阿立哌唑联用小剂量氯氮平治疗女性难治性精神分裂症对照研究

目的 探讨阿立哌唑联合小剂量氯氮平对女性难治性精神分裂症（TRS）的疗效和安全性。方法 将62例女性TRS患者随机分成研究组和对照组各31例,对照组采用阿立哌唑治疗,研究组采用阿立哌唑联用小剂量氯氮平治疗,观察26周。于治疗前及治疗后第8、12、26周末进行阳性和阴性综合征量表（PANSS）评定;治疗后第1、2、6、12、26周末用治疗中需处理的不良反应症状量表（TESS）评定不良反应。结果 治疗后第8、12、26周末两组PANSS总分均较治疗前下降（P〈0.01）,研究组PANSS总分低于对照组（P〈0.05）。两组间不良反应发生率比较差异无统计学意义（P〉0.05）。结论 阿立哌唑联合小剂量氯氮平治疗女性TRS更有效且安全。     

The CMYA5 gene confers risk for both schizophrenia and major depressive disorder in the Han Chinese population

Objectives. A recent genome-wide association study (GWAS) of the European population implicated the CMYA5 gene in schizophrenia. Previous functional studies showed that the CMYA5 protein can interact with DTNBP1 and PKA, providing further support for a role of CMYA5 in the pathogenesis of schizophrenia. However, this association requires additional validation in independent populations. Methods. To validate the association between CMYA5 and schizophrenia and major depressive disorder, we genotyped 16 SNPs within the CMYA5 gene and performed case–control studies in 1330 schizophrenia patients, 1045 patients with major depressive disorder, and 1235 normal controls. All patients were of Han Chinese origin. Results. rs6883197 and rs259127 were significantly associated with schizophrenia, and rs12514461, rs259127, and rs7343 were associated with major depressive disorder. Additionally, one risk haplotype of rs16877109–rs3828611 (G–G) was associated with both schizophrenia (P = 0.0000784, after correction) and major depressive disorder (P = 0.00230, after correction). Conclusions. Our findings support the idea that specific alleles and haplotype in the CMYA5 confer genetic risk for both schizophrenia and major depressive disorder in the Han Chinese population.     

Prolactin serum levels correlate with inflammatory status in drug-naïve first-episode schizophrenia

Objectives. The present study was to examine the relationship between serum levels of prolactin and the inflammatory status in drug-naïve, first-episode schizophrenia patients with normal weight. Methods. Patients with normal weight, drug-naïve, first-episode schizophrenia and healthy controls were enrolled in the study. Serum levels of prolactin (PRL) were measured using electrical chemiluminescence immunoassay. Serum levels of interleukin-1β (IL-1β), tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were examined using enzyme-linked immunosorbent assay (ELISA). Results. Sixty patients with normal weight, drug-naïve, first-episode schizophrenia and 60 healthy controls were enrolled. The schizophrenia group had higher serum levels of PRL, IL-1β, IL-6 and TNF-α compared with the control group. There was a gender difference of hyperprolactinemia in schizophrenia group. There were positive relationships between serum levels of PRL and serum levels of IL-1β, IL-6 and TNF-α within the schizophrenia group. Within the schizophrenia group, TNF-α was the strongest predictor among the three cytokines for serum levels of prolactin after controlling for gender, age, education, smoking status and disease duration. Conclusions. Patients with normal weight, drug-naïve, first-episode schizophrenia present elevated serum levels of PRL, which might be related to the up-regulated inflammatory status in this patient population.     

Dominant negative DISC1 mutant mice display specific social behaviour deficits and aberration in BDNF and cannabinoid receptor expression

Objectives. Disrupted in schizophrenia 1 (DISC1) is considered the most prominent candidate gene for schizophrenia. In this study, we aimed to characterize behavioural and brain biochemical traits in a mouse expressing a dominant negative DISC1mutant (DN-DISC1). Methods. DN-DISC1 mice underwent behavioural tests to evaluate object recognition, social preference and social novelty seeking. ELISA was conducted on brain tissue to evaluate BDNF levels. Western blot was employed to measure BDNF receptor (TrkB) and cannabinoid receptor CB1. Results. The mutant DISC1 mice displayed deficits in preference to social novelty while both social preference and object recognition were intact. Biochemical analysis of prefrontal cortex and hippocampus revealed a modest reduction in cortical TrkB protein levels of male mice while no differences in BDNF levels were observed. We found sex dependent differences in the expression of cannabinoid-1 receptors. Conclusions. We describe novel behavioural and biochemical abnormalities in the DN-DISC1 mouse model of schizophrenia. The data shows for the first time a possible link between DISC1 mutation and the cannabinoid system.     

Genes and schizophrenia: a pseudoscientific disenfranchisement of the individual

The biological model of schizophrenia remains the dominant model within mental health services. It has a powerful influence on the culture of mental health services; providing the structure for the delivery and selection of mental health treatments. There is widespread acceptance of a genetic cause for schizophrenia. Acceptance of a genetic cause is inconsistent with a person-centred recovery-orientated approach. The following paper provides a rigorous review of the underpinning research that supports the genetic argument. Appraisal of family, twin and adoption studies uncovers serious flaws in the methodologies and statistical analyses used in studies. These flaws not only artificially inflate the genetic contribution to schizophrenia but also invalidate many of the findings. More recent micro-imaging techniques have also failed to find replicable and consistent findings indicating a clear genetic pathway to schizophrenia. Freed from the implied pessimism of an unmodifiable genetic cause for schizophrenia, mental health nurses can confidently work to instil hope with people that have a diagnosis of schizophrenia.     

Schizophrenia: a review of the contemporary literature and implications for mental health nursing theory, practice and education

Contemporary research in the aetiology, neuropsychology and epidemiology of schizophrenia is reviewed. The picture coming from this work is of a group of brain diseases of neurodevelopmental origin which manifest themselves in a variety of ways. In turn, there are a range of cognitive deficits associated with the schizophrenias which may, in the extreme, produce major functional handicap. This new knowledge has obvious implications for nurse education and a priority is to place this in undergraduate programmes. However, more importantly, it is argued that we need to alter conceptual frameworks. For example, in some cases we should care for people with schizophrenia in the same way as one would care for an individual suffering the after-effects of a head injury. In the more severe forms of the illness we should take into account the probability that our patients may have significant problems of memory and attention, and thus modify interventions accordingly. It seems clear that our current nursing theories are not underpinned by relevant knowledge of the nature of schizophrenia and this problem warrants urgent attention.     

工娱治疗对慢性精神分裂症患者的康复作用

目的探讨工娱治疗对慢性精神分裂症患者康复的效果。方法对70例慢性精神分裂症患者随机分为观察组和对照组各35例，两组均在药物治疗基础上，按常规护理。观察组在此基础上采用工娱疗法进行系统康复治疗，两组在治疗前后用阴性症状量表（SANS）观察效果。结果观察组工娱治疗12周后，SANS评分与对照组差异显著。结论工娱治疗对慢性精神分裂症患者康复疗效肯定，对慢性精神精神分裂症患者重返社会起重要的促进作用。     

慢性精神分裂症患者的康复护理模式探讨

目的：探讨结对护理模式对慢性精神分裂症患者康复的影响。方法：将96例慢性精神分裂症患者按住院顺序随机分为研究组(结对康复)和对照组(一般康复),每组各48例,在常规治疗护理不变的情况下,研究组采用结对护理模式进行康复训练。分别于入院时和康复训练12周末,采用住院患者护士观察量表(NOSIE)、阴性症状评定量表(SANS)、日常生活能力量表(ADL)对每位患者进行评定。结果：研究组和对照组各量表评分优于康复训练前,差别有显著性意义(P＜0．01),研究组疗效优于对照组(P＜0．01)。结论：结对护理模式对慢性精神分裂症患者的康复有积极作用。     

精神分裂症的抑郁症状

为了探讨精神分裂症抑郁症状发生率及其相关因素,对159例精神分裂症患者在疗前和疗后8周进行了阳性症状量表(SAPS)、阴性症状量表(SANS)和Hamilton抑郁量表(HAMD)评定,并对抑郁症状的相关因素进行了分析。结果显示,精神分裂症患者的抑郁症状发生率为60.38%;抑郁症状与阳性症状(SAPS总分)、住院次数和自杀未遂发生率有显著相关,而与阴性症状(SANS总分)和疗效无明显相关。作者认为抑郁症状是精神分裂症症状的组成部分,一般不需合并抗抑郁剂治疗。