodopa/carbidopa preparations eventually starts to shorten, a phenomenon known as end-of-dose “wearing off.” The involvement of core nonmotor symptoms of “wearing off” (depressed mood, pain/aching, anxiety, and cloudy/slowed thinking) is not well understood.

Methods

A post hoc analysis from a study to validate the self-rated 9-item, Wearing-Off Questionnaire (WOQ-9), which was designed to identify motor and nonmotor symptoms of “wearing off” in PD patients, was performed to compare the frequency and sensitivity of motor and nonmotor symptoms of “wearing off” from dopaminergic therapy.

Results

Analysis of responses to the WOQ-9 from 216 PD patients found that individual nonmotor symptoms were reported by 25% to 50% and motor symptoms by 55% to 80% of patients. Individual nonmotor symptoms improved following the next dose of dopaminergic therapy in 43% to 53% of the patients who presented with such symptoms, whereas motor symptoms improved in 48% to 66% of the cases, suggesting both types of symptoms respond to dopaminergic therapies.

Conclusion

Nonmotor symptoms of PD appear sensitive to dopaminergic treatment. These symptoms resemble those seen with depressive, anxiety, and somatoform disorders suggesting potential shared mechanisms as well as possible treatment implications.  相似文献   

4.

Background

Brain morphometric measures from magnetic resonance imaging (MRI) have not been used to discriminate between first-episode patients with schizophrenia and healthy subjects.

Methods

Magnetic resonance images were acquired from 34 (17 males, 17 females) first-episode schizophrenia patients and 48 (24 males, 24 females) age- and parental socio-economic status-matched healthy subjects. Twenty-nine regions of interest (ROI) were measured on 1-mm-thick coronal slices from the prefrontal and central parts of the brain. Linear discriminant function analysis was conducted using standardized z scores of the volumes of each ROI.

Results

Discriminant function analysis with cross-validation procedures revealed that brain anatomical variables correctly classified 75.6% of male subjects and 82.9% of female subjects, respectively. The results of the volumetric comparisons of each ROI between patients and controls were generally consistent with those of the previous literature.

Conclusions

To our knowledge, this study provides the first evidence of MRI-based successful classification between first-episode patients with schizophrenia and healthy controls. The potential of these methods for early detection of schizophrenia should be further explored.  相似文献   

5.
目的 初步探索氟西汀治疗持续的躯体形式疼痛障碍(PSPD)的成本-效果分析.方法 将80例PSPD患者随机分为氟西汀组和安慰剂组,每组各40例,分别服用氟西汀胶囊(20 ms/d)和安慰剂胶囊(1粒/d)8周,研究者和患者双肓.调查入组前后直接医疗成本,计算两组患者入组前后共4个月的成本与效果比值.结果 (1)氟西汀组有效率为40%,安慰剂组有效率为8%.(2)氟西汀组和安慰剂组成本与效果比值分别为0.53万元(5345元)和1.83万元(18 345元).(3)敏感度分析,氟西汀组和安慰剂组的成本与效果比值分别为0.40万元(4033元)和1.22万元(12 188元).结论 应用氟西汀治疗PSPD的成本与效果比值较低,具有较好的药物经济学价值.  相似文献   

6.

Background

Cardiopulmonary exercise testing (CPET) provides insights into ventilatory, cardiac and metabolic dysfunction in heart and lung diseases and might play a role in cardiac risk stratification in major depressive disorder (MDD).

Objective

The VE/VCO2-slope indicates ventilatory efficiency and has been applied to stratify the cardiac risk in heart failure (HF). Therefore, the current study was conducted to evaluate and classify ventilatory efficiency and its relationship to physical fitness and disease severity in MDD.

Methods

Exhaustive incremental exercise testing was completed by 15 female MDD patients and pair matched controls. The ventilatory threshold (VT) and the VE/VCO2-slope were assessed. Statistical analyses were conducted by means of MANOVAs and follow-up univariate ANOVAs.

Results

In patients with MDD, significant different relative work rates and oxygen uptakes at the VT in comparison to healthy controls were observed. Furthermore, we found an increased VE/VCO2-slope in depressed patients. We additionally report an inverse relationship between the VE/VCO2-slope and peak power output as well as peak oxygen uptake solely in patients. We did not observe any association of assessed parameters with disease severity.

Conclusion

CPET measures indicate ventilatory inefficiency in patients with MDD. The elevated VE/VCO2-slope indicates that patients with MDD need to ventilate significantly more to a given amount of developing CO2. Further investigations are needed to verify the application of the ventilatory classification system to stratify cardiovascular risk in depressive disorder.  相似文献   

7.

Purpose

Autism is a childhood-onset neurodevelopmental disorder with a strong genetic component in its etiology. Several studies reported that the solute carrier family 25 member A12 (SLC25A12) gene was associated with autism. This study aimed to replicate this finding in a Han Chinese sample from Taiwan using a population-based case–control approach.

Methods

We genotyped two single nucleotide polymorphisms (SNPs, rs2056202 and rs2292813) of the SLC25A12 gene that were previously reported to be associated with autism in 465 patients (402 males and 63 females) and 450 control subjects (227 males and 223 females) from Taiwan. Differences in the genotype, allele, and haplotype frequencies between the two groups were compared.

Results

We found no differences in the allele, genotype, or haplotype frequencies of these two SNPs between patients and controls.

Conclusions

Our data do not support that the SLC25A12 gene is associated with autism in our population. The discrepant results of other studies may come from the clinical heterogeneity of patients recruited for studies, or the genetic heterogeneity of autism in different populations.  相似文献   

8.

Background

Pharmacogenetics of tardive dyskinesia and dopamine D3 (DRD3), serotonin 2A (HTR2A), and 2C (HTR2C) receptors has been examined in various populations, but not in Russians.

Purpose

To investigate the association between orofaciolingual (TDof) and limb-truncal dyskinesias (TDlt) and Ser9Gly (DRD3), -1438G>A (HTR2A), and Cys23Ser (HTR2C) polymorphisms in Russian psychiatric inpatients from Tomsk, Siberia.

Methods

In total, 146 subjects were included. Standard protocols were applied for genotyping. TDof and TDlt were assessed with AIMS items 1–4 and 5–7, respectively. Two-part model, logistic and log-normal regression analyses were applied to assess different variables (e.g., allele-carriership status, age, gender, and medication use).

Results

TDlt, but not TDof, exhibited an association with Ser9Gly and Cys23Ser (with 9Gly and 23Ser alleles exhibiting opposite effects). However, -1438G>A was not associated with TDof and Dlt.

Conclusions

This is the first pharmacogenetic report on tardive dyskinesia in Russians. Subject to further replication, our findings extend and support the available data.  相似文献   

9.

Background

Studies have yielded conflicting results concerning flow cytometric lymphocyte analyses in patients with depression. Data about the effect of antidepressants on lymphocyte subsets are also contradictory. The aim of this study was to determine effects of venlafaxine versus fluoxetine on lymphocyte subsets in depressive patients.

Methods

Sixty-nine patients diagnosed with major depressive disorder (MDD) according to DSM-IV and 36 healthy controls are included in the study. Sixty-nine patients were randomized to take fluoxetine (FLX) (n = 33) or venlafaxine (VEN) (n = 36). Serum lymphocyte subsets included CD3, CD4, CD8, CD16/56, CD19, CD45, Anti-HLA-DR which were measured by flow cytometric analyses at baseline and 6 weeks after the start of treatment. The severity of depression was evaluated with Hamilton rating scale for depression.

Results

At baseline, patients with MDD had significantly lower CD16/56 ratio and higher CD45 ratio compared to the controls. Although numerically higher in the VEN treated patients, treatment response rates between the FLX (53%) and the VEN (75%) groups were not different statistically. CD45 values decreased significantly in the VEN group at the end of the 6 week treatment period whereas no difference was observed in the FLX group. By the 6th week, treatment responders showed a significantly higher CD16/56 ratio than non-responders. Baseline severity of depression and anxiety was positively correlated with baseline CD45 ratio and negatively correlated with baseline CD16/56 ratio. We did not observe consistent changes in the absolute number of circulating B or T cells, nor in the helper/inducer (CD4) or suppressor/cytotoxic (CD8) subsets.

Conclusions

CD16/56 was lower in patients with MDD and increased in treatment responders at 6th week. CD45 ratio was higher in patients with MDD than healthy subjects; it decreased with antidepressant treatment and was positively correlated with the severity of depression. Antidepressant treatment contributes to immune regulation in patients with major depressive disorder.  相似文献   

10.
目的探讨持续性躯体形式疼痛障碍(persist somatoform pain disorder,PSPD)患者的生命质量及相关因素。方法采用横断面调查研究,对60例PSPD患者应用健康状况调查问卷(SF-36)评定其生命质量,医疗结局研究用疼痛量表(MOSPM)评定PSPD严重程度,汉密顿抑郁量表(HAMD17),汉密顿焦虑量表(HAMA)评定伴随的情绪状态。结果(1)除精神健康和精力分量表外,SF-36各分量表评分均显著低于普通居民(P〈0.01);(2)除一般健康状况分量表外,SF-36各分量表评分与MOSPM总分及各因子分均显著负相关,与HAMD17及HAMA总分显著负相关;(3)除一般健康状况分量表外,有抑郁组的SF-36各分量表、躯体健康总评(PCS)及精神健康总评(MCS)分均显著低于无抑郁组(P〈0.01);(4)多元逐步回归结果,SF-36的PCS与年龄和MOSPM总分相关,MCS则与HAMD总分和MOSPM总分相关。结论PSPD患者的生命质量显著低于普通人群,疼痛症状、抑郁和焦虑情绪与患者的生命质量密切相关,年龄、疼痛、抑郁为PCS和MCS重要影响因素。  相似文献   

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