神经症患者的性行为及婚姻质量分析

目的为了进一步研究神经症患者的性行为特点、婚姻生活质量。方法对124例神经症患者以婚姻质量问卷（性生活、婚姻质量部份）及自编的性生活调查问卷评定,并与健康对照进行比较分析。结果1、神经症患者的婚姻质量、性生活质量因子分比对照组低（P〈0．01）。2、神经症患者性生活的意向、满意度、频度、感受,均明显低于对照组（P〈0．01）。3、性生活被动原因主要为性生活后无快感,而焦虑症、神经衰弱、躯体形式障碍的性被动原因也有不同（P〈0．01）。结论神经症患者的婚姻质量、性生活质量较低。     

慢性抑郁症的临床特征对照分析

目的 探讨慢性抑郁症患者的临床特征。方法 对258例住院抑郁症患者的有关临床资料进行回顾性调查。结果 有43例（16．7％）为慢性抑郁症患者；同非慢性者相比，其结果为慢性者多在25岁前起病，具神经质人格，病前多有负性生活事件及躯体疾病，且有明显的认识障碍及焦虑躯体化症状，较多伴有精神病性症状；经逐步回归分析，影响患者病程慢性化的主要因素为：病前神经质人格、负性生活事件、社会支持系统、精神病性症状。结论 抑郁症预后并不乐观，应加强社会心理因素的干预。     

直接皮质刺激运动诱发电位在累及运动区胶质瘤切除术中运动通路保护研究

目的在累及运动区的胶质瘤切除术中．利用直接皮质刺激产生的运动诱发电位（MEP）去判断运动传导通路纤维的数量和功能，并分析其变化和术后病人四肢运动功能的关系。方法对42例累及运动区的胶质瘤病人．术中利用微弱电流直接刺激运动区皮质并记录产生的运动诱发电位，比较肿瘤切除前、中、后MEP的变化，分析肿瘤切除后MEP下降程度和术后3个月四肢运动功能的关系。结果切瘤后MEP较切瘤前波幅下降50％以上26例，其中出现严重运动功能障碍17例（65．4％）．轻度运动功能障碍9例（34．5％）；MEP下降50％以下16例，其中出现严重运动功能障碍2例（1.3％），轻度运动功能障碍10例（62．5％）．基本正常4例（25．0％）。两组严重运动功能障碍经Х^2检验，P〈0．05，差异有统计学意义。结论术中行直接皮质刺激运动诱发电位监测可直接反映运动传导纤维的数量和功能，预测术后肢体运动情况。MEP波幅下降50％可作为将发生严重运动功能障碍的临界警戒点．     

手术戒毒复吸原因及影响因素的对比研究

目的探讨立体定向射频毁损伏隔核手术戒毒后复吸原因及影响因素。方法对2000年7月．2004年11月272例在我院接受定向伏隔核射频毁损手术戒毒的病人进行随访，其中术后复吸58例。分析术后复吸的原因，并与其以往药物戒毒复吸原因及影响因素进行回顾性分析对比研究。结果回到过去吸毒环境、受毒友引诱致复吸17例（29．3％），生活负性事件致复吸30例（51．7％），其他原因致复吸11例，复吸多发生在术后3-6个月。主观欣快感与术前相比无变化28例（48.3％），减弱30例（51．7％），无欣快感增强病例；吸食毒品量及频度与术前相比减少47例（81．0％），无明显变化6例（10．3％），增加5例（8．7％）。结论社会环境因素是手术戒毒复吸的主要原因．心理因素为次要原因。术后3-6个月易发生复吸，吸食毒品欣快感多数减弱或无明显变化。影响术后复吸的因素还与病人受教育程度．吸毒史长短，吸食毒品种类等有关。     

脑血管病患者介入术后失眠原因分析及对策

目的 探讨脑血管病患者介入术后失眠的原因及护理对策。方法 采用自行设计的睡眠情况调查表，对80例脑血管病患者（手术组）介入治疗前后睡眠状况进行问卷调查，同时选取同期入院的非手术治疗的脑血管病患者20例作为对照组。结果96．2％（77/80）的脑血管病患者行介入治疗后24h内出现失眠，明显高于对照组（65．0％，13／20），差异有显著性（P〈0．01）介入治疗后24h失眠发生率以介入溶栓术患者最高（100％，35／35）。最常见的失眠症状是人睡困难和睡眠维持障碍（睡眠中断和再入睡困难）。失眠的原因依次为：精神心理因素、肢体制动、腰背酸痛、排尿困难和环境因素。结论多种原因影响魑血管病患者介入治疗术后的睡眠质量，为此采取相应有针对性的护理策略对改善其睡眠质量具有重要意义。     

难治性癫痫手术效果评判时限

目的 总结分析难治性癫痫手术效果，以及手术后效果趋于稳定的时限。方法 对120例难治性癫痫手术患者进行长期追踪随访，并依照Engel分级对患者术后效果进行分类；比较患者术后半年，1年和远期（1年半以上）随访疗效，观察术后达到EngelⅠ-Ⅱ疗效比例的变化。结果 120例难治性癫痫手术患者中，术后半年随访发现：61％术后无癫痫再发，18％术后仅有先兆发作，7％偶有痫性发作（半年中小于2次），痫性发作明显减少（痫性发作减少大于80％）为5％，手术效果不明显（痫性发作减少小于20％）占9％；术后1年随访发现：无癫痫再发为45％，术后仅有先兆为12％，术后偶有痫性发作为12％（1年中小于3次），痫性发作明显减少为13％，手术效果不明显为18％。最近的随访结果如下（随访1．5～3年，平均1．8年）：无癫痫再发占43％，仅有先兆占13％，术后偶有痫性发作占14％，痫性发作明显减少占13％，手术效果不明显占17％。半年期随访预后和1年期随访预后中达到EngelⅠ-Ⅱ的比例有明显差异（组间差异有统计学意义，P〈0．05），1年期随访预后与长期随访预后中达到EngelⅠ-Ⅱ的比例无明显差异（组间差异无统计学意义，P〉0．05）。结论 药物难治性癫痫术后半年期随访评判疗效不可靠，而1年期疗效预示术后长期效果。     

精神病人暴力肇事行为的成因机制探讨

目的：分析精神病人攻击行为原因，探讨攻击行为机制。方法：回顾性分析38例暴力肇祸住院病人的临床资料。结果：所查病例的人口学特征与常人易犯暴力罪群体相似，但年龄偏大于中年，诊断涉及八类分属六种情况，精神分裂症占81．6％，其它诊断18．4％，在发病期和慢性期肇祸的病人分别占57．9％和42．1％，激发患者暴力攻击的因素包括现实事件（57．9％），精神病理性症状（34．2％）和性质不明的突发冲动。患者肇祸前普遍存在持续的人际关系障碍（86％8％）和负性情绪（97．4％），36．8％的病例在本次肇祸前有他人或自身的行为，21．05％的人病前有不良品行记录，结论：心理，社会环境因素作为患者攻击行为的激发因素和基本动因，在精神病的体系里建立起新的对应关系，大多数患者的攻击行为可以“挫折－攻击”机制解释，负性情绪是提示患者攻击危险的重要标志，强调评估和处理病人时的整体思考框架。     

择期神经外科手术术后镇痛及不良反应的回顾性研究

目的探讨颅内肿瘤切除术患者术后镇痛状况及年龄等因素对镇痛效果的影响。方法回顾127例颅内肿瘤切除术后患者麻醉镇痛（芬太尼联合昂丹司琼静脉持续镇痛）过程,根据视觉模拟评分（VAS）、Ramsay评分和静脉镇痛是否影响患者下床活动等标准,评价手术前和手术后24h、48h之心率、平均动脉压、呼吸频率,以及手术后24和48h疼痛程度、精神状态、活动状态和术后不良反应（呕吐、皮肤瘙痒、尿潴留、排气障碍）发生情况。结果不同年龄组患者平均动脉压和呼吸频率差异有统计学意义（均P=0．000）,但仍在正常值范围。术后总体镇痛优良率为84．25％（107／127）。不同年龄组同一测量时间点静息和活动时VAS评分差异无统计学意义（均P〉0．05）,但各组手术后48hVAS评分均低于24h时（均P=0．000）。术后总体呕吐发生率为29．13％（37／127）,尿潴留发生率为14．96％（19／127）,各年龄组之间差异均无统计学意义（P〉0．05）。影响因素分析,性别与手术后呕吐有关（P=0．022）,而美国麻醉医师协会（ASA）分级、年龄与手术后精神状态、活动状态呈正相关（P〈0．05）。结论芬太尼联合昂丹司琼持续静脉镇痛仍可为颅内肿瘤切除术患者提供较好的术后镇痛效果。性别可能为术后发生恶心、呕吐高危因素,而手术后精神状态和活动状态主要与患者年龄、ASA分级有关。     

肝移植患者术后住院期间的中枢神经系统并发症

目的探讨肝移植术后住院期间中枢神经系统并发症的发病情况、临床和神经影像学特征及可能的危险因素及预后。方法对中山大学附属第一医院1996年1月至2005年6月间共337例患者的358次肝移植手术进行回顾性研究。结果术后住院期间患者出现中枢神经系统并发症共58例，发生率16．2％，病死率41．4％。最常见的表现为肝移植脑病（10．3％），次之为癫痫（4．5％）和脑血管疾病（2．8％）。与无中枢神经系统并发症的肝移植患者相比，术后发生中枢神经系统并发症者的年龄、是否再次肝移植及病死率差异有统计学意义（P〈0．05）。结论肝移植术后住院期间中枢神经系统并发症的发生率及病死率较高，直接影响患者的生活质量及预后。年龄偏大、再次肝移植可能是其危险因素。     

显微血管减压术治疗三叉神经痛预后因素的分析

目的探讨显微血管减压术治疗三叉神经痛影响预后的因素。方法经显微血管减压术治疗三叉神经痛并获得完整随访资料的187例病人，用时序检验及COX回归模型分析影响预后诸因素。结果近期疗效优者164例（87．7％），良者23例（12．3％）。平均随访期7．38年，随访期间33例有不同程度的复发，中位复发时间为6个月，临床总有效率为82．4％，且复发大多在术后2年内，单因素分析表明动脉性压迫、神经存在血管压迹及减压方式与临床有效率有关，而单因素及多因素分析均显示静脉性压迫为复发的主要因素。结论神经受压程度、压迫血管的类型及不同的手术方式为影响显微血管减压术治疗三叉神经病预后的主要因素。     

Self-Reported Sexual Function and Sexual Arousability in Women with Epilepsy

Summary: Purpose: Women with epilepsy are at risk for sexual dysfunction but the frequency and types of dysfunction have not been well characterized.
Methods: Self-reported sexual function was evaluated in 116 women aged 18-65 years with epilepsy and no concomitant medical or psychiatric illness, including 99 with localization-related epilepsy (LRE) and 17 with primary generalized epilepsy (PGE). Variables evaluated included seizure frequency, age of seizure onset, and antiepileptic drug (AED) exposure. Standardized inventories assessed sexual functioning, sexual arousability and anxiety, sexual behavior, and depression.
Results: Although sexual experience was not reduced, women with PGE and LRE reported significantly less sexual arousability and women with LRE reported significantly more sexual anxiety. Women with LRE experienced significantly more dyspareunia, vaginismus, arousal insufficiency, and sexual dissatisfaction, whereas women with PGE experienced an-orgasmia and sexual dissatisfaction. Sexual symptoms were not associated with seizure frequency, AED exposure, sexual experience, depression, or prepubertal seizure onset.
Conclusions: In contrast to subjects of previous research, the women in our study did not have a disorder of sexual desire, but more than one third experienced disorders of sexual arousal, implying a physiological deficit. Although the etiology for these arousal phase dysfunctions has not been defined, such conditions are treatable and warrant referral to a gynecologist versed in the treatment of sexual disorders.     

Sexual dysfunction in depressed patients undergoing treatment with antidepressants

INTRODUCTION: To determine the incidence of treatment-induced sexual dysfunction in depressed outpatients treated with five different antidepressants. METHODS: 100 depressed patients (ICD-10 criteria for depressive episode, recurrent depressive disorder, and dysthymia) with an active sex life were assessed by the MADS, the CGI, and the Sexual Function Questionnaire at baseline and at 1, 2, and 4 months. RESULTS: Although the sample showed a slight improvement, generally, in sexual functioning after 4 months treatment, there were several cases of deterioration. CONCLUSIONS: Greatest interefernce with sexual functioning occurs with paroxetine, venlafaxine, and clomipramine.     

Transient cessation of female rat sexual cycle after electrolytic damage of locus coeruleus

SOLANO-FLORES, L. P., H. U. AGUILAR-BATURONI AND R. GUEVARA-AGUILAR. Transient cessation offemale rat sexual cycle after electrolytic damage of locus coeruleus. BRAIN RES. BULL. 8(6) 703–709, 1982.—In order to evaluate the possible participation of the locus coeruleus (LC) in the regulation of estrous cyclicity, bilateral LC electrolytic lesions were made in intact female rats. Vaginal smears were sampled daily and the estrous cyclicity was established. LC lesions resulted in a transient loss of cyclicity characterized by a sustained diestrous period. The delay in recovery was dependent on the percentage of LC destroyed. The cyclicity of sham operated rats and of nonoperated rats showed no change. Results are discussed within the context of the LC as a generalized influencing system.     

137例性侵害案件中受害人性防卫能力鉴定分析

目的对性侵害案件的鉴定资料进行统计分析,旨在探讨精神障碍患者受性侵害的特征及性防卫能力评定问题。方法统计2002年1月～2008年12月鉴定的性侵害案件137例,分析性防卫能力评定的相关因素,并与谢斌等编制的性自卫能力评定量表的评定结果作比较。结果生长发育阶段的病史、文化程度、工作学习能力、生活自理能力、社会交往能力、病情严重程度等与医学诊断有较密切的关系,对受性侵害性质、后果的认识、现实检验能力、病情严重程度等因素均影响性防卫能力的评定。结论性防卫能力评定应掌握客观证据,从疾病的严重程度、社会功能状况、犯罪嫌疑人的犯罪特征、环境因素以及检查中被鉴定人对性行为的认识能力等多方面综合考察评定,而客观化、标准化的量表评定不失为性防卫能力评定的参考方法 。     

Sexuality in a community based sample of adults with autism spectrum disorder

Few studies have examined the sexual attitudes and behaviours of individuals with high functioning autism spectrum disorders (ASDs) living in community settings. A total of 82 (55 female and 17 male) adults with autism were contrasted with 282 members of the general population on their responses to an online survey of sexual knowledge and experiences. Findings revealed that individuals with ASD display an interest in sex and engage in sexual behaviours and showed no significant differences in breadth and strength of sexual behaviours and comprehension of sexual language when contrasted with non-ASD participants. However, despite these similarities, a higher rate of asexuality was found among individuals with ASD. In addition, the results of the current study indicated that females with ASD show a significantly lower degree of heterosexuality when compared to males with ASD. The results also suggested a higher degree of homosexuality among females with ASD although this effect did not reach significance.     

Association between sexting and sexual coercion among female adolescents

This study aims to investigate whether experiences of offline sexual coercion are associated with adolescent females’ involvement in different types of sexting behaviors. It draws on data from 450 ethnically diverse female adolescents with an average age of 19.02 years (SD = 0.74) who were originally recruited in southeast Texas. The participants were asked about their experiences with sexual coercion, and their engagement in sexting behavior (i.e., sending, requesting, and being asked for a sext, and receiving a sext without giving permission). Logistic regressions were used to analyze these relationships, while controlling for age, ethnicity, education level, living situation, and sexting behaviors in the year prior of the study. Offline sexual coercion was significantly associated with sending and being asked for a naked image, as well as receiving a naked image without giving permission. The results suggest that sexting could function as an online extension of offline forms of sexual coercion.     

Sexual debut and college entrance among South Korean adolescents

IntroductionFor the past few decades, numerous theoretical perspectives have predicted a negative association between adolescent sexual debut and the probability of college entrance. The present article extends the literature by using nationally representative longitudinal data from South Korea to assess these perspectives.MethodsDrawing on longitudinal data from South Korea, this article examined the impact of becoming sexually active between 8th and 12th grades on the probability of college entrance. We controlled for a wide array of confounding variables by using logit models that account for longitudinal attrition and school-based sampling design.ResultsAnalytical results showed that the initiation of sexual intercourse during adolescence predicted a statistically significant decrease in the probability of college entrance for both boys and girls. Gender-specific analyses suggested that, on average, sexual debut in adolescence was associated with a decrease of 10.3 percentage points in the probability of college entrance for boys and a decrease of 14.7 percentage points for girls.ConclusionsThese findings strongly support the theoretical perspectives of age norm theory and sexual double standards in South Korea, where strictly conservative attitudes toward sexuality and sexual behaviors are dominant.     

Prospective assessment of sexual function in women treated for recurrent major depression

Although multiple factors may influence the sexual function of depressed women over the course of treatment, the independent contributions of these factors are poorly understood. The current study examined the effects of depression, SSRI treatment, and sexual partner availability on women's sexual function. The sexual function of 68 recurrently depressed women was assessed at 3-month intervals over a 1-year course of treatment with interpersonal psychotherapy with or without adjunctive SSRI treatment. Random regression models assessing changes in sexual function were conducted to test the effects of three time-dependent covariates: depression symptom scores, sexual partner availability, and SSRI medication status. Controlling for the other variables, depressive symptoms were associated with decrements in sexual desire, sexual cognition/fantasy, sexual arousal, orgasmic function, and global evaluations of sexual function. SSRI treatment was associated with orgasmic difficulty only. The availability of a sexual partner was associated with increased sexual arousal, orgasmic function, and sexual behavior. Among treatment remitters, patient reports of severe sexual dysfunction did not change over the course of treatment, although mild improvement was observed in patients' global assessment of the quality of their sexual function. This report illustrates the prevalence and persistence of sexual dysfunction in this sample, and highlights the importance of monitoring both pharmacologic and psychosocial variables that can affect the sexual function of recurrently depressed women throughout the course of treatment.     

Psychiatric factors related to sexual functioning in patients with Parkinson's disease

Introduction

This research deals with the topic of sexual life among people suffering from Parkinson's disease (PD) and with selected factors related to sexual functioning in these patients. Parkinson's disease is a serious chronic disease whose symptoms as well as treatment substantially affect the sexual life of the patients. Despite this fact, very little published work has dealt with this topic.

Aim

This research focuses on describing the structure of deterioration of sexual functions of the patients suffering from PD, and statistical analysis of the interdependence of selected factors (age, duration of the disease, subjective score of the impact of the disease, depression, anxiety) as well as the patients’ sexual satisfaction. The most substantial factors influencing sexual satisfaction of men and women with PD are analysed and their impact assessed, the greatest stress being put on psychiatric factors.

Methods

The research project examined a group of 103 people with PD. In order to identify the specifics of the patients’ sexual lives, two questionnaire-sets were designed (separate for men and women), containing psychological (BDI-II, STAI) and sexological (FSFI, IIEF, GRISS) questionnaires.

Main outcome measures

The main outcome measures were depression, state and trait anxiety, sexual satisfaction, erectile function, the Female Sexual Function Index.

Results

The acquired data was statistically elaborated using the programme SPSS. The results of the sexological questionnaires show a decrease in overall sexual functioning and the presence of sexual dysfunctions related to PD. With the help of regression models it was elicited that in case of men with this illness, the most influential factor on their sexual life is depression and their subjective scoring of the illness, in the case of women the prevailing factors are depression and anxiety.

Conclusions

Sexuality for people suffering from Parkinson's disease is a very complex issue and psychiatric factors (depression, anxiety) have an important impact on the sexual functioning of the patients.