Sustained attention-deficit confirmed in euthymic bipolar disorder but not in first-degree relatives of bipolar patients or euthymic unipolar depression.

BACKGROUND: Cognitive dysfunction persists in the euthymic phase of bipolar disorder and may provide a marker of underlying neuropathology and disease vulnerability. This study aimed to replicate a deficit in sustained attention in euthymic bipolar patients and investigate sustained attention in first-degree relatives of bipolar probands and in remitted patients with major depressive disorder. METHODS: The rapid visual information processing (RVIP) task was used to measure sustained attention in 15 euthymic patients with bipolar disorder and 15 control subjects in experiment 1 and in 27 first-degree relatives of bipolar probands, 15 remitted patients with major depressive disorder, and 46 control subjects in experiment 2. RESULTS: Sustained attention deficit was confirmed in the euthymic bipolar patients in experiment 1, but the deficit was not statistically significant in remitted major depressed patients or in the relatives of bipolar probands. CONCLUSIONS: A deficit of sustained attention is not present in patients with recurrent major depression tested during remission nor is it discriminable in the first-degree relatives of bipolar probands. Thus, the confirmed abnormality in euthymic bipolar patients may be acquired as a consequence of bipolar illness. However, future studies of relatives will require larger sample sizes to exclude or utilize small genetic effects.     

精神分裂症患者额叶至杏仁核径路中电阻值变化规律的观察

目的 :研究精神分裂症患者立体定向毁损杏仁核手术径路中所测电阻值的变化规律及其辅助定位意义 .方法 :对 12 0例精神分裂症患者的额叶和手术径路中及杏仁核的电阻值进行测定 ,计算手术径路中及杏仁核的电阻值与额叶皮质的差值 ,将差值与额叶阻值之比进行统计学处理 .结果 :12 0例患者手术径路中的电阻值和额叶皮质阻值的差值与额叶皮质阻值比值 95 %的分布区间为 - 0 .0 2 10± 0 .0 0 5 2 (α =0 .0 5 ) ,杏仁核的阻值为 :(5 5 6± 84 )Ω ,白质的电阻值高于灰质 ,在近靶点 18～ 8mm位置有一高阻值区 ,该区与杏仁核之间阻值及差值比曲线下降明显 .结论 :阻值比值曲线可以反映手术径路中的阻值变化的趋势 ,该曲线稳定、可靠 .杏仁核阻值及邻近靶点高阻值区是接近杏仁核的特征 ,曲线下降明显的部分在手术中可以作为确定杏仁核位置的参考 .     

Multichannel near-infrared spectroscopy in depression and schizophrenia: cognitive brain activation study.

BACKGROUND: Recent developments in near-infrared spectroscopy (NIRS) have enabled the noninvasive clarification of brain functions in psychiatric disorders with measurement of hemoglobin concentrations as cerebral blood volume. METHODS: Ten patients with depression, 13 patients with schizophrenia, and 16 age- and gender-matched healthy control subjects participated in the study after giving consent. The relative concentrations of oxyhemoglobin [oxyHb] were measured with frontal and temporal probes every.1 sec during word fluency and unilateral finger tapping tasks, with two 24-channel NIRS machines. RESULTS: The [oxyHb] increase patterns during the word fluency task varied among the three groups, although their task performances were similar: the depression group was characterized by a smaller [oxyHb] increase during the first half of the task period and the schizophrenic group by a small trough of [oxyHb] at the start of the task period and [oxyHb] re-increase in the posttask period. [OxyHb] increases during the finger-tapping task were rather larger in the patient groups than in the control group. CONCLUSIONS: The characteristic time courses of [oxyHb] changes in the frontal lobe were elucidated for depression and schizophrenia. Near-infrared spectroscopy, with its noninvasiveness and high time resolution, can be a useful tool for research and clinical purposes in psychiatry.     

强迫症、精神分裂症患者事件相关电位P300对比分析

目的比较并分析事件相关电位(event-related potentials,ERPs)P300在强迫症(obsessive-compulsive disorder,OCD)和精神分裂症(schizophrenia, Sch)中的应用价值.方法应用脑诱发电位技术对36例OCD和36例Sch患者及33例正常对照组进行ERPs听觉P300检查.结果正常对照组、OCD和Sch三组相比潜伏期P2、N2、P3,波幅N1、P2、N2、P3差异有显著性意义(P＜0.01～0.05),异常以Sch明显.在P300地形分布图上,OCD和Sch患者均为失正态分布,其中OCD表现为以颅顶区能量缺乏或下降为主,Sch表现为左颞区能量缺乏或全脑普遍性能量下降为主.结论ERPs听觉P300能比较客观地反映OCD和Sch患者的认知功能,其在P300的不同表现源于其不同的认知缺陷类型和不同的病理心理现象,值得进一步探讨.     

Multivariate modelling and the Defence Mechanism Test: a comparative study of defensive structures in borderline, other personality disorders and schizophrenic disorder.

The study aims at discerning discriminating patterns in the perceptual responses according to the projective percept-genetic method Defence Mechanism Test (DMT) among 45 subjects with the diagnoses borderline personality disorder (BPD), other personality disorders (OPD), schizophrenic disorder (SD) and a non-patient group. The overall results show that, by means of partial least squares (PLS) discriminant analysis of 130 DMT variables, it is possible to separate these groups. Patients with a BPD or a SD diagnosis and the non-patient group are clearly separated, whereas the OPD group shows a less homogeneous pattern. The findings support both the validity of the DMT as a method to measure personality features and the psychodynamic validity of BPD. The most characteristic properties of the BPD group are responses of emotional expressions, especially introaggression and frequent distortions of the stimulus picture. Regarding the SD/OPD group, a pattern of high threshold values for perception emerges as a discriminating feature as well as different variants of introjection. The non-patients are characterized by very few DMT distortions and consequently show a good reality orientation. The conclusion is that the DMT and the PLS discriminant analysis are powerful methods in the assessment of personality pathology.     

吡拉西坦改善慢性精神分裂症患者认知功能的临床研究

目的 探讨吡拉西坦改善慢性精神分裂症患者认知功能的效果。方法 对68例慢性精神分裂症患者随机分为试验组和治疗组。治疗前进行阳性和阴性症状量表(PANSS)、简明精神状态量表(MMSE)、中国修订韦氏成人智力量表、韦氏记忆量表(WMS)及威斯康星卡片分类测验等评定,然后经利培酮(2.7±0.8)mg/d治疗8周。研究组与利培酮治疗同步使用吡拉西坦1200mg/d治疗,治疗组仅用利培酮治疗。治疗后第8周末再次进行上述评定,将结果与正常人组成的对照组进行比较。结果 治疗前研究组和治疗组的MMSE、WMS及WAIS-RC均低于对照组,差异有非常显著性(P<0.05),提示患者组的认知功能呈广泛性损害;研究组治疗后认知功能评定MMSE、MCST、WMS、WAIS-RC分数与治疗前比较有显著性差异(P<0.05);而治疗组治疗后认知功能测定MCST、WMS、WAIS-RC分数与治疗前比较无差异性(P>0.05)。结论 吡拉西坦对神经细胞有激活、保护和修复作用,能有效改善患者的认知功能,疗效确切。     

精神分裂症患者弓形虫感染率的对照研究

目的 :比较精神分裂症患者及健康人群弓形虫感染情况 ,探讨提高血清弓形虫抗体检测率的方法。方法 :同时采用ELISA和IHA法进行了血清弓形虫抗体的测定 ,对弓形虫感染率进行比较。结果 :精神分裂症患者ELISA和IHA的弓形虫抗体检出率分别为 10 5 8%和 9 6 2 % ,健康人群检出率分别为 3 80 %和 2 86 % ,差异有显著性 (P <0 0 5 ) ;农村和病程长的患者弓形虫感染率高于城镇及病程短者 (P <0 0 5 ) ,感染率与患者的年龄和性别比较差异无显著性 ;ELISA和IHA检测弓形虫抗体的符合率为 98 72 %。讨论 :精神分裂症患者弓形虫感染率较高的原因与其细胞免疫功能降低、生活自理能力及卫生状况差而易于感染有关。同时认为弓形虫病的实验室诊断最好选取两种血清学方法平行检测 ,以利于提高检测率。     

利培酮、氯氮平治疗精神分裂症患者6个月的生活质量比较

目的 :比较利培酮、氯氮平对精神分裂症患者生活质量的影响。方法 :对符合CCMD 2 R诊断标准的精神分裂症患者 ,在使用利培酮 (30例 )、氯氮平 (30例 )治疗 6个月的随访 ,观察利培酮、氯氮平对精神分裂症患者的精神症状、生活质量的影响。结果 :①利培酮组与氯氮平组相比 ,利培酮对精神分裂症阳性、阴性症状的改善和氯氮平相似 ,对患者的一般精神病理和PANSS总分的改善优于氯氮平。② 6个月的治疗前后相比 ,利培酮对患者的生活质量的影响 ,除生理领域、精神支柱外均非常明显地提高 ;氯氮平可以部分提高患者的生活质量 ,但对患者的生理领域、独立性领域、社会关系领域、精神支柱没有明显改善。③治疗 6个月后 ,利培酮组与氯氯平组相比 ,利培酮对患者的生活质量总评、心理领域、独立性领域、社会关系领域明显优于氯氮平。结论 :利培酮比氯氮平更有利于改善精神分裂症患者的社区康复功能 ,有利于患者重返社会     

不良的家庭教育方式对子女心理的影响

通过黑龙江省民族中专300余名在校学生的心理及社会生活经济状况调查资料的分析指出学生精神分裂症倾向、交往障碍等不良心理状况与家庭教育方式有直接关系。建议父母注重以民主的方式教育子女，以使他们能健康成长。     

An association study between the Cys311 variant of dopamine D2 receptor gene and schizophrenia in the Okinawan population

Abstract  Neuroleptic drugs have a high affinity for the dopamine D₂ receptor (DRD2); therefore DRD2 is thought to be a candidate gene for schizophrenia. Arinami et al . have reported a positive association between schizophrenia and the Cys311 variant of the DRD2 gene. We determined the allele frequency of this polymorphism in 78 Okinawan schizophrenic patients and 112 control subjects. The patients and controls did not differ significantly in allele frequencies of Cys311.