具有凶杀行为的精神疾病患者自杀行为研究

目的:探讨具有凶杀行为的精神疾病患者自杀的危险因素。方法:调查1986年至2006年具有凶杀行为的精神疾病患者院内自杀身亡31例,采用多因素Logistic回归分析自杀行为危险因素。结果:具有凶杀行为精神疾病患者自杀男:女=3.43∶1,自杀行为的发生与家族自杀史、悔恨、绝望、心理社会因素及杀害对象有关。结论:悔恨、绝望、心理社会因素等是具有凶杀行为精神疾病患者自杀的危险因素,对于有凶杀行为的精神疾病患者自杀行为应加以干预。     

精神疾病患者凶杀犯罪学特征

目的：探讨凶杀精神疾病患者犯罪学特征及相关因素。方法：对167例凶杀精神疾病患者和158例非凶杀精神疾病患者进行对照分析。结果：凶杀行为的发生与心理社会因素、负性生活事件、社会支持低、家庭经济状况差及未得到及时治疗、病期长等因素有关。精神疾病患者作案时常无预谋、无隐蔽性,杀害对象以亲人为主,作案后缺乏自我保护性。结论：给予精神疾病患者社会支持,及时就医,进行心理干预,减少凶杀行为的发生。     

抑郁症患者自杀的危险因素研究

目的:探讨抑郁症患者自杀的危险因素及生物学指标.方法:以抑郁症患者入院时有无自杀行为分为自杀组和无自杀组.用汉密尔顿抑郁量表(HAMD,24项)、生活事件量表(LES)及自行编制的自杀行为调查表对入组患者进行调查;酶法测定两组患者的总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)水平.结果:共107例.多因素Logistic回归分析发现,自杀与既往自杀行为、内向性格、生活事件、严重的抑郁(尤其是绝望感明显,存在严重的认识障碍)有关;两组的血脂水平差异无显著.结论:既往自杀行为、内向性格、生活事件、严重的抑郁是抑郁症患者自杀的主要危险因素;抑郁症患者的自杀可能与血脂水平无关.     

综合医院有自杀倾向的住院患者发生自杀行为的影响因素分析

目的描述综合医院具有自杀倾向患者的特征,并分析此类患者发生自杀行为的危险因素.方法回顾性连续纳入南方医科大学南方医院2012年10月至2017年10月的住院患者中具有自杀倾向的病例共680例,根据是否发生自杀行为分为自杀倾向组(有自杀倾向无自杀行为,527例)和自杀行为组(有自杀倾向亦有自杀行为,153例).收集他们的性别、年龄、婚姻状况、户籍、入院科室、自杀诱因、自杀方式、精神疾患、躯体疾患及显著的精神症状等资料.采用单因素分析比较两组间的社会人口学和临床特征差异,采用二分类Logistic回归分析研究自杀行为的危险因素.结果自杀倾向组主要为女性[66.6%(351例)]、已婚[77.4%(458例)]、心理科[74.4%(392例)]、抑郁症[66.2%(349例)].自杀行为组中,男性和女性的自杀方式差异有统计学意义(χ^2=12.489,P=0.014),选择跳楼方式的男性较多,药物及割脉方式的女性更多.Logistic回归分析结果表明,入住重症医学科(OR=7.844,95%CI:2.240~27.475,P=0.001)、婚恋受挫(OR=3.646,95%CI:1.217~10.917,P=0.021),肿瘤(OR=4.620,95%CI:1.552~13.755,P=0.006),双相情感障碍(OR=3.734,95%CI:1.157~12.052,P=0.028)是自杀行为的危险因素.结论具有自杀倾向的患者中,入住重症医学科、双相情感障碍、肿瘤、婚恋挫折是发生自杀行为的危险因素,而且两性的自杀方式有所不同,需要临床高度重视,并采取针对性预防措施.     

30例高校学生自杀行为原因调查及分析

目的通过对高校学生自杀行为的调查,分析了解其自杀的原因。方法本项调查使用自编的自杀行为登记表,于2008-2011年收集30例高校学生自杀行为的基本资料,采用SPSS进行统一分析。结果 30例中男性14例(46.7%),女性16例(53.3%),最近一次有自杀行为时年龄分布为18～37岁,平均年龄(23.5±17.2)岁。曾经恋爱或者正在恋爱8例(27.6%),30例中14例(46.7%)可以诊断为精神疾病,26例(86.7%)在本次自杀前一月遭遇明显的生活事件和心理应激,自杀方法以从高处坠下和跳楼13例(43.3%)、服药5例(16.7%)居多。结论调查结果显示高校生的自杀平均年龄较国内报告的平均年龄小。精神疾病依然是高校学生自杀行为主要危险因素之一,学生自杀前遭遇恋爱冲突、学习压力、就业问题、人际关系问题及经济困难等生活事件和心理应激可能是高校生自杀的诱发因素。     

抑郁症自杀行为的相关危险因素研究

目的　研究抑郁症自杀行为的危险因素。方法　按CCMD 2 R诊断标准收集 2 0 7例住院的抑郁症病人 ,采用多因素Logistic回归分析与抑郁症自杀行为有关的危险因素。 结果　抑郁症自杀未遂 6 6例 ( 31 9% ) ,自杀与绝望 (相对危险度RR =9 30 8)、负性生活事件 (RR =3 84 2 )、妄想 (RR =3 56 5)及自责 (RR =2 99)呈正相关。结论　提示绝望、负性生活事件、妄想及自责是抑郁症患者自杀的危险因素     

5-羟色胺和胆固醇水平对抑郁症患者再次自杀风险评估的研究

目的 探讨抑郁症患者血小板5-羟色胺（5-HT）和胆固醇水平与抑郁症患者再次自杀的关系.方法 对33例有自杀行为的抑郁症患者在接受治疗前测定血小板5-HT和胆固醇水平,评定汉密尔顿抑郁量表（HAMD-24）和Beck绝望量表（BHS）,然后进行2年的随访.结果 16例患者再次出现自杀行为,再次自杀组血小板5-HT及血清胆固醇水平显著低于无再次自杀组（P＜0.01）.5-HT和血清胆固醇水平与HAMD-24、BHS分及自杀次数、自杀严重程度均呈负相关（P＜0.01）,且5-HT与血清胆固醇水平呈正相关（P＜0.01）.多重回归分析显示血小板5-HT浓度、家族史是自杀次数的主要影响因素.结论 低血小板5-HT及血清胆固醇浓度是抑郁症自杀的危险因素,对抑郁症自杀行为可能具有一定的的预测作用.     

老年与自杀

老年与自杀邱惠摘译翟书涛校不同年龄的自杀行为有所差异，如心理状态和精神疾病就各有特点。例如青春期和绝经期的心理社会因素、精神疾病和与自杀行为有关的方面均有不同。Ｌｅｓｔｅｒ（１９９１）把生命历程分为婴儿期、学龄前期、童年期、青春期、青年期、中年期和老...     

银杏内酯 K 通过 PI3K/Akt/mTOR 通路促进 血管生成改善缺血性卒中

目的 描述综合医院具有自杀倾向患者的特征，并分析此类患者发生自杀行为的危险因 素。方法 回顾性连续纳入南方医科大学南方医院 2012 年 10 月至 2017 年 10 月的住院患者中具有自杀 倾向的病例共 680 例，根据是否发生自杀行为分为自杀倾向组（有自杀倾向无自杀行为，527 例）和自杀 行为组（有自杀倾向亦有自杀行为，153 例）。收集他们的性别、年龄、婚姻状况、户籍、入院科室、自杀诱 因、自杀方式、精神疾患、躯体疾患及显著的精神症状等资料。采用单因素分析比较两组间的社会人口 学和临床特征差异，采用二分类 Logistic 回归分析研究自杀行为的危险因素。结果 自杀倾向组主要为 女性［66.6%（351例）］、已婚［77.4%（458例）］、心理科［74.4%（392例）］、抑郁症［66.2%（349例）］。自杀行为 组中，男性和女性的自杀方式差异有统计学意义（χ2 =12.489，P=0.014），选择跳楼方式的男性较多，药物 及割脉方式的女性更多。Logistic回归分析结果表明，入住重症医学科（OR=7.844，95%CI：2.240～27.475， P=0.001）、婚恋受挫（OR=3.646，95%CI：1.217～10.917，P=0.021），肿瘤（OR=4.620，95%CI：1.552～13.755， P=0.006），双相情感障碍（OR=3.734，95%CI：1.157～12.052，P=0.028）是自杀行为的危险因素。结论 具 有自杀倾向的患者中，入住重症医学科、双相情感障碍、肿瘤、婚恋挫折是发生自杀行为的危险因素，而 且两性的自杀方式有所不同，需要临床高度重视，并采取针对性预防措施。     

精神疾病患者自杀行为的相关因素分析

精神病人的自杀是精神疾病患者常见的死亡原因，据国内文献报道，因各种精神疾病引起的自杀占自杀原因的第二位，并且越来越年轻化。为进一步探讨住院精神疾病患者自杀行为发生的相关因素，本文作者对2001年8月．2002年10月住院的精神疾病患者的临床资料进行回顾词查分析，现将结果报道于后。     

Replacing prelinguistic behaviors with functional communication

This study evaluated the effectiveness of a teacher-implemented intervention package designed to replace prelinguistic behaviors with functional communication. Four young children with autism participated in a multiple-probe design across three communicative functions. Initially, three existing communication functions were selected for each child. Next, the existing prelinguistic behaviors that the children used to achieve these functions were identified. Replacement forms that were considered more recognizable and symbolic were defined to achieve these same functions. After a baseline phase, teachers received inservice training, consultation, and feedback on how to encourage, acknowledge, and respond to the replacement forms. During intervention, the replacement forms increased and prelinguistic behaviors decreased in most cases. The results suggested that the teacher-implemented intervention was effective in replacing prelinguistic behaviors with alternative forms of functional communication.     

Hoarding behaviors in children with learning disabilities

Our objective was to describe the prevalence, comorbidity, and neuropsychological profiles of children with hoarding and learning disabilities. From 61 children with learning disabilities, 16.4% exhibited hoarding as a major clinical issue. Although children with learning disabilities and hoarding displayed greater rates of obsessive-compulsive disorder (30%) as compared to those with learning disabilities without hoarding (5.9%), the majority of patients belonging to the former group did not display obsessive-compulsive disorder diagnosis. When learning disability patients with hoarding were compared to age-, sex-, and IQ-matched learning disability subjects without hoarding, hoarders exhibited a slower learning curve on word list-learning task. In conclusion, salient hoarding behaviors were found to be relatively common in a sample of children with learning disabilities and not necessarily associated with obsessive-compulsive disorder, supporting its nosological independence. It is unclear whether underlying cognitive features may play a major role in the development of hoarding behaviors in children with learning disabilities.     

Postictal behaviors associated with psychogenic nonepileptic seizures

The postictal behavior of responding to questions in a whispering voice or responding to commands with partial motor responses has not, to our knowledge, been previously associated with psychogenic nonepileptic seizures. We performed a retrospective review of 100 consecutive patients admitted to the epilepsy monitoring unit for evaluation of medically refractory seizures or clinically indeterminate spells to determine if this association exists. Twenty-four patients had a diagnosis of psychogenic nonepileptic seizures, and 18 of the 24 (75%) exhibited postictal whispering voice or partial motor responses. None of the patients diagnosed as having epileptic seizures or other physiologic events exhibited these postictal signs. We conclude that postictal behavior may be helpful in the diagnosis of psychogenic nonepileptic seizures, and whispering or partial motor responses to commands may be commonly observed.     

与自杀行为相关的神经认知因素研究进展

自杀行为包括与自杀相关的想法、非致命性自杀企图和致命性的自杀[1].2012年全球估计有80.4万人自杀死亡,经标准化后的全球年自杀率为11.4/10万,自杀已成为严重的公共卫生问题,对自杀的预防是多数国家的重点工作之一[2].研究者们一直致力于找出自杀行为的危险因素,近年来对自杀行为的神经认知基础的研究取得了很大进展,神经认知扭曲被视为自杀行为的易感因子(并且是治疗的目标)及自杀行为潜在的内表型[3].本文对与自杀行为相关的神经认知因素的研究方法与现有模型进行综述,供同仁参考.     

Pharmacotherapy of disruptive behaviors associated with brain disease

Disordered behavior resulting from central nervous system dysfunction is a common clinical problem for practitioners and for patients. Setting aside the problem of overtly aggressive, violent behavior, this article addresses the problem of disordered or disruptive behavior associated with neuropsychiatric conditions.     

Dynamic neural circuit disruptions associated with antisocial behaviors

Antisocial behavior (ASB) is believed to have neural substrates; however, the association between ASB and functional brain networks remains unclear. The temporal variability of the functional connectivity (or dynamic FC) derived from resting‐state functional MRI has been suggested as a useful metric for studying abnormal behaviors including ASB. This is the first study using low‐frequency fluctuations of the dynamic FC to unravel potential system‐level neural correlates with ASB. Specifically, we individually associated the dynamic FC patterns with the ASB scores (measured by Antisocial Process Screening Device) of the male offenders (age: 23.29 ± 3.36 years) based on machine learning. Results showed that the dynamic FCs were associated with individual ASB scores. Moreover, we found that it was mainly the inter‐network dynamic FCs that were negatively associated with the ASB severity. Three major high‐order cognitive functional networks and the sensorimotor network were found to be more associated with ASB. We further found that impaired behavior in the ASB subjects was mainly associated with decreased FC dynamics in these networks, which may explain why ASB subjects usually have impaired executive control and emotional processing functions. Our study shows that temporal variation of the FC could be a promising tool for ASB assessment, treatment, and prevention.     

Replacement behaviors for identified functions of challenging behaviors

Functional assessment has become a major feature of learning-based research. A critical element of the majority of these studies includes not only methods and procedures to identify the cause of the challenging behavior, but to establish replacement treatment methods. By far the most common intervention in the 176 studies we reviewed was reinforcement. Noncontingent reinforcement (NCR) was the most common reinforcement method, followed by differential reinforcement of other behavior (DRO). Reinforcement plus extinction was the second most commonly employed treatment followed by functional communication training with or without reinforcement. Researchers proved to be very creative. Forty different treatment methods were employed. The implications of these data are discussed.