精神分裂症患者社会功能与护理对策

精神分裂症患者社会功能与护理对策朱玲精神分裂症患者出院后急性精神症状基本消失，但常遗留社会功能缺陷。本研究调查其可能的有关因素，并讨论相应的护理对策。对象与方法对象：均系１９９０年１月～１９９４年６月的精神分裂症出院患者，符合ＣＣＭＤ—２诊断标准，病...     

不同文化程度的精神分裂症患者行为障碍临床观察

不同文化程度的精神分裂症患者行为障碍临床观察耿跃雨蒲晓庆对１９９４年５～７月住院的３００例精神分裂症患者进行临床症状观察，比较不同文化程度患者行为障碍的差异。其中男１８０例，女１２０例。符合ＣＣＭＤ—２诊断标准。年龄１５～６９岁，平均３５．０±１１．...     

精神分裂症住院患者的苯二氮类药物使用情况调查

近年来,苯二氮艹卓类（ＢＺＤ）的滥用问题越来越引起了人们的重视。我们调查了本院住院精神分裂症病人中ＢＺＤ的应用情况,现报道如下：１对象与方法查阅我院１９９６年６月～１９９７年５月住院的精神分裂症患者９２３例,诊断皆符合ＣＣＭＤ－２标准。年龄１６～６１...     

未婚精神分裂症女性患者对婚姻的心态

对１９９０年３月～１９９６年６月期间的未婚精神分裂症住院女性患者进行调查，均符合ＣＣＭＤ－２－Ｒ诊断标准。年龄１８～２９岁，平均２２．１±３．８岁；病期４月～６年，平均２１．６±１８．４月；住院１～４次，平均１．３±０．７次。病情均已缓解，共１００例...     

住院精神分裂症患者的自杀

对１９７８年７月～１９９７年１１月在我院住院的精神分裂症患者自杀情况进行分析。１临床资料患者均符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准,在住院期间死亡者４９６例,男３２２例,女１７４例;其中自杀死亡３４例（６．９％）,男２８例,女６例。已婚１１例,无偶...     

利培酮对血清催乳素的影响

对以用利培酮治疗的精神分裂症患者作血清催乳素（ＰＲＬ）测查,以探讨利培酮的作用机理。１　对象与方法对符合ＣＣＭＤ２Ｒ精神分裂症诊断标准的女性住院患者３２例进行观察,均排除躯体疾病、妊娠、哺乳期及月经期妇女。年龄１８～４８岁,平均３７２岁;病程４月～２４年,平均７４年;利培酮剂量２～６ｍｇ／ｄ,平均３７ｍｇ／ｄ;用药７～１４５天,平均２９６天。以４０名健康妇女为对照,平均年龄为３６１岁,与观察组相仿（Ｐ＞００５）。使用美国德普公司生产的ＧＡＭＭＡＣ１２γ计数器,计量为ｎｇ／ｍｌ…     

精神分裂症患者性别,年龄与药物有效剂量的相关性

精神分裂症患者性别、年龄与药物有效剂量的相关性凌云熹作者对１９９１年１月～１９９２年８月期间出院，符合ＣＣＭＤ—２精神分裂症诊断标准的病例进行分析。选择单用一种抗精神病药，且不合用抗胆碱能药物而无严重锥外系等副反应的患者，其最大治疗剂量使用６周以上，...     

利培酮与氯氮平治疗精神分裂症比较

探讨利培酮治疗精神分裂症患者的长期疗效、安全性及依从性,以氯氮平为对照,报告如下。１对象与方法１．１研究对象：共１２０例,系１９９７年２～１０月在我院住院的病人,均符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准。年龄１８～７３岁,其中男性７６例,女性４４例;...     

89例早发与晚发性精神分裂症临床比较

８９例早发与晚发性精神分裂症临床比较郑华胜，冯丽华，欧文前本研究将早发与晚发性精神分裂症的临床特征与性别、年龄之间的差异进行比较，现报告如下。资料对象与方法：病例均选择于１９９３年１～６月首次发病的住院精神病人，符合ＣＣＭＤ－２精神分裂症的诊断标准，...     

精神分裂症患者自杀未遂对照研究

精神分裂症患者自杀未遂对照研究刘华清，梁红导师张培琰Ｏｓｍｏｎｄ等报告精神分裂症的自杀率是正常人群的２０倍，我们时连续住院的精神分裂症中自杀未遂的患者进行对照研究。对１９８４年６月～１９９４年６月在北京回龙观医院两个病区的符合ＣＣＭＤ一２诊断标准精神...     

Self-report of family functioning and risk for psychotic disorders in male adolescents with behavioural disturbances

Objective: Previous studies indicate that a poor family environment might affect vulnerability for the later manifestation of psychotic illness. The current study aims to examine family functioning prior to the onset of psychosis. Method: Subjects were 42 948, 17‐year old males with behavioural disturbances who were asked about the functioning of their family by the Israeli Draft Board. Data on later psychiatric hospitalizations were obtained from a National Psychiatric Hospitalization Registry. Results: Poorer self‐reported family functioning was associated with greater risk for later hospitalization for psychosis [adjusted hazard ratio (HR) = 1.16, 95% CI = 1.05–1.27], with a trend in the same direction for schizophrenia (adjusted HR = 1.1, 95% CI = 0.98–1.24). Conclusion: In male adolescents with behavioural disturbances, perceived poorer family functioning is associated with increased risk for non‐affective psychotic disorders and schizophrenia. These data do not enable us to determine if perceived familial dysfunction increases vulnerability for psychosis, if premorbid behavioural abnormalities disrupt family life, or neither.     

Do premorbid impairments predict emergent ‘prodromal’ symptoms in young relatives at risk for schizophrenia?

Aims: Individuals at risk for developing schizophrenia (SZ) in the future frequently exhibit subtle behavioural and neurobiological abnormalities in their childhood. A better understanding of the role of these abnormalities in predicting later onset of ‘prodromal’ symptoms or psychosis may help in early identification of SZ. Methods: In an ongoing prospective follow‐up study of young genetically at‐risk relatives of patients with SZ, we studied the prevalence of problems in premorbid social adjustment and childhood psychopathology and examined their relationship with the presence and progression of ‘prodromal’ symptoms of SZ. Results: Growth curve analyses showed that ‘prodromal’ symptoms, as measured by the Scale of ‘Prodromal’ Symptoms, increased during follow‐up. Premorbid maladjustment and childhood behavioural disturbances were cross‐sectionally correlated broadly with ‘prodromal’ symptomatology scores. Longitudinal analyses revealed that behavioural disturbances, but not childhood maladjustment at baseline, significantly predicted increases in ‘prodromal’ symptomatology during the 2‐year study period. Conclusion: Premorbid behavioural disturbance and maladjustment may predict the later emergence of ‘prodromal’ symptoms. ‘Prodromal’ symptoms in young at‐risk relatives may define a subgroup worthy of follow‐up into the age of risk for psychosis in order to cost‐effectively characterize the predictors of psychotic symptoms and SZ.     

Pursuit tracking impairments in schizophrenia and mood disorders: step-ramp studies with unmedicated patients.

BACKGROUND: Eye tracking abnormalities are highly prevalent in schizophrenia, and are among the most promising phenotypic familial markers for the disorder. The neurophysiologic mechanisms underlying these disturbances and their diagnostic specificity for schizophrenia are not yet well characterized. METHODS: This study assessed eye tracking deficits using foveopetal and foveofugal step-ramp tasks (ramps moving toward and away from central fixation after an initial step respectively) across a range of target velocities in anti-psychotic-naive schizophrenia patients, previously treated but currently unmedicated chronic schizophrenia patients, unmedicated patients with either bipolar or unipolar mood disorders, and healthy volunteers. RESULTS: All patient groups demonstrated reduced pursuit gain in open loop and closed loop visual tracking conditions. There were no significant group differences in the latency or accuracy of catch-up saccades on foveofugal ramp tasks. CONCLUSIONS: These findings indicate that open and closed loop pursuit eye movements are impaired during acute episodes of schizophrenia and mood disorders. The intact accuracy of saccades to moving targets in all patient groups indicates that an adequate representation of motion information is available to the saccade system. Therefore, pursuit disturbances in mood disorders and schizophrenia seem to result, at least in part, from a disturbance in sensorimotor integration in the pursuit system after the initial extraction of sensory motion information. No eye movement abnormalities observed during performance of step ramp tasks were specific to schizophrenia.     

Frontotemporal dementia and neuropsychology: the value of missing values

OBJECTIVE: To investigate the effect of missing values due to behavioural disturbances on the neuropsychological test profile in frontotemporal dementia (FTD). The neuropsychological examination of patients with FTD poses a methodological problem. In many patients it is impossible to administer a complete test battery, due to behavioural disturbances inherent to the disease. This study describes the test behaviour of patients with FTD, the number of missing values due to disturbed test behaviour, and its influence on neuropsychological test results. METHODS: Thirty one patients with probable FTD were administered a neuropsychological test battery including measures of memory, intelligence, and executive functioning. Moreover, patients were rated on a global deterioration scale and a test behaviour scale, constructed for this study. RESULTS: The more disturbing the test behaviour, the less tests were assessable, leading to many missing values. The most disturbing features were "positive symptoms" of FTD, such as perseveration and stimulus boundedness. The effect of test behaviour was largest for tests measuring executive functions and reasoning capabilities. The replacement of the missing values due to behavioural disturbances by the lowest score also showed the largest effect on tests of executive function and reasoning abilities. CONCLUSION: Data imputation of missing values due to test behaviour disturbances provides a more differentiated picture of cognitive deficits in FTD.     

Eye movement disturbances and working memory deficit in bipolar affective disorder

THE AIM AND METHODS: The aim of this study was to assess the intensity and frequency of eye movement abnormalities measured with infrared reflectometry, and working memory disturbances assessed with the Wisconsin Card Sorting Test (WCST). The study was performed in 87 patients with bipolar affective illness, in 119 patients with schizophrenia and in 90 healthy persons. In patients, the assessment was done during a mild symptomatic period or in remission. RESULTS: In patients with bipolar affective illness significant disturbances of eye movement and working memory compared with healthy subjects were found. Frequency and intensity of fixation abnormalities was less intense compared to schizophrenic patients, while smooth pursuit abnormalities had a similar degree. Working memory disturbances in bipolar patients were, as to the ability of formulation of logical conception, of similar degree as in schizophrenia. On the other hand, as to the effectiveness of thinking, no difference compared with healthy controls was found. CONCLUSIONS: The results obtained suggest that eye movement and working memory disturbances may constitute neurophysiological and neuropsychological endophenotypic markers of bipolar affective illness what makes possible using them in molecular genetic studies of this illness.     

Sexual disturbances during clozapine and haloperidol treatment for schizophrenia

OBJECTIVE: The aim of this study was to evaluate the frequency and course of sexual disturbances associated with clozapine and haloperidol and their potential influence on compliance with medication regimens in patients with schizophrenia. METHOD: The authors prospectively investigated 153 patients with schizophrenia who received clozapine (N = 100) or haloperidol (N = 53) in a drug monitoring program. RESULTS: The frequency of sexual disturbances was lower in female patients than in male patients. There was no statistically significant difference between the patients taking haloperidol and those taking clozapine in the frequency of these disturbances. Clozapine plasma levels had a significant effect on diminished sexual desire and functional disturbances in male patients. Functional disturbances and diminished sexual desire did not have any influence on compliance in patients taking either haloperidol or clozapine. CONCLUSIONS: There was no statistically significant difference between haloperidol and clozapine in regard to their propensity to induce sexual side effects.     

Behavioural and emotional disturbances in people with Prader-Willi Syndrome

BACKGROUND: The study of the behaviour profile in subjects with Prader-Willi Syndrome (PWS). METHODS: A total of fifty-eight 3- to 29-year-old subjects with PWS were studied using a standardized parent report of behavioural and emotional disturbances. RESULTS: There was an increase of behavioural and emotional disturbances for the adolescent and young adult age range, whereas gender and intelligence were not significant. Increasing body mass index (BMI) was also associated with more behavioural and emotional disturbances. There was no significant relation between genetic status and behavioural abnormalities. CONCLUSIONS: This systematic study supports single case observations of a heightened psychiatric vulnerability of adolescent and young adult PWS subjects.     

Increased prefrontal cerebral blood flow in first-episode schizophrenia following treatment: longitudinal positron emission tomography study

OBJECTIVE: Cognitive deficits, particularly those related to executive function and behavioural control, are a core feature of patients with schizophrenia and implicate disturbances of the prefrontal cortex (PFC). Consistent with this, functional imaging studies have identified abnormalities of PFC activity in chronically affected patients. The objective of the current study was to investigate executive-control related neural activity from first onset of the illness through to symptom stabilization. METHOD: The authors examined eight neuroleptic-na?ve first-episode psychosis (FEP) patients within 3 days of first presentation and eight healthy age- premorbid-IQ, and gender-matched controls (CTL). All FEP patients were later confirmed with a diagnosis of schizophrenia. Subjects underwent H2-15O positron emission tomography (PET) while performing the Stroop interference task that has previously been shown to engage the PFC in healthy samples. In a double-blind paradigm, FEP patients were randomly treated with either haloperidol or risperidone for 8 weeks, after which CTLs and all but one of the FEP patients were re-scanned. RESULTS: Behaviorally, there was no change in task performance from baseline to follow up for either the FEPs or CTLs. However, there were significant changes in functional activation in both groups across the same period. For CTLs, task-performance was associated with greater recruitment of posterior brain regions at follow up compared to baseline, while for FEP this involved greater recruitment frontal regions. Concurrently, FEP also showed significant improvement in positive symptomatology. CONCLUSIONS: These findings suggest that disturbances of the PFC often seen in FEP may be, at least partially, associated with acute symptom expression. However, it is still unclear whether this increase in frontal activity is due to symptom stabilization per se, the effects of medication, a lack of neurophysiological 'learning' with experience/practice, or a combination of these factors. In the context of the CTLs performance, we interpret the patient findings as reflective of greater neurophysiological effort required for task accomplishment relative to the learned, more automated, processing apparent in the CTLs.     

Abnormal EEG complexity in patients with schizophrenia and depression.

OBJECTIVE: Schizophrenics are usually unable to perform well on cognitive tasks due to disturbances in cortical information processing that are observable as abnormalities in electroencephalogram (EEG) signals. However, whether such cortical disturbances can be assessed by quantitative EEG analysis remains unclear. The purpose of this study was to characterize EEG disturbances, using the Lempel-Ziv complexity (LZC), in the subjects with schizophrenia at rest or while performing mental arithmetic tasks. The results were compared to those from the subjects with depression and with healthy controls. METHODS: The subjects included 62 schizophrenia patients, 48 depression patients and 26 age-matched healthy controls. EEG was recorded under two conditions: (i) resting with eyes closed, and (ii) a mentally active condition wherein the subjects were asked to subtract 7 from 100 iteratively with their eyes closed. EEG signals were analyzed by LZC and conventional spectral methods. RESULTS: In all the groups, LZC of EEG decreased during the mental arithmetic compared with those under the resting conditions. Both the schizophrenia and the depression groups had a higher LZC (p<0.05) than the controls. Also, the schizophrenia group had a lower LZC (p<0.05) than the depression group during the mental arithmetic task as well as during the resting state. Significant differences in LZC, at some symmetrically located loci (FP1/FP2, F7/F8), between the two hemispheres were found in all the patient groups only during the arithmetic task. CONCLUSIONS: Compared with conventional spectral analysis, LZC was more sensitive to both the power spectrum and the temporal amplitude distribution. LZC was associated with the ability to attend to the task and adapt the information processing system to the cognitive challenge. Thus, it would be useful in studying the disturbances in the cortical information processing patients with depression or schizophrenia. SIGNIFICANCE: LZC of EEG is associated with mental activity. Thus, LZC analysis can be an important tool in understanding the pathophysiology of schizophrenia and depression in future studies.     

The impact of cognitive decline and workload on the costs of dementia care

Costs of dementia care and its relation to cognitive capacity, activities of daily living (ADL) and behavioural disturbances were studied in a prospective, non-randomized concurrent control study. The participants consisted of 173 demented patients who at inclusion were cared for in four caring alternatives: 45 in home care, 55 in day care (DC), 49 in group living (GL) and 24 institutionalized patients in Sundsvall, an industrial city in northern Sweden. The use of institutional care and costs were constant for the GL patients, independently of cognitive capacity, ADL capacity and behavioural disturbances, while institutional care and costs of the home care patients and the DC patients increased when cognitive capacity and the ADL capacity deteriorated and behavioural disturbances increased. The main conclusion is that care in GL seems to be a caring alternative in which institutionalization figures and costs are independent of measurements of the degree of dementia. The costs for the municipality and the county council regarding the DC group were lower than GL, particularly in relation to impaired cognitive function. In the sensitivity analysis, however, where ‘hotel costs’ and the value of the families' informal work were included, the costs of the DC and the home care group increased considerably.