影响慢性精神分裂症患者认知功能的多因素分析

目的：探讨慢性精神分裂症病人认知功能的影响因素。方法：采用简明智能评定量表、简明精神病评定量表（BPRS）、自知力与治疗态度问卷（ITAQ）对80例长期住院的慢性精神分裂症病人进行评定，以简明智能评定量表的总分（智能百分比）及其6个因子变量，以能够反映病人病情的BPRS总分、BPRS的5个因子分、ITAQ总分以及病程、Andrensens分型、年龄、首发年龄、受教育年限、家族史等因素为自变量，进行因素分析。结果：显示认知功能和总病情、Andrensens分型和受教育年限等有关，而与病程及其它因素无明显相关，结论：精神分裂症的认知功能障碍与病情和阴性症状密切相关，但不随病程而加重，提示认知功能障碍是独立于阴性症状以外的第三个症状成分。     

精神分裂症患者神经系统软体征的影响因素（附105例分析）

对１０５例住院的男性精神分裂症患者神经系统软体征的影响因素作了调查分析，逐步回归分析表明，软体征的主要影响因素依次为住院时间，阴性症状，文化程度，精神因素，阳性症状及家族史，其中文化程度，精神因素呈负相关，余呈正相关，同时对软体征各因子分的影响因素也分别进行了相应的研究。     

长期住院对精神分裂症患者认知功能的影响

目的：探讨长期住院对精神分裂症患者认知功能的影响。方法：对56例长期住院（≥5年）与49例住院时间较短（≤1年）的精神分裂症患者的精神症状和认知功能进行比较，采用阳性与阴性症状量表（PANSS）、韦氏成人智力量表（WAIS-R）、威斯康星卡片分类试验（WCST）等评定患者的认知功能。结果：长期住院（≥5年）组在智商、注意、记忆，以及信息整合与执行功能等均显著较差。结论：长期住院对精神分裂症患者认知功能有负面影响。     

精神分裂症患者住院时间的相关因素研究

目的探讨精神分裂症患者住院时间的相关因素。方法以我院2009-01—2013-01收治的100例精神分裂症患者为研究对象,对患者的临床资料进行单因素分析和线性相关性分析,比较入院时和出院时PANSS、ITAQ和DAI评分并进行线性相关性分析,对相关因素进行多因素Logistic回归性分析。结果出院时阴性症状评分、阳性症状评分和PANSS总分均低于入院时(P0.05),出院时一般精神病理症状评分高于入院时(P0.05);出院时ITAQ和DAI评分高于入院时(P0.05)。线性相关性分析显示,入院时PANSS阴性症状评分与住院时间呈正相关(r=0.183,P0.05),入院时PANSS阳性症状评分、一般精神病理症状评分、ITAQ和DAI评分及各量表残差与患者住院时间无相关性(P0.05);单因素分析示,住院时间和性别、年龄、受教育年限无相关性(P0.05),与病程呈正相关(r=0.213,P0.05);通过单因素分析确认病程和入院时阴性症状评分是影响住院时间的线性相关因素,对相关因素进行多因素Logistic回归性分析结果显示,病程和入院时阴性症状评分是影响住院时间的独立危险因素,且与住院时间呈正相关(P0.05)。结论病程和入院时阴性症状程度是影响精神分裂症住院时间的相关因素。     

慢性精神分裂症社会功能缺陷的相关因素分析

目的：研究长期住院的慢性精神分裂症患者社会功能缺陷及相关因素，方法；采用住院精神分裂症社会功能缺陷筛选量表，简明精神病评定量表，阳性症状评定量表和阴性症状评定量表，对３８例连续住院精神症患者进行评估。结果：３８例患者ＳＤＳＳ－Ｉ的６个项目具有缺陷，ＳＤＳＳ－Ｉ评分与病期，住院时间，次数评分呈正相关，与假出院天数，参加工娱疗天数呈负相关。     

未婚发病精神分裂症患者的社会功能和影响因素调查

目的 调查首次发病为未婚的社区精神分裂症病人的社会功能状况和影响因素。方法 以自制调查问卷、简明精神症状量表(BPRS)、阳性症状量表(SAPS)、阴性症状量表(SANS)和社会功能缺陷筛选量表(SDSS)，对未婚发病的社区精神分裂症病人进行调查：结果 共完成有效调查642例，存在社会功能缺陷者508例，占79．1％。主要表现在职业与工作功能、对外界的兴趣、缺乏责任心和计划性、社会退缩，分析表明，与社会功能缺陷密切相关的显著性因素除了阳性、阴性精神症状的严重程度之外，回归分析还显示其影响因素依次为婚姻、住院次数、文化程度、职业。结论 社区中未婚发病的精神分裂症患者的社会功能残疾仍较为普遍，应该重视这些患者的社会康复。     

影响男性长期住院精神分裂症患者注意及记忆力的相关因素分析

目的探讨影响男性长期住院精神分裂症患者注意及记忆功能的相关因素。方法采用重复性成套神经心理状态测验(RBANS)中Stroop色词测验(SCW)、持续操作测验(CPT)、数字序列测验、言语记忆及视觉记忆测验对120名男性长期住院(≥5年)精神分裂症患者进行测查,结果与患者一般资料做Pearson相关分析。结果男性长期住院精神分裂症患者的年龄、起病年龄、住院时间、受教育年限、PANSS总分、阴性症状量表分与注意、记忆损害相关,而总病程、既往住院次数、苯海索的使用以及阳性量表分、一般精神病理学分、家族史与注意、记忆损害无明显相关。结论男性慢性精神分裂症患者的注意、记忆损害受多种因素影响,患者症状越重,注意、记忆功能受损越重,尤其阴性症状影响明显,同时,年龄偏大,起病年龄低,文化程度低,住院时间长均影响精神分裂症患者的注意、记忆功能,应该引起临床关注。     

阿尔茨海默病和血管性痴呆的临床症状研究

目的：了解阿尔茨海默病(AD)和血管性痴呆(VD)患者不同严重程度痴呆时临床症状。方法：认知功能测试量表采用简易智力状态检查(MMSE)、日常生活活动能力量表(ADL)，精神行为症状采用汉密尔顿抑郁量表(HAMD)、老年临床评定量表(SCAG)对住院AD157例及VD150例进行测试。结果：两组患者有不同程度的认知功能障碍及精神行为症状。AD组患者认知功能较差，VD组患者躯体生活自理较差。结论：不同严重程度的AD和VD患者临床症状有差异。     

帕金森病伴发认知功能障碍的相关因素分析

目的 探讨认知功能障碍在帕金森病中（Parkinson＇s disease,PD）的发生率及其影响因素.方法 对确诊的PD患者采用蒙特利尔认知评价量表（Montreal Cognitive Assessment MOCA中文版）、汉密尔顿抑郁量表（Hamilt depression scale,HAMD）及Webster功能评分量表进行评定分析PD伴发认知功能障碍的发生情况和相关影响因素.结果 PD伴发认知功能障碍者50例,认知功能障碍的发生率为76.9%,病程、文化程度、Webster评分、HAMD评分与帕金森病伴发认知功能障碍的发生均有统计学意义（P＜0.05）,年龄、性别、婚姻状况、经济情况与帕金森伴发认知功能障碍的发生均无统计学意义（P＞0.05）.回归分析发现病程和PD病情严重程度是PD患者伴发认知功能障碍的危险因素.结论 PD患者有较高认知功能障碍的发生率,PD伴发认知功能障碍的发生可能与PD患者的病程、文化程度、PD患者病情的严重程度及抑郁有关.     

首发及慢性精神分裂症患者与健康人认知功能的差异

目的比较首发及慢性精神分裂症与健康人认知功能的差异,并探讨影响认知功能的相关因素。方法符合美国精神障碍诊断与统计手册第四版（DSM—Ⅳ）诊断标准的首发精神分裂症住院患者90例,慢性精神分裂症患者89例,健康人94例;使用重复性神经心理测查系统（RBANS）检测认知功能,阳性和阴性症状量表（PAN-SS）、临床总体印象量表（CGI）评估患者精神症状及严重程度,Simpson锥体外系不良反应量表（SEPS）、异常不自主运动评定量表（AIMS）评定锥体外系不良反应及迟发性运动障碍。结果三组教育年限之间差异有统计学意义（F=41,P〈0．001）,即刻记忆和延时记忆因子在慢性患者和首发患者之间差异不显著,无统计学意义（P=0．42,P=0.13）,RBANS总分及其它因子分在三组之间均有显著性差异（P〈0.05—0．001）;慢性患者的受教育年限、既往住院次数、病程、精神症状、AIMS、SEPS与认知功能存在着显著相关性（P〈0．05～0．000）;首发患者的年龄、受教育年限、首次精神症状发生年龄、精神症状、CGI与认知功能存在着显著相关性（P〈0．05—0．000）。结论认知功能障碍是精神分裂症的核心症状之一;影响首发精神分裂症和慢性分裂症患者认知功能的因素有一定的差异。     

血管性痴呆精神行为学症状的相关因素分析

目的 了解血管性痴呆(VaD)患者的精神行为学症状特点及与认知障碍、年龄、受教育程度等因素的相关性,探讨神经精神科问卷(NPI)中不同因子之间的内在联系. 方法 采用NPI和简易智能状态检查量表(MMSE),分别评价120例VaD患者和61例健康老年人的精神行为学症状. 结果 VaD组患者NPI量表中的妄想、幻觉、激越、抑郁/心境恶劣、淡漠、易激惹、异常行为、食欲和饮食障碍等8个症状得分均明显高于正常对照组,差异有统计学意义(P＜0.05),其中得分最高的3个症状依次为抑郁/心境恶劣、情感淡漠、易激惹;其中幻觉、情感淡漠、异常行为等因子与认知障碍程度高度相关;异常行为与年龄、受教育程度均相关;同时对NPI各因子进行分析,获得了3个亚综合征,分别代表精神病性、情感异常和失控制行为. 结论 VaD患者普遍存在精神行为学症状,其症状的出现及严重程度与认知障碍、年龄、受教育程度有不同程度的相关性,各亚综合征中的子因子可能存在共同的病理生理基础.     

Resilience and rejection sensitivity mediate long-term outcomes of parental divorce

Increasing divorce rates leave more and more children to deal with the separation of their parents. Recent research suggests that children of divorced parents more often experience psychological and physical symptoms than children of non-divorced parents. The processes that mediate the relationship between parental divorce and ill-health, however, are still elusive. This study investigated the mediating role of psychological factors such as resilience and rejection sensitivity on the long-term consequences of parental divorce in young adults. One hundred and ninety-nine participants (mean age 22.3 years) completed an online survey, including measures of mental health, childhood trauma, resilience, and rejection sensitivity. Participants with divorced parents (33 %) reported increased levels of psychological symptoms, childhood trauma, rejection sensitivity, and lower levels of resilience. The association between parental divorce and mental health was fully mediated by resilience, rejection sensitivity, and childhood trauma. The mediation model explained up to 44 % of the total variance in mental health symptoms. Resilience and rejection sensitivity are crucial factors for successful coping with the experience of parental separation. Prevention programs that help to boost children’s resilience might help to reduce the long-term effects of parental divorce on their attachment style (e.g., rejection sensitivity), thereby improving their mental health on the long run. Furthermore, the results call for parental awareness and counseling to target and reduce the observed increased level of childhood trauma. Limitations concern the cross-sectional and retrospective design of the study.     

Symptomatological and cognitive predictors of insight in chronic schizophrenia

Studies of schizophrenia show lack of agreement about the relationship of symptomatological and cognitive factors to insight. In this study, positive and negative symptomatology and cognitive function were assessed by the Positive and Negative Syndrome Scale (PANSS), the Wisconsin Card Sorting Test (WCST), and the Wechsler Adult Intelligence Scale Revised (WAIS-R) in male chronic schizophrenic patients in relation to level of insight measured with the Japanese version of the Schedule for the Assessment of Insight (SAI-J). Negative symptoms were significantly and negatively associated with overall insight, particularly with treatment compliance and recognition of mental illness. The present findings suggest that aspects of insight such as treatment compliance and recognition of mental illness are negatively associated with negative symptoms.     

Sensory modulation and daily-life participation in people with schizophrenia

Schizophrenia is considered to be an extreme mental health disturbance that affects a person's well-being and participation in everyday activities. Participation in meaningful everyday occupations is an important component of recovery from mental illness, the ultimate goal of mental health services. The participation restrictions of people with schizophrenia have been widely investigated through different factors, such as illness symptoms and course, cognition, and demographic data; however, the resulting explanations were incomplete. The purpose of the study was to explore the contribution of sensory modulation (SM), in addition to cognition and schizophrenia symptoms, to participation in daily life activities of people with schizophrenia. Forty nine in-patients with schizophrenia (study group) and 32 adults without mental illness (control group) comprised the study. They were assessed for their participation patterns, sensory modulation processes, cognitive functioning and symptoms severity. Results indicate significant differences between the study groups in most measurements addressed: participation (diversity and satisfaction), sensory modulation scores (intensity of the response and frequency of response), and cognitive measurements. The most contributive parameters for the prediction of participation dimensions among people with schizophrenia were negative symptoms severity and general cognitive status. In conclusion, people with schizophrenia experience SM disorder with an under responsive tendency. However the complex condition of schizophrenia dominates its influence on participation dimensions.     

Abnormal involuntary movements and chronic schizophrenic disorders

We hypothesized that chronic schizophrenic patients with abnormal involuntary movements would exhibit specific psychopathological, neurological, and cognitive disturbances at a more severe level than those free of such movements. Twenty-two chronic schizophrenic patients were assessed for abnormal movements, cognitive impairment, psychopathology, and medication history. Unequivocal evidence of movement abnormality on the Abnormal Involuntary Movement Scale divided the subjects into groups with (n = 13) and without (n = 9) involuntary movement anomaly. Age, education, length of illness, depressive symptoms, total symptom ratings, and medication variables did not differ in the two groups. However, the group with involuntary movements had more negative symptomatology, greater impairment on voluntary motor tasks, lower premorbid intelligence, and a trend toward poorer recall on mental status examination. These results demonstrate that schizophrenic patients with abnormal involuntary movements have more severe psychopathology as reflected in certain defect symptoms, more abnormal voluntary movements, and more cognitive impairment than schizophrenic patients without involuntary movements.     

The question of autism in an atypical infant

The evaluation and brief treatment of a less-than-a-year-old girl whose parents were concerned she was autistic is described. We review what is known about the initial symptoms of autism and consider how early it is feasible to make a diagnosis. We outline the domains of cognitive, language, and social development that ought to be monitored given concern about autism and explain how we evaluated these domains in our home-based intervention. Finally, we consider possible explanations for this infant's recovery from a serious early disturbance in social relatedness.     

Associations between adolescent depression and parental mental health, before and after treatment of adolescent depression

The negative impacts of parental mental health problems on children and adolescents are well known, but the relationship between a child’s depression and their parents’ health is not so well understood. Being a carer/parent of someone with mental illness can be associated with negative outcomes for the caregiver. This paper reports the associations between the mental health of adolescents with major depression and their parents, before and after treatment of the adolescent’s depression. Data were collected as part of the Adolescent Depression Antidepressants and Psychotherapy Trial, a randomised controlled trial of selective serotonin reuptake inhibitors with and without cognitive behaviour therapy in 208 clinic-recruited adolescents with major depression. The baseline severity of depression in the adolescent was significantly associated with both maternal and paternal mental health (as rated by the General Health Questionnaire). This effect was not confounded by other psychiatric symptoms. The degree of improvement in parental and child mental health was positively correlated across time. Our results support the hypothesis that there is a significant association between parental mental health and adolescent depressive symptoms. This study was not able to establish the direction of this association. In clinical practice, the findings demonstrate the importance of considering the mental health of the parents when treating depressed adolescents.     

The biopsychosocial effects of restless legs syndrome (RLS)

The symptoms of restless legs syndrome (RLS) are associated with reductions in patients’ quality of life (QoL) and mental heath. Sleep disturbance, which is often the most troublesome symptom of RLS, may have a negative impact on patients’ daytime cognitive abilities. Research has established a relationship between the symptoms of RLS and mood symptoms, but causality is unclear. Some studies have indicated that the symptoms of RLS precede those of depression or anxiety, and others relate the severity of mood symptoms to the severity of RLS symptoms. Associations between the sleep disturbance produced by RLS and patients’ mood symptoms have also been demonstrated. The impact of RLS symptoms and their treatment on QoL, mental health, and cognition are reviewed herein.     

Self‐esteem and symptoms of depression in children with seizures: Relationships with neuropsychological functioning and family variables over time

Purpose: To test over time the relationships of neuropsychological functioning to mental health in children following a first recognized seizure and, of primary importance, to determine if the strength of these relationships differs based on risk and protective factors. Methods: In a larger prospective study, 135 children with a first seizure (ages 8–14 years) and 73 healthy sibling controls completed neuropsychological testing at baseline and 36 months. Structured telephone interviews were used to obtain data from children on mental health and family environment; major caregiving parents provided data on demographic and family variables. Data analyses included correlation coefficients and linear regression models. Results: Children with seizures showed an overall trend for improvement in mental health. More children with seizures than siblings had declines in processing speed. Declines in neuropsychological functioning were correlated with worse mental health. With regard to risk and protective factors, higher parent education protected against decline in self‐esteem related to decline in processing speed. Better family functioning and greater parental support protected against decline in self‐esteem related to decrease in verbal memory and learning. Older child age protected against increase in depressive symptoms related to decline in processing speed. Discussion: Seizure onset had a negative impact on mental health in children with declines in cognitive functioning except for older children and those with more family resources. Children should be assessed for declines in processing speed and, if found, those subgroups of children with less educated or more anxious parents and those in less supportive families should be targeted for interventions.     

认知功能障碍与血清白细胞介素2的关系

目的 :探讨精神分裂症患者认知功能损害与精神症状及血清白细胞介素 2 (IL 2 )水平的关系。　方法 :在 5 7例未服抗精神病药的患者中 ,采用数字划销测验 (CT)、韦氏成人记忆量表 (WMS RC)、威斯康星卡片分类测验 (WCST)测试认知功能 ,用阳性症状与阴性症状量表 (PANSS)评定精神症状 ,同时测定血清IL 2浓度 ,分析其间的关系 ;并将记忆商数 (MQ)≤ 85者与MQ >85者比较血清IL 2水平及精神症状。　结果 :阴性症状分与各项认知测验的成绩均呈显著相关 ,部分认知损害还与一般病理性症状分相关 ,阳性症状分与所有认知测验的成绩均无相关性 ;血清IL 2水平与注意力、记忆力测验成绩呈显著负相关 ,与WCST测验成绩不相关 ;MQ≤ 85者与MQ >85者比较血清IL 2水平及阴性症状显著增高。　结论 :精神分裂症认知损害与阴性症状相关 ,与阳性症状不相关 ;血清IL 2水平可能与精神分裂症的注意力、记忆力损害相联系