气功所致精神病与精神分裂症的临床特征对照研究

目的　比较气功所致精神病与精神分裂症的临床特征。方法　比较分析按CCMD - 2诊断为气功所致精神病 84例、气功所致精神分裂样障碍 4 4例和精神分裂症 37例的临床特征。结果　气功所致精神病平均发病年龄大于精神分裂症。三组BPRS总分均值比较 ,说明初次精神病发作时症状严重程度没有差别。抗精神病药平均日剂量 ,气精组 <分裂样组 <分裂症组 ,而显效率分别为 88.1%、75 .0 %、32 .4 %。结论　气功所致的精神病初次发作严重程度与分裂症没有明显差异 ,且抗精神病药物能有效地控制其精神病发作 ;短期治疗效果比分裂症要好 ;发病有独特的文化基础与病因。如果属于气功诱发精神分裂样精神障碍 ,而短期内又不能确诊者 ,笔者倾向于诊断为精神分裂症 ,而临床表现和精神障碍内容是气功所致精神障碍和精神分裂症的早期诊断参考指标     

气功相关精神障碍患者82例随访对照分析

目的：对气功所致精神障碍与气功相关的精神分裂症的临床特点差异进行探讨。方法：收集在1990年至2000年间连续入院患者中与气功相关的精神病性障碍患者82例，其中住院时诊断为气功所致精神障碍46例，精神分裂症36例。收集两组病例的人口统计学、临床表现等资料并作5年以上随访。结果：气功所致精神障碍（气功组）与精神分裂症（分裂症组）比较，在性别、婚姻、年龄、接受教育年限、起病年龄及病程方面差异均有显著性（P均〈0．001）。获得68例5年以上的随访资料，其中气功组38例，分裂症组30例。至随访结束，气功组中84％（32例）、分裂症组中57％（17例）维持原诊断，二者差异有显著性（P〈0．001）。气功组的精神障碍缓解程度达89％（34例），而分裂症组的缓解程度仅33％（10例），差异有显著性（P〈0．001）。气功组的社会功能也明显优于分裂症组（P〈0．01）。结论：气功所致精神障碍与气功相关的精神分裂症是两种不同类型的疾病，根据临床特点，二者可以鉴别。     

对精神疾病患者就诊途径的调查

作者对精神疾病患者就诊途径进行了调查 ,现报告于后。1　对象与方法1.1　调查对象　为 1999年 8月～ 2 0 0 0年 8月首次入院的精神疾病患者 ,共计 2 6 0例。其中 ,男 15 8例 ,女 10 2例 ,平均年龄 (34 .7± 10 .9)岁 ,大专以上文化 16例 ,中专 19例 ,高中 78例 ,初中 81例 ,小学以下 6 6例 ,城市 172例 ,农村 88例 ,平均病程 (85 .4± 41.7)天。诊断为精神分裂症 12 5例、分裂样精神病 9例、偏执性精神病 3例、情感性精神障碍 38例、酒精所致精神障碍 9例、颅脑创伤所致精神障碍 8例、癫疒间 所致精神障碍 10例、阿尔茨海默病 3例、气功所…     

慢性癫痫性分裂样精神病临床分析

慢性癫痫性分裂样精神病是癫痫病人在意识清醒状态下发生联想障碍、强制性思维、被害妄想和幻听等类似偏执型精神分裂症的临床征象[1]。在临床上易误诊为精神分裂症。为了进一步探讨慢性癫痫性分裂样精神病的临床特征,作者对我院收治的31例慢性癫痫性分裂样精神病作一回顾性分析,现报告如下。1　资料1.1　临床资料:病例选自1990年6月至1998年7月首次住本院的慢性癫痫性分裂样精神病患者。入组标准为:①符合中国精神疾病分类方案与诊断标准第二版修订本癫痫性精神障碍诊断标准;②精神障碍类型以精神病性症状为主要特征,且为持续性精神障碍。…     

牛肝蕈中毒所致精神障碍30例临床分析

目的：分析牛肝蕈中毒所致精神障碍的临床表现及治疗。方法：对食用牛肝蕈，符合中国精神障碍分类与诊断标准第3版非成瘾物质所致精神障碍诊断标准的30例患者进行临床分析。结果：牛肝蕈中毒所致精神障碍的临床表现为精神分裂样症状，有特殊的“小人”幻视、妄想、兴奋紧张、失眠、行为紊乱等，并对肝脏和血液系统等有损害。精神障碍的程度与食蕈量有关；精神症状越重，所需缓解时间越长。经短程抗精神病药物等相应处理后精神病性症状可消除。结论：过量食用牛肝蕈可影响和损害神经系统，经短程抗精神病药物治疗，精神障碍可在短时间内治愈。     

“气功”与精神障碍

“气功所致精神障碍”自1989年纳入精神疾病分类与诊断标准后,对其诊断的独立性一直有分歧。为了统一认识,促进气功与精神障碍关系的进一步研究,上海市精神医学会于1999年6月23日举行了“气功所致精神障碍”的专题讨论,现将讨论内容介绍给各位同道,以供参考。     

气功所致精神障碍与分裂样精神障碍MMPI对照研究

ＭＭＰＩ测试气功所致精神障碍住院男性患者２１例，同期住院分裂样精神障碍男性患者２６例作对照研究，结果发现前者Ｆ、２、６、８量表美国Ｔ分均值明显升高，可能有个性偏移。但其ＭＭＰＩ特征及各量表Ｔ分增高程度与分裂样精神障碍有明显的差别。     

酒中毒性幻觉症和妄想症与精神分裂症的比较

酒中毒性幻觉症和妄想症由长期饮酒引起，患者意识可以清晰，有时与精神分裂症不易鉴别，现对此作一比较。在60例酒精所致精神障碍的患者中，能符合CCMD—2—R酒中毒性幻觉症和酒中毒性妄想症的诊断标准，饮酒5年以上，排除其他精神障碍，无精神分裂症及情感性精神障碍家族史者46例（饮酒组）；与首次发病在30岁以后，以偏执症状为主要表现的精神分裂症（含分裂样精神病，均符合CCMD－2－R诊断标准）30例（分裂症组）进行比较。两组患者均男性，年龄、病程和复发次数、病前性格、文化程度、婚姻和职业皆无显著差异（P均＞0．05）。饮酒…     

气功所致精神分裂样障碍随访对照研究

目的：研究气功所致精神分裂样障碍的临床特征和近期疗效。方法：比较分析气功所致精神障碍84例、气功所致精神分裂样障碍44例和精神分裂症37例的近期疗效。结果：精神分裂症的发作次数明显多于气功所致精神障碍。精神分裂症和气功所致精神分裂样障碍者的精神功能减退比气功所致精神障碍者明显。结论：气功所致精神分裂样障碍近期治疗效果比精神分裂症要好，但是，停止治疗和继续练功也可能导致疾病复发。     

精神分裂症与分裂样精神病前躯症状对照分析

为探讨精神分裂症和分裂样精神病前躯症状诊断价值，对80例首次诊断为分裂样精神病，复发后改诊为精神分裂症病人(SC组)与60例维持诊断分裂样精神病的病人(SCF组)的前躯症状进行了比较分析。结果显示：前躯症状的发生率，尤其是不恰当行为、性格改变、讲话离题、躲避亲人或与人疏远、敏感、多疑、怪异想法、无端恐惧、强迫症状等发生率SC组显高于SCF组。提示精神分裂症一分裂样精神病的前躯症状确有差异。     

Is schizophrenia associated with narcolepsy?

OBJECTIVE: To determine the nature of the relationship between schizophrenia-like psychosis and narcolepsy. BACKGROUND: A relationship between schizophrenia and narcolepsy has long been postulated due to the association of schizophrenia-like psychosis with narcolepsy and its treatment. METHOD: We report two patients who presented with schizophrenia-like psychosis of narcolepsy and review the literature regarding possible shared neurobiology between the two disorders that might explain their co-occurrence. RESULTS: There appears to be little in the way of common pathology between these two conditions when symptoms, human leukocyte antigen associations, rapid eye movement sleep architecture, D2-dopamine receptor changes, and hypocretinergic function are examined. CONCLUSIONS: The available literature suggests that schizophrenia-like psychosis in narcolepsy is most commonly medication related or a chance co-occurrence, with limited evidence for a separate psychosis of narcolepsy.     

Schizophrenia-like psychosis arising de novo following a temporal lobectomy: timing and risk factors

OBJECTIVES: To clarify risk factors for the development of schizophrenia-like psychotic disorders following temporal lobectomy, and to explore the possibility that the early postoperative period is a time of high risk for the onset of such chronic psychotic disorders. METHODS: Patients who developed schizophrenia-like psychosis were identified from a series of 320 patients who had a temporal lobectomy for medically intractable epilepsy. The relationship of their disorders to both the operation and subsequent seizure activity was examined. Using a retrospective case-control design, risk factors for the development of schizophrenia-like psychosis were established. RESULTS: Eleven patients who developed schizophrenia-like psychosis postoperatively were identified and compared with 33 control subjects who remained free of psychosis postoperatively. The onset of de novo psychotic symptoms was typically in the first year following the operation. No clear relationship between postoperative seizure activity and fluctuations in psychotic symptoms emerged. Compared with the controls, patients who become psychotic had more preoperative bilateral electroencephalogram (EEG) abnormalities, pathologies other than mesial temporal sclerosis in the excised lobe and a smaller amygdala on the unoperated side. CONCLUSIONS: Temporal lobectomy for medically intractable epilepsy may precipitate a schizophrenia-like psychosis. Patients with bilateral functional and structural abnormalities, particularly of the amygdala, may be at particular risk for the development of such psychoses.     

Are Black Caribbean patients more likely to receive an incorrect diagnosis of very-late-onset schizophrenia-like psychosis than their white British counterparts?

OBJECTIVE: Increased rates of schizophrenia and schizophrenia-like psychoses are repeatedly reported within migrant populations. The authors investigated whether some or all of an observed increase in service contact rates for very-late-onset schizophrenia-like psychosis in older black people of Caribbean origin could be explained by underdiagnosis of affective psychosis. METHODS: The case-notes of 47 patients with very-late-onset schizophrenia-like psychosis were rated with a 44-point psychopathology checklist. RESULTS: Black Caribbean patients with very-late-onset schizophrenia-like psychosis were younger and more likely to be male than their white British counterparts. Although there were some differences in symptoms between the groups, these did not reach levels of statistical significance. CONCLUSION: Further studies will be required to establish the diagnostic stability and outcome of very-late-onset schizophrenia-like psychosis in older black Caribbean migrants.     

分裂样精神病与首发精神分裂症临床特征比较

目的:比较分裂样精神病与首发精神分裂症的临床特征。方法:选取同期出院的分裂样精神病、首发精神分裂症患者各45例进行临床特征比较。结果:分裂样精神病与首发精神分裂症在思维贫乏、懒散、紧张恐惧和冲动破坏方面差异显著。结论:分裂样精神病与首发精神分裂症相比,某些症状有显著差异。     

Cannabis psychoses in south Sweden

Eleven patients with a psychosis in connection with cannabis abuse admitted to two mental hospitals during 1 year were examined. Patients with a preexistent psychosis or a mixed abuse were excluded. The patients were divided into three groups: acute, sub-acute and chronic. The features of the disease were essentially similar in all patients, with a mixture of affective and schizophrenia-like symptoms, confusion and a pronounced aggressiveness. The course as a rule was self-limiting leaving no residual symptoms. There was almost no heredity of severe mental disease. The symptoms were very similar to those seen in cycloid psychosis, and a possible relationship between the two diseases is discussed. As regards the widespread abuse of cannabis we conclude that psychosis is a rare complication but that in unclear psychotic states it is recommended to actively search for a cannabis psychosis.     

Is psychosis a neurobiological syndrome?

OBJECTIVE: To describe theoretical weaknesses in the DSM-IV criteria for psychotic disorders and to argue that schizophrenia-like psychosis is a neurobiological syndrome similar to aphasia or apraxia. METHOD: We outline the criteria for the concept of neurobiological syndrome and present supporting evidence for schizophrenia-like psychosis as a neurobiological syndrome. RESULTS: There is evidence in the literature to support the hypothesis that schizophrenia-like psychosis is a neurobiological syndrome. CONCLUSION: Conceptualizing schizophrenia-like psychosis as a neurobiological syndrome has important implications for both clinicians and researchers.     

分裂样精神病2年随访研究

目的 探讨分裂样精神病（简称ＳＦＰ）的临床特征及转归。方法 对首次入院诊断ＳＦＰ的８９例患者进行２年随访，分别按照ＣＣＭＤ－２－Ｒ及ＤＳＭ－ＩＶ二种诊断标准作比较。结果 从诊断标准看，根据ＣＣＭＤ－２－Ｒ，改诊ＳＰ的５４例（６０．７％），维持ＳＦＰ的３１例（３４．８％），根据ＤＳＭ－ＩＶ，改诊ＳＰ的４８例（５３．９％），维持ＳＦＰ的３７例（４１．６％），两种标准间无显著差异。从临床特征看，ＳＦＰ患者与改诊ＳＰ患者比较，临床不具思维化声，维持治疗期疗效好，阴性症状改善明显等特点。结论 ＳＦＰ作为一个独立的疾病单元有其存在价值。     

利培酮合并氯硝安定肌注和氟哌啶醇肌注治疗精神分裂症急性期兴奋、激越的对照研究

目的　比较利培酮合并氯硝安定肌注和氟哌啶醇肌注对治疗精神分裂症急性期兴奋、激越的疗效和副反应。方法　将符合CCMD 2 R诊断标准的精神分裂症及分裂样精神病患者 ,随机分别进入利培酮合并氯硝安定组和氟哌啶醇组 ,观察 8周。以PANSS和TESS量表评定药物的疗效和不良反应。结果　治疗 1周后 :利培酮合并氯硝安定组和氟哌啶醇组的PANSS量表总分、兴奋因子分均显著下降 ,但二组之间比较未达到统计学上的差异 (P >0 .0 5 ) ,在后续阶段 (8周时 )利培酮合并氯硝安定组的PANSS量表总分减分率较氟哌啶醇组明显 (P <0 .0 5 ) ;TESS量表的评分两组间则有非常显著性差异 (P <0 .0 1)。结论　利培酮合并氯硝安定及氟哌啶醇均获得较好的镇静效果 ,利培酮合并氯硝安定在后续阶段治疗效果较氟哌啶醇好且相对较安全。