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1.
河北省2004-2005年抑郁症的现况调查   总被引:1,自引:0,他引:1  
目的 了解河北省抑郁症的患病率、抑郁症患者的人口学特征及社会生活功能状况。方法 采用随机抽样方法对河北省≥18岁人群进行调查,共24000人。以改编的一般健康问卷12项(GHQ-12)为筛选工具,以美国精神障碍诊断与统计手册第4版轴Ⅰ障碍定式临床检查患者版为诊断工具。采用功能大体评定量表(GAF)评价功能状况。结果 (1)抑郁症时点患病率为27.01%o[399例;95%可信区间(CI)=24.80%0~29.22%0],终生患病率为47.47‰(608例;95%CI=44.58%0~50.37%0)。(2)时点患病率:城市[20.98%o(40例)]低于农村[27.88%0(359例);u=4.02;P〈0.01];女性[31.53%0(248例)]高于男性[22.48%0(151例);u=2.05;P〈0.05]。1〉40岁者患病率高(30.51%~44.19%)。(3)Logistic回归分析:危险因素有女性、年龄40~70岁、农民、无业和失业、学生和家庭妇女、年家庭总收入0~5000元等。(4)反复发作抑郁症占29.11%;严重程度以中度(39.6%)和重度(53.9%)多见,社会和生活功能受损明显[GAF评分为(58.95±14.86)分]。结论 河北省抑郁症的患病率较高,严重影响患者社会生活功能。  相似文献   

2.
目的探讨保定市民特殊恐怖症的患病率和分布特点。方法2004年10月~2005年3月采用多阶段分层整群抽样方法随机抽取18周岁及以上的人群10073例,用扩展的一般健康问卷(GHQ—12)将调查对象分为高、中、低危险组,采用美国精神障碍诊断标准(DSM—Ⅳ),以美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查病人版对调查对象进行特殊恐怖症的诊断。结果9021例完成调查,特殊恐怖症的终生患病率为0.74%,时点患病率为0.68%;各类型的终生及时点患病率分别为:动物型0.38%、0.36%,自然环境型0.31%、0.27%,其他型0.07%、0.03%;血液-注射-损伤型的终生和时点患病率均为0.09%,情景型仅终生患病率为0.01%。女性时点患病率高于男性;农村时点患病率高于城市;30-39岁的患病率最高,18~19岁的患病率最低。特殊恐怖症的精神科就诊率为2.5%。结论特殊恐怖症常见于年轻的女性,各类型患病率不同,且就诊率低。  相似文献   

3.
河北省精神障碍的现况调查   总被引:27,自引:0,他引:27  
目的了解河北省≥18岁人群各类精神障碍的患病率和分布特点。方法2004年10月至2005年3月采用多阶段分层整群抽样方法随机抽取≥18岁人群,共24000名,以美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查患者版进行调查,用DSM,Ⅳ对各类精神障碍进行诊断。结果(1)患病率:20716人完成调查,精神障碍的时点患病率为162.43‰[95%可信区间(95%CI)为15.8%-16.7%],排在前三位的是重性抑郁障碍(27.01‰)、未特定的焦虑障碍(25.09‰)和心境恶劣障碍(23.12‰);终生患病率为185.12‰(95%CI为18.0%~19.0%),排在前三位的是重性抑郁障碍(47.47‰)、酒精依赖性和滥用性障碍(38.62‰)和未特定抑郁障碍(25.51‰)。(2)时点患病率:女性(167.95‰)高于男性(156.95‰),农村(165.63‰)高于城市(144.31‰),均P〈0.05~0.01;并随年龄的增长而不断上升,其中30~49岁为137.17‰~156.71‰,50-≥70岁为201.44‰~285.41‰。结论河北省精神疾病的患病率较高,其中女性和农村的患病率高;重性抑郁障碍是省内患病率最高的精神疾病。  相似文献   

4.
目的:了解保定市重性抑郁障碍的患病率、人口学特征和社会生活功能状况。方法:采用多阶段分层整群抽样方法随机抽取≥18岁的人群10073人,以一般键康问卷12项(GHQ-12)为筛选工具,以美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查病人版(SCID-I/P)为调查诊断工具。用功能大体评定量表(GAF)评价功能状况。结果:重性抑郁障碍的终生患病率为4.19%(95%CI:3.78%~4.60%);时点患病率为2.64%(95%CI:2.31%~2.97%)。时点患病率女性3.26%明显高于男性2.00%(u=3.73,P〈0.01);农村2.84%明显高于城市1.40%(u=2.76,P〈0.01);50~69岁年龄段患病率较高;单次发作60.80%,复发39.20%;GAF平均为(50.74±6.73)分,社会和生活功能受损明显。结论:重性抑郁障碍的患病率相对较高,严重影响患者的社会生活功能。  相似文献   

5.
目的比较保定地区和承德地区18岁及以上人群创伤后应激障碍患病率的差异。方法采用多阶段分层整群抽样方法随机抽取保定地区10073名,承德地区3358名均≥18岁的人群为调查对象,用扩展的一般健康问卷(GHQ—12)将调查对象分为高、中、低危险组,以美国精神障碍诊断与统计手册第4版(DSM—IV)对调查对象进行DSM—IV修订版轴I障碍定式临床用治疗提纲(SCID-1/P),对各类精神障碍进行诊断-结果保定地区9021人完成调查,创伤后应激障碍时点患病率3.7%e,终生患病率5.7%e;承德地区3025人完成调查,创伤后应激障碍时点患病率4.3%c,终生患病率7.27‰。。保定地区和承德地区时点患病人数分别为33例,13例;终生患病的人数分别为51例,22例。两地男性与男性之间,女性与女性之间,城市与城市之间,农村与农村之间时点患病率没有显著性差异(P均〉0.05),两地区终生患病率无显著差异(U=0.901P〉0.05)。结论创伤后应激障碍在我省两地区之间发病无差异,但发病率逐渐增高,为迫切需要关注的公共卫生问题之一。  相似文献   

6.
威海市精神疾病流行病学调查   总被引:1,自引:0,他引:1  
目的:了解威海市≥15岁人群各类精神疾病的患病率和分布特点。方法:2006年9月至2007年2月随机抽取≥15岁人群共50174人,使用心理卫生筛选表、神经症筛选表、精神现状检查(PSE)140题等工具进行调查,以中国精神疾病分类方案与诊断标准第3版为诊断依据。结果:各类精神障碍的时点患病率为70.34‰,终生患病率为89.51‰。排在前3位的为抑郁症(37.49‰)、神经症(30.06‰)和酒依赖(11.38‰)。农村患病率(93.22‰)高于城市(84.30‰),女性(95.27‰)高于男性(83.82‰)。3种精神疾病均存在较高的未识别率,且农村高于城市。结论:山东威海市精神疾病的患病率以女性和农村较高;抑郁症是威海市患病率最高的精神疾病。  相似文献   

7.
江西省抑郁症患病率的流行病学调查   总被引:35,自引:3,他引:32  
目的 调查江西省抑郁症的患病率。方法 资料来自江西省11个地市的样本,年龄≥15岁的城区和农村常住居民,共15939人。使用复合性国际诊断交谈检查和专门设计的社会人口学调查表,采用国际疾病分类第10版精神与行为障碍分类中的诊断标准。结果 (1)11个地市抑郁症时点患病率为0.95%,总患病率为1.15%[95%的可信区间(CI)=0.91-1.49]。其中抑郁发作的时点患病率为0.35%,总患病率为0.51%;恶劣心境的时点患病率为0.60%,总患病率为0.65%。(2)年龄45—54岁[相对危险度(RR)=2.09]、女性(RR=1.91)、离婚或丧偶(RR=2.09)、文盲(RR=2.43)或低收入(RR=2.73)与抑郁症明显相关,而有无固定的职业、地区的不同、经济区域的不同对抑郁症的总患病率没有明显的关联。女性患抑郁症的相对危险度是男性的1.91倍。结论 抑郁症是一种患病率较高的精神障碍。年龄45—54岁、女性、离婚或丧偶、文盲或低收入,与抑郁症明显相关。  相似文献   

8.
目的:了解河北省承德地区18岁及以上人群各类精神疾病的时点患病率和分布特点。方法:2004年10月至2004年11月采用多阶段分层整群随机抽样方法,抽取≥18岁者为调查对象。用一般健康问卷(CHQ-12)将调查对象分为高、中、低危险组,以美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ用定式临床检查患者版进行调查,用DSM-Ⅳ对精神障碍进行诊断。结果:3025人完成调查,精神疾病总时点患病率为177.19‰,终生患病率为216.86‰。除精神发育迟滞和痴呆外,各类精神疾病时点患病率为175.86‰,终生患病率为215.54‰。时点患病率农村为(176.65‰),城市为(180.08‰);女性(182.05‰)高于男性(171.94‰)。重性抑郁障碍患病率最高(51.57‰)。结论:本调查基本掌握了河北省承德地区18岁及以上人群各类精神障碍的患病水平和分布特点。  相似文献   

9.
独居老人抑郁症状和抑郁症的调查   总被引:4,自引:0,他引:4  
目的调查城市独居老人的抑郁症状和抑郁症情况。方法抽查上海市虹口区一个街道、两个居委的12岁以上常住人口共5512名,收集社会人口学资料并应用流调用抑郁量表(CES—D),对于CES—D评分在16分及以上者使用定式临床检查(SCID)进行诊断,分析60岁以上独居者的人口学、抑郁症状及抑郁症情况。结果60岁以上独居老人占调查对象的1.19%,占60岁以上老年人口的4.20%,独居老人的人口学资料和一般情况与非独居老人差异没有统计学意义。60岁以上老人的抑郁症状检出率为8.26%(118/1428),高于60岁以下者的抑郁症状检出率(4.2%);60岁以上老人中抑郁症状检出率独居者高于非独居者(20.00%vs7.74%,χ^2=2.57,P〈0.01),抑郁症检出率独居者高于非独居者(5.0%vs0.58%,χ^2=14.66,P〈0.01)。结论城市人口老龄化程度高,老年人尤其独居者的抑郁症状及抑郁症检出率较高,应该重视独居老年人心理健康。  相似文献   

10.
保定市焦虑障碍流行病学调查   总被引:2,自引:0,他引:2  
目的:了解保定市焦虑障碍的患病率和分布特点。方法:于2004年10月至2005年5月采用多阶段分层整群抽样方法随机抽取≥18岁的人群,共10073名,用扩展的一般健康问卷(GHQ-12)将调查对象分为高、中、低危险组,采用美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)轴Ⅰ障碍定式临床检查患者版(SCID)对调查对象进行焦虑障碍的诊断。结果:共9021人完成调查,焦虑障碍的终生患病率为45.12‰,时点患病率为41.79‰,5种常见的焦虑障碍是未特定的焦虑障碍(分别是25.72‰及25.39‰)、创伤后应激障碍(5.65‰及3.66‰)、广泛性焦虑症(仅现患6.43‰)、特殊恐怖症(5.10‰及4.43‰)和惊恐障碍(3.44‰及2.66‰)。时点患病率:女性(54.21‰)明显高于男性(29.73‰)(P〈0.01);50~59岁患病率最高(58.39‰),20~29岁最低(23.07‰)。Logistic回归分析显示,焦虑障碍的易患危险因素为女性、年龄40-69岁、低文化、低收入。焦虑障碍的精神科就诊率为1.86‰。结论:焦虑障碍是保定市常见的一类精神障碍,患病率高,而其精神卫生服务利用率低。  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
Diagnostic Difficulties and Treatment Implications   总被引:1,自引:0,他引:1  
Robert J. Gumnit 《Epilepsia》1987,28(S3):S9-S13
Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.  相似文献   

13.
Cognitive Dysfunction Associated with Antiepileptic Drug Therapy   总被引:7,自引:5,他引:2  
Eileen P.G. Vining 《Epilepsia》1987,28(S2):S18-S22
Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.  相似文献   

14.
B. J. Wilder 《Epilepsia》1987,28(S2):S1-S7
Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.  相似文献   

15.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

16.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

17.
Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.  相似文献   

18.
Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.  相似文献   

19.
Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity   总被引:5,自引:1,他引:4  
G. Trube  R. Netzer 《Epilepsia》1994,35(S5):S62-S67
Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.  相似文献   

20.
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.  相似文献   

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