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1.
痴呆伴发抑郁症状的临床研究   总被引:12,自引:0,他引:12  
目的 了解痴呆伴发抑郁症状的发生率及评估方法的适用性。方法 用单盲交叉设计 ,由不同职称的临床医生分别采用Hamilton抑郁量表 (HAMD)和老年抑郁量表 (GDS)对 36例符合《中国精神疾病分类方案与诊断标准》(CCMD 2 R)痴呆患者的抑郁症状进行评估。结果 HAMD评分为(18.80± 11.13) ,抑郁症状发生率为 4 1.7% ;GDS评分为 (12 .6 0± 5 .96 ) ,抑郁症状发生率为 36 .1%。HAMD条目中较常见的有能力减退 2 6例 (72 % )、精神性焦虑 2 3例 (6 4 % )、有罪感 19例 (5 3% )、抑郁 17例 (4 7% )、睡眠障碍 17例 (4 7% )。逐步多元回归分析表明 ,影响抑郁症状评定的因素有病情严重程度、病人受教育程度和GDS。结论 痴呆伴发抑郁症状较常见 ,评估时应注意患者的病情、教育程度。HAMD适用于对痴呆病人抑郁症状的评估  相似文献
2.
神经症患者心理防御机制的特点对照研究   总被引:6,自引:0,他引:6  
目的 探讨神经症患者心理防御机制的特点以及与正常人的异同。方法 应用防御方式问卷 (DSQ) ,汉密顿焦虑、抑郁量表 (HAMA ,HAMD) ,对 5 1例神经症患者 ,30例正常人进行了测试。结果 ①神经症患者不成熟防御机制得分明显高于正常人组 (P <0 0 1) ;②神经症患者隔离、交往倾向、投射、被动攻击和制止得分明显高于正常人组 (P <0 0 1或P <0 0 5 )。结论 神经症患者多使用隔离、投射、交往倾向、被动攻击及制止特定的防御机制  相似文献
3.
Excessive free radical production leading to oxidative stress may be involved in the pathophysiology of schizophrenia. Determination of total antioxidant status (TAS) provides an index of the sum of activities of all antioxidants. However, there have been few systematic studies to examine the relationship between TAS levels and psychopathology in first-episode and drug-naive patients with schizophrenia.TAS levels were determined in the plasma of 60 never-medicated first-episode patients with schizophrenia and 68 healthy control subjects. The schizophrenia symptomatology and the depressive symptoms were assessed by the positive and negative syndrome scale (PANSS) and the Hamilton rating scale for depression (HAMD). The results showed that TAS levels were significantly lower in first-episode patients with schizophrenia than in healthy control subjects (159.8 ± 45.8 U/ml vs 211.4 ± 46.8 U/ml, F = 39.5, df = 1, 126, p < 0.001). A trend toward significant inverse correlation between TAS levels and PANSS negative subscore was observed (r = 0.25, df = 60, p = 0.06). Our results suggest that oxidative stress occurs in an early course of schizophrenia and may have an important role in pathogenesis and perhaps, negative symptomatology of schizophrenia.  相似文献
4.
肌萎缩侧索硬化症患者抑郁状况调查及药物干预效果   总被引:1,自引:0,他引:1  
目的调查肌萎缩侧索硬化症(ALS)患者抑郁发生率并观察药物干预效果。方法采用汉密尔顿抑郁量表(HAMD)对64例ALS患者进行测评,对伴有抑郁的不同性别、年龄及文化程度的患者进行评分比较,并对其中30例患者行抗抑郁药物干预,1个月后再进行量表测定。结果 64例ALS患者中有60例(93.4%)存在不同程度的抑郁,不同性别及年龄组的ALS患者HAMD得分无显著差异(P>0.05),但文化程度较高的ALS患者抑郁程度显著高于文化程度较低的ALS患者(P<0.01),30例伴有抑郁的ALS患者在接受抗抑郁药物干预1个月后其抑郁程度明显减轻(P<0.01)。结论绝大多数ALS患者合并抑郁,合理药物干预能有效改善ALS患者的抑郁状态。  相似文献
5.
Existing therapies for major depressive disorder (MDD) have either limited efficacy and/or poor tolerability. The present study examined the effects of duloxetine, a potent and balanced dual reuptake inhibitor of serotonin (5-HT) and norepinephrine (NE), in patients with MDD. Adult patients (N=267) with MDD were randomly assigned to receive duloxetine (60 mg/day) or placebo in this 9-week, multi-center, double-blind, parallel-group clinical trial. Efficacy was evaluated using the 17-item Hamilton Depression Rating Scale (HAMD17), Visual Analog Scales (VAS) for pain, Clinical Global Impression of Severity (CGI-S), Patient's Global Impression of Improvement (PGI-I), and Quality of Life in Depression Scale (QLDS). Safety was evaluated by assessing discontinuation rates, adverse event rates, vital signs, and laboratory tests. Duloxetine (60 mg QD) significantly reduced the HAMD17 total score compared with placebo at the end of 9-week therapy. Estimated probabilities of response and remission were 65 and 43%, respectively, for duloxetine compared with 42 and 28% for placebo. Duloxetine also reduced overall pain, back pain, shoulder pain and time in pain while awake significantly more than placebo. Global measures of improvement, including PGI-I and QLDS, were significantly improved by duloxetine compared with placebo. Discontinuations due to adverse events were more frequent for duloxetine-treated patients (12.5%) than for placebo-treated patients (4.3%). Nausea, dry mouth, dizziness, and constipation were more frequent for duloxetine than placebo. There was no significant incidence of hypertension, nor any other safety issues. Duloxetine 60 mg administered once daily appears to be a safe and effective treatment for MDD.  相似文献
6.
Taking into consideration the previous evidence of revealing the relationship of early life adversity, major depressive disorder (MDD), and stress-linked immunological changes, we recruited 22 MDD patients with childhood trauma exposures (CTE), 21 MDD patients without CTE, and 22 healthy controls without CTE, and then utilized a novel cytokine antibody array methodology to detect potential biomarkers underlying MDD in 120 peripheral cytokines and to evaluate the effect of CTE on cytokine changes in MDD patients. Although 13 cytokines were identified with highly significant differences in expressions between MDD patients and normal controls, this relationship was significantly attenuated and no longer significant after consideration of the effect of CTE in MDD patients. Depressed individuals with CTE (TD patients) were more likely to have higher peripheral levels of those cytokines. Severity of depression was associated with plasma levels of certain increased cytokines; meanwhile, the increased cytokines led to a proper separation of TD patients from normal controls during clustering analyses. Our research outcomes add great strength to the relationship between depression and cytokine changes and suggest that childhood trauma may play a vital role in the co-appearance of cytokine changes and depression.  相似文献
7.

Objective

Only two-thirds of depressive patients respond to antidepressant treatment. In recent years, addition of an atypical antipsychotic drug to ongoing treatment with an antidepressant has been considered effective and well-tolerated. In the present study, we compared the efficacy between paroxetine and sertraline augmented with aripiprazole in patients with refractory major depression.

Subjects and methods

Twenty-four patients who met the DSM-IV criteria for major depressive disorder who did not at least two different classes of antidepressants were enrolled in the study. Nine were male and thirteen were female, and their ages ranged from 28 to 66 (mean ± SD = 39 ± 12) years. Patients were prescribed paroxetine (n = 11) or sertraline (n = 13) for 4 weeks. Then, those whose scores on the 17-item Hamilton Rating Scale for Depression (HAMD17) decreased below 50% received adjunctive therapy of aripiprazole for 4 weeks.

Results

Although the use of either combination treatment decreased the HAMD17 scores compared to the respective monotherapy, there was no significant difference in HAMD17 scores between the paroxetine plus aripiprazole group and sertraline plus aripiprazole group.

Conclusion

Aripiprazole augmentation therapy with paroxetine or sertraline was equally effective and tolerated in patients with refractory major depressive order.  相似文献
8.
Excessive free radical production or oxidative stress may be involved in the pathophysiology of schizophrenia as evidenced by increased superoxide dismutase (SOD) activities, a critical enzyme in the detoxification of superoxide radicals. This study compared plasma SOD activities in 78 never-medicated first-episode and 100 medicated chronic schizophrenia patients to 100 healthy control subjects and correlated these SOD activities with the Positive and Negative Syndrome Scale (PANSS) among the schizophrenic patients. We found that both first-episode and chronic patients had significantly increased plasma SOD activities compared to controls, and that chronic schizophrenic patients on antipsychotic medication had significantly higher SOD activities than first episode schizophrenic patients. Plasma SOD activities were also negatively correlated with positive symptoms of schizophrenia, but only in first-episode patients. Thus, oxidative stress appears to be greater in first episode schizophrenic patients with fewer positive symptoms and may become greater as schizophrenia becomes more chronic, although we cannot exclude the possibility that chronic antipsychotic treatment may increase SOD activities and presumed oxidative stress in schizophrenia.  相似文献
9.
目的 探讨阿尔茨海默病(AD)与血清脑源性神经营养因子(BDNF)水平的关系。方法 采用酶联免疫吸附法对46例AD患者(研究组)和44例正常对照者(对照组)的外周血清进行BDNF水平检测。所有受试者均进行简易精神状态量表(MMSE)、Hachinski缺血指数(HIS)及汉密尔顿抑郁量表(HAMD)评定,AD患者用临床痴呆评定量表(CDR)进行痴呆严重程度分级。结果 研究组血清BDNF水平低于对照组(P〈0.01)。研究组轻度、中度与重度AD患者血清BDNF水平均低于对照组(P〈0.01),重度AD血清BDNF水平低于轻度AD(P〈0.05)。研究组血清BDNF水平与年龄、病程呈负相关(P〈0.01),与MMSE评分呈正相关(P〈0.01)。结论 AD患者存在血清BDNF水平降低,且与其年龄、病程及痴呆程度显著相关。  相似文献
10.
目的探讨度洛西汀对恶性肿瘤患者伴发抑郁障碍的临床疗效及安全性。方法60例肿瘤伴发抑郁的患者,随机分为两组,每组30例,两组患者均接受常规抗肿瘤治疗,研究组在此基础上联合度洛西汀治疗,观察8周。于治疗前及治疗2周、4周及8周末采用汉密尔顿抑郁量表评定抑郁情绪,副反应量表评定不良反应。结果治疗8周末研究组抑郁情绪改善率为76.7%,未治疗组为26.7%,研究组显著高于未治疗组(P〈O.01);研究组汉密尔顿量表评分较未治疗组显著下降(P〈O.05);两组不良反应无差异性。结论度洛西汀治疗肿瘤患者伴发抑郁障碍效果显著,安全性高。  相似文献
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