药物自我处置模式训练对精神分裂症疗效的随访研究

目的探讨药物自我处置模式训练对精神分裂症的远期疗效。方法将72例精神分裂症患者随机分成技能训练组和对照组各36例,其中7例脱落。对技能训练组进行模式化训练共10周,然后随访6个月。采用简明精神病评定量表（BPRS）、阳性症状评定量表、阴性症状评定量表、社会功能缺陷筛选量表（SUSS）及一些自制标准对患者进行评估。结果训练组患者的BPRS评分（19.9±2.3）和SDSS评分（3．8±3．0）明显优于对照组（分别为25．7±5．2,8．8±3．9,P＜0．01）;训练组患者自行管理药物的能力和对药物的满意程度也明显强于对照组（P＜0．01）;训练组的复发率（7％）和再住院率（3％）均低于对照组（分别为15％和12％）,但差异无显著性。结论模式化技能训练作为一种辅助性治疗手段,有益于精神分裂症患者疗效的长期保持。     

慢性精神分裂症住院患者的程式化技能训练

目的:探讨程式化技能训练对慢性精神分裂症住院患者的康复效果.方法:将 120 例住院患者随机分成训练组和对照组各 60 例,对训练组进行 8 周的程式化训练,然后全部随访 24 周.采用阳性与阴性症状量表(PANSS),自知力与治疗态度问卷(ITAQ)和 Morningside 康复状态量表(MRSS)进行评估.结果:训练组的 PANSS 总分、阴性症状分和一般精神病理分及 ITAQ 分以及 MPSS 各量表分在训练第 20 周末起,都明显优于对照组.结论:程式化技能训练可使慢性精神分裂症住院患者增进多方面的康复效果.     

精神分裂症患者氯氮平治疗前后免疫指标的变化

目的　探讨精神分裂症患者抗精神病药物氯氮平治疗前后总T细胞 (CD3 )、T辅助 /T诱导细胞 (CD4)、T抑制 /T杀伤细胞 (CD8)及血清白细胞介素 6 (IL 6 )水平的变化。方法　对 6 6例精神分裂症患者 (男 32例 ,女 34例 )和 30名健康对照者 (男 16名 ,女性 14名 )的血清CD3 、CD4、CD8、CD4/CD8及IL 6的水平进行检测。用酶联免疫吸附法 (ELISA)及碱性磷酸酶抗碱性磷酸酶法 (APAAP)检测各受试者血清IL 6及T细胞亚群。结果　 (1) 6 6例精神分裂症患者治疗前CD3 、CD4、CD8、CD4/CD8比值均低于对照组 (P <0 0 1～ 0 0 0 1) ,而IL 6 [(1 8± 0 6 )ng/L]则高于对照组 [(1 2± 0 6 )ng/L],P <0 0 0 1;(2 )氯氮平治疗后CD3 、CD4、CD4/CD8高于治疗前 (P <0 0 1) ;(3)阳性、阴性组患者治疗前CD3 、CD4、CD8、CD4/CD8均低于对照组 (P <0 0 1) ,而IL 6水平则高于对照组高 (P <0 0 1) ;(4)治疗后阳性、阴性组患者IL 6水平 [(1 2± 0 3)ng/L、(1 1± 0 5 )ng/L]均较治疗前有所降低 ,与对照组的差异无显著性 (P >0 0 5 ) ;(5 )阳性、阴性组患者治疗后组间比较 ,阳性组CD3 、CD4、CD4/CD8明显高于阴性组 ,CD8低于阴性组 (P <0 0 5 ) ,两组间IL 6水平的差异无显著性 (P >0 0 5 ) ;(6 )多元逐步回归分析显示 ,阳     

易肇事精神分裂症患者应用程式化技能训练的疗效研究

目的 探讨程式化技能训练对易肇事精神分裂症患者的疗效.方法 将102例易肇事精神分裂症患者随机分为训练组(51例)和对照组(51例).两组患者接受常规药物及康复治疗的同时,仅对训练组进行8周的程式化技能训练.训练结束后对两组均进行半年的随访,并采用阳性和阴性症状量表(PANSS)在入组时、训练结束时、随访第3,6个月时进行评估.结果 与入组时相比,训练组患者训练结束时的PANSS总分、阳性量表分、阴性量表分均显著降低(P＜0.05).训练结束后及随访期,训练组患者的PANSS部分项目评分显著低于对照组患者(P＜0.05).结论 程式化技能训练对易肇事精神分裂症患者的精神症状具有康复作用.     

家庭干预联合药物自我管理技能训练治疗精神分裂症的疗效

目的 探讨家庭干预联合药物自我管理技能训练治疗精神分裂症的效果.方法 160例精神分裂症患者随机分为观察组和对照组各80例,对照组接受常规治疗,观察组在此基础上给予家庭干预联合药物自我管理技能训练,观察2组简明精神病量表(BPRS)、社会功能缺陷筛选量表(SDSS)、生存质量测量量表(BREF)、阳性症状评定量表(SAPS)和阴性症状评定量表(SANS)评分.结果 2组治疗前各项评分差异均无统计学意义(P＞0.05),治疗6个月与治疗前比较,均明显下降,差异有统计学意义(P＜0.05);观察组优于对照组,差异有统计学意义(P＜0.05).结论 家庭干预联合药物自我管理技能训练提高了治疗依从性,改善了病情、社会功能及生活质量,精神分裂症阳性和阴性症状也明显降低.     

工娱疗法合并氯氮平治疗慢性精神分裂症的对照研究

目的探讨工娱疗法合并氯氮平治疗慢性精神分裂症的效果。方法将112例服用氯氮平治疗的慢性精神分裂症患者随机分为工娱治疗组和对照组。工娱治疗组进行为期16周的训练。采用简明精神症状量表（BPRS）、阴性症状量表（SANS）、临床疗效总评量表（CGI）进行临床效果评定，日常生活能力量表（ADL）来评定患者的日常生活能力。用药物依从性量表来判断患者的服药情况。结果治疗16周末，治疗组患者的服药依从性。慢性精神分裂症阴性症状的缓解，患者的日常生活能力的提高都优于对照组P〈0．05）。结论工娱疗法有助于慢性精神分裂症的治疗和康复。     

氯氮平合并帕罗西汀治疗精神分裂症阴性症状临床研究

目的　观察氯氮平合并帕罗西汀治疗精神分裂症阴性症状的疗效和副作用。方法　将 66例女性慢性精神分裂症患者平均分为研究组 (氯氮平加帕罗西汀 )和对照组 (氯氮平加安慰剂 )。在治疗前、治疗后 4、8、12周末分别以阳性症状和阴性症状量表(PANSS)和副反应量表 (TESS)评定疗效和副作用。同时测定氯氮平与去甲氯氮平的血浓度。结果　治疗 8周后研究组PANSS总分、阴性因子分比治疗前明显降低 ,且阴性因子分值显著低于对照组 ,氯氮平及去甲氯氮平血浓度明显升高。治疗后 4、8、12周末TESS评分 ,研究组均低于对照组 ,且治疗后低于治疗前 ,均有显著性差异。结论　氯氮平合并帕罗西汀能明显改善精神分裂症患者的阴性症状 ,且副作用减少。     

氯氮平治疗对以阳性或阴性症状为主的精神分裂症患者血清一氧化氮含量的影响

目的　探讨以阳性症状为主 (以下简称阳性 )或阴性症状为主 (以下简称阴性 )的精神分裂症患者用氯氮平治疗前后血清一氧化氮 (NO)含量变化及其与疗效的关系。方法　对 32例阳性患者、30例阴性患者均用氯氮平 (30 0mg/d)治疗 8周。用阳性症状评定量表 (SAPS)和阴性症状评定量表 (SANS)评定其疗效。治疗前及治疗第 8周末分别检测血清NO含量 ,并与 2 8名健康志愿者 (对照组)比较。结果　治疗前阳性组、阴性组及对照组血清NO含量分别为 :(5 9± 16 ) μmol/L、(2 6± 7) μmol/L和 (38± 11) μmol/L ,三组间的差异有非常显著性 (P <0 0 1)。治疗前阳性组血清NO含量与SAPS总分呈显著正相关 (r =0 6 92 ,P <0 0 1) ;阴性组血清NO含量与SANS总分呈显著负相关(r=- 0 916 ,P <0 0 1)。治疗第 8周末阳性组血清NO含量降低至 (39± 8) μmol/L ,其NO降低值与SAPS减分率之间呈显著正相关 (r=0 86 8,P <0 0 1) ;阴性组血清NO含量升高至 (32± 8) μmol/L ,显著高于治疗前 (P <0 0 5 ) ,但仍低于对照组 (P <0 0 1)。NO升高值与SANS减分率呈负相关(r=- 0 916 ,P <0 0 1)。结论　以阳性症状为主与以阴性症状为主的精神分裂症患者血清NO含量的差异有显著性 ;患者血清NO含量变化与疗效之间高度相关。氯氮平可能     

加用银杏叶片对氯氮平合并心得安治疗慢性精神分裂症的疗效和安全性的影响

目的 探讨银杏叶片对氯氮平合并心得安治疗慢性精神分裂症的疗效和安全性的影响.方法 将80例慢性精神分裂症病人随机分为研究组和对照组各40例,对照组给予抗精神病药物氯氮平、心得安治疗,研究组在此基础上,加用银杏叶片治疗,治疗12周.治疗前和治疗4、8、12周末分别用阳性与阴性症状量表(PANSS)评定临床疗效,用不良反应症状量表(TESS)评定不良反应,了解药物的安全性.结果 两组PANSS各因子评分比较差异无统计学意义(P＞0.05),但是阴性症状评分(P ＝0.053),有异质性和可比性,银杏叶片还可减少氯氮平的不良反应.结论 以阴性症状为主的精神分裂症在氯氮平合并心得安治疗过程中适合加用银杏叶片以增强疗效,减少不良反应.     

综合性心理行为干预对慢性精神分裂症的康复效果

目的　探讨综合性心理行为干预对慢性精神分裂症的康复效果。方法　 6 4例慢性精神分裂症患者根据其意愿被分为对照组和研究组。在精神药物剂量不变的情况下 ,对照组结合简单娱乐活动及支持性心理治疗 ,研究组结合综合性心理行为干预 ,疗程 12周。结果　疗程结束后 ,研究组有效率 6 4.5 % ,而对照组 2 1.2 % ;研究组简明精神病评定量表 (BPRS)、阴性症状量表 (SANS)、社会功能评定量表 (DAS)和生活质量量表 (QOL)评分优于对照组 (P <0 .0 5或 0 .0 1)。结论　综合性心理行为干预能提高临床疗效 ,改善慢性精神分裂症的阴性症状、社会功能及生活质量。     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.