Bell s面瘫对患者的心理影响及其心理健康状况

目的探讨Bell's面瘫对首次发病患者形象、情绪、日常生活及社会活动的影响及发病早期患者的心理健康状况。方法采用自编面瘫对患者形象、情绪及社会活动影响的调查问卷及症状自评量表(SCL-90),对63例首次发病的Bell's面瘫患者进行调查。统计分析采用t检验及相关分析。结果Bell's面瘫对首次发病患者形象、情绪、日常生活及社会活动均有明显影响。Bell's面瘫患者SCL-90的躯体化、强迫、人际关系敏感、焦虑、抑郁、敌对、恐怖、精神病性因子分均高于全国成人常模,其SCL-90总分与自编面瘫影响问卷各条目得分均存在统计学相关关系。结论Bell's面瘫给首次发病患者带来不良心理影响,他们存在广泛的心身症状,这些不良影响与其心身症状有关。     

Exploring the potential association among sleep disturbances,cognitive impairments,and immune activation in 22q11.2 deletion syndrome

22q11.2 deletion syndrome (22q11.DS) is a neurogenetic disorder caused by a microdeletion in chromosome 22. Its phenotype includes high rates of psychiatric disorders, immune system abnormalities, and cognitive impairments. We assessed the quality of sleep in 22q11.2DS and its potential link to inflammatory markers and cognitive deficits. Thirty‐three 22q11.2DS individuals and 24 healthy controls were studied. Sleep parameters were assessed by the Pittsburgh sleep quality index (PSQI) questionnaire and correlated with serum cytokine levels and cognitive functioning, measured using the Penn computerized neurocognitive battery (CNB). The 22q11.2DS individuals had significantly worse sleep quality scores than the controls, unrelated to the psychiatric or physical comorbidities common to 22q11.2DS. Interleukin 6 levels were correlated with the overall score of the PSQI questionnaire for nonpsychotic 22q11.2DS participants only. Several domains of the CNB were associated with poorer sleep quality, suggesting that cognitive impairments in 22q11.2DS may be at least partially explained by poor sleep quality. Our findings confirm sleep impairments in individuals with 22q11.2DS, which might negatively affect their cognitive functioning, and corroborate a potential role of immunological pathways in the 22q11.2DS neuro‐phenotype.     

Long-term culture of neurones from human cerebral cortex in serum-free medium

A method for cultivating neurones from the fetal human central nervous system in the absence of glial cells is described. Brain cells from 15-18-week-old human fetuses are plated on polylysine-coated surfaces and grown in a serum-free hormonally-defined medium. About 98% of the cells were identified as neurones using tetanus toxin as a marker. The cultures survive for up to 7 weeks and develop an extremely complex network of neurites.     

Alcoholism and drug abuse in three groups — bipolar I, unipolars and their acquaintances

Objective: Previous work has shown that manic-depressive illness and alcohol abuse are linked. This study further explores the relationship of alcohol and drug abuse in bipolar I patients and unipolar depressives and a comparison group obtained through the acquaintance method. Method: Diagnosis was accomplished according to Research Diagnostic Criteria (RDC): controls=469; bipolars=277; unipolar depressives=678. Systematic data were gathered using the SADS on lifetime and current drug abuse and alcoholism. Both patients and comparison subjects were then followed prospectively for 10 years. First degree family members were interviewed using the RDC family history method. Results: The group of bipolar patients and the group of unipolar patients had higher rates of drug and alcohol abuse than the comparison group when primary and secondary affective disorder patients were combined. However, primary unipolar patients did not have higher rates of alcohol or drug abuse than the comparison group. In contrast, primary bipolar patients had higher rates of alcoholism, stimulant abuse, and ever having abused a drug than the primary unipolar group and the control group. In an evaluation of the bipolar patients, drug abusers were significantly younger at intake and had a significantly younger age of onset of bipolar disorder. There was a significant increase in family history of mania or schizoaffective mania in the drug-abusing bipolar patients as compared to the non-abusing bipolar patients. Limitation: As in all adult samples of patients with affective illness, the chronology of alcohol and substance problems vis-à-vis the onset of illness was determined retrospectively. Conclusions: (1) Alcoholism and drug abuse are more frequent in bipolar than unipolar patients. (2) The drug abuse of bipolar patients tends toward the abuse of stimulant drugs. (3) In a bipolar patient, familial diathesis for mania is significantly associated with the abuse of alcohol and drugs. (4) More provocatively, these findings suggest the hypothesis of a common familial-genetic diathesis for a subtype of bipolar I, alcohol and stimulant abuse. Clinical implications: The present analyses, coupled with two previous ones from the CDS, suggest that drug abuse may precipitate an earlier onset of bipolar I disorder in those who already have a familial predisposition for mania. Furthermore, in dually diagnosed patients with manic-depressive and alcohol/stimulant abuse history, mood stabilization of the bipolar disorder represents a rational approach to control concurrent alcohol and drug problems, and should be studied in systematic controlled trials.     

不同时期在押罪犯司法精神病学鉴定案例的对比分析

目的 探讨近年来在押犯罪司法精神病学鉴定的特点和发展趋势。方法 对1994年后经该院鉴定的87例与1993年前鉴定的33例在押罪犯案例进行对比分析。结果 1994年后组在押罪犯鉴定的案例明显增加（P＜0．01）。服刑能力的鉴定,1994年后组较多（P＜0．01）,服教能力的鉴定,1993年前组较多（P＜0．05）。1994年后组经济类案件有上升趋势（P＜0．05）,诊断为精神分裂症的有明显下降（P＜0．01）,诊断为拘禁性精神障碍的有明显上升（P＜0．05）。结论 在押罪犯司法精神病学鉴定已成为司法精神病学鉴定的重要组成部分,对其法定能力的评定需进一步入研究。     

The frequency of shared delusions in delusions of infestation

Summary The phenomenon of shared delusions was found in 9 (8.4%) of 107 personally investigated patients suffering from delusions of infestation (88 females, 19 males). A greater number of females (ratio of females to males 3.5:1) induced others, whereas a gender ratio of 1:1 was evident in the group of affected patients. Since the ratio of blood relations to non-blood relations was 1:2.3, genetic factors seem to play a less important role than the direct impact of deluded patients on their environment. The rare occurrence of shared delusions of infestation leads to the conclusion that only persons with a paranoid predisposition(paranoide Bereitschaft) may be affected. Cases of induced delusions are also described in which attending physicians act as inducers.     

From hysterical psychosis to Reactive Dissociative Psychosis

In this paper Reactive Dissociative Psychosis (RDP) is seen as a post-traumatic stress response and as a subcategory of Brief Reactive Psychosis (BRP). A review of the literature and the evolution of RDP from Hysteria and Hysterical Psychosis are given. Issue is taken with defining the duration of BRP as Brief. The authors argue that long-standing psychotic symptoms may be traumatically induced. The dissociative aspects of RDP as its key feature and the concomitant implications for accurate diagnosis are proposed. The usefulness of applying hypnosis in RDP treatment is summarized in a case study from Janet and detailed in a case from the authors' practice.This article was accepted for publication under the Editorship of Charles Charles R. Figley.     

PTSD and Comorbid Psychotic Disorder: Comparison with Veterans Diagnosed with PTSD or Psychotic Disorder

Symptoms of posttraumatic stress disorder (PTSD), psychosis, general psychopathology, role functioning, violence potential, and cognitive and emotional aspects of psychotic states were compared in three groups of veterans. Groups were defined on the basis of their DSM-IV diagnoses: Psychotic disorder and war-related PTSD, war-related PTSD without psychotic symptoms, and psychotic disorder without PTSD. Veterans with PTSD and a comorbid psychotic disorder showed significantly higher levels of positive symptoms of psychosis, general psychopathology, paranoia, and violent thoughts, feelings, and behaviors than the other two groups. These data show that patients with comorbid PTSD and psychotic disorder show levels of cognitive, emotional, and behavioral disturbance that far exceed the levels of disturbance seen in patients with PTSD without psychosis or in patients with psychotic disorder.     

Prevalence and predictors of parasuicide in chronic psychosis. UK700 group

OBJECTIVE: This study estimates the prevalence of and risk factors for parasuicide in a large community-based sample of patients with chronic psychosis. METHOD: A total of 704 subjects with chronic psychosis were interviewed using a battery of instruments. The 2-year prevalence of parasuicide was estimated and a comparison was made between attempters and nonattempters on a wide range of sociodemographic and clinical variables. RESULTS: The 2-year prevalence of parasuicide was 18.8%. Attempters were significantly more likely to be younger, of white ethnic origin, to have a diagnosis of affective disorder, to be currently depressed, to have experienced more auditory hallucinations and to have received treatment with antipsychotic drugs for a longer period. CONCLUSION: Parasuicide was found to present a considerable clinical problem in this group. Continual risk assessment is essential to reduce this unacceptably high rate.     

A case of small cerebral cyst and pericentric inversion of chromosome 9 that developed schizophrenia-like psychosis

A case of schizophrenia-like psychosis (psychotic disorder not otherwise specified according to the DSM-IV criteria) with pericentric inversion on chromosome 9 [inv.(9) (p11; q13)] is reported. In this case, a minor brain anomaly, a small cyst in the left subcortex, was observed on magnetic resonance imaging of the brain. In the clinical course, prominent chronic hallucinations were observed; however, there was no evidence of the disorganization of personality, delusion, and deterioration in level of functioning that are usually seen in schizophrenia. This case and a review of the literature indicate that the pericentric region of chromosome 9 might be a potential areas of interest for the aetiology of psychiatric disorders. The phenotype-karyotype relationship of pericentric inversion on chromosome 9 and its relationship to psychosis are discussed.