与迷信巫术相关的精神障碍44例分析

目的：探讨与迷信巫术相关的精神障碍的临床特征、治疗和转归。方法：对出院诊断为与迷信巫术相关的精神障碍患者44例进行2年随访，按中国精神疾病分类方案与诊断标准第2版修订本进行再诊断。结果：23例(52．3％)患者维持原诊断，21例(27．7％)的患者更正诊断，精神分裂症10例，情感性精神障碍8例，癔症3例。结论：迷信、巫术是致病因素，可引发“与迷信巫术相关的精神障碍”疾病，也可是其他精神障碍，尤其是精神分裂症、情感性精神障碍的一种诱因。     

17例与迷信巫术相关的精神障碍临床分析

１７例与迷信巫术相关的精神障碍临床分析四川省绵阳市精神卫生中心（６２１０００）刘华莉杜海英王新英与迷信巫术相关精神障碍最早在ＣＣＭＤ—２［１］中单独列出，是否符合临床实际，本文作者对１７例与迷信巫术相关精神疾病进行了分析，现将结果报告如下。１资料１．...     

与迷信巫术相关的精神障碍同癔症的对照研究

目的　研究与迷信巫术相关精神障碍的临床特征。　　方法　将与迷信巫术相关的精神障碍41例与社会心理应激诱发的癔症 52例进行临床对照研究。　　结果　研究组平均发病年龄大于对照组 ,遗传史、文化背景、临床特征均有明显不同。附体体验显著高于对照组 ,且附体内容也存有差异。　　结论　表明两者属不同类型的精神障碍 ,与迷信巫术相关的精神障碍作为一类文化相关精神障碍是合理的 ,支持CCMD—Ⅱ—R。     

与迷信巫术相关的精神障碍31例10年随访分析

目的探讨“与迷信巫术相关的精神障碍”的临床特征和转归。方法对我院1989年10月至1993年9月出院诊断为“与迷信、巫术密切相关的精神障碍”的患者进行为期10年的随访．按中国精神疾病分类方案与诊断标准第3版制定的诊断标准进行再诊断结果14例(45．16％)的患者维持诊断为“与迷信巫术相关的精神障碍”;17例《54.84％,的患者修改诊断．结论与迷信巫术相关的精神障碍的诊断应重视对病人临床随访和病人的病程转归;更应强调其相关性是“密切”相关的。迷信巫术既是“与迷信巫术相关的精神障碍”的致病因素．也是精神分裂症、心境障碍及其他精神障碍的诱发困素。     

区别迷信巫术相关的精神障碍与癔症性精神病之我见

在临床表现上，与迷信巫术相关的精神障碍和癔症性精神病有许多类同性，在病中它们都可出现自我意识障碍，即神秘状态、双重人格、附体体验。在病因学方面，社会心理因素与疾病的发生有一定关系。据此，两种疾病易被混淆。但实际上，两种疾病的转归及治疗方法有所不同，应严格加以区分。本文列举两例典型病例，讨论区别迷信巫术相关的精神障碍与癔症性精神障碍的几个特点。例１，女，５５岁，文盲，退休工人，平素性格要强，自我中心，信奉鬼神，遇到不顺心的事情极易情感发泄，青年期曾两次受到精神刺激后，发作性倒地，四肢抽动，持续近半…     

与文化相关的精神障碍时间和地域差异性研究

目的：探讨与文化相关的精神障碍的变化属性及时间、地域差异。方法：统计１９８８～１９９７年间城、乡３所精神病院与文化相关精神障碍的门诊率、住院率及患者的一般资料，对其时间、地域、性别、年龄、文化程度差异及文化内涵的变化进行分析。结果；城市以气功所致精神障碍为主，发病率近１０年有逐渐增高的趋势；农村以迷信巫术所致精神障碍为主，就诊率的时间差异不明显，内容前几年以迷信为主，后几年以宗教为主。气功所致者的     

与迷信相关精神障碍的再诊断与分析

与迷信相关精神障碍的再诊断与分析满常红杨冬林近年来，由于信仰迷信而致精神障碍日益引起精神医学界的重视。我国在ＣＣＭＤ—２—Ｒ中也增加了与迷信相关的精神障碍，随之精神科门诊、住院病人中诊断与迷信相关精神障碍的病例逐渐增加，但与迷信相关精神障碍能否成为一...     

修炼“法轮功”致精神障碍病因初探

为探讨“法轮功”致精神障碍相关因素，根据临床病例对照分析的原则，对“法轮功”致精神障碍患的致病因素、发病机制等进行了对照分析探讨。结果显示：“法轮功”具有极大的欺骗性、暗示性，接受其暗示的人，极易误入歧途，出现精神障碍。提示“法轮功”致精神障碍与迷信观念重、易接受暗示等有相关关系。     

与迷信巫术相关的精神障碍26例女性患者临床特征分析

目的：对26例女性患与迷信巫术相关的精神障碍进行临床分型，并对其临床特征、防治进行探讨。方法：收集曾在我院住院的1993－1996年间的26例女性患，并分为三型：类癔病疗。结果：所有病人症状很快被控制，本组住院缓解时间平均17天。结论：绝大多数预后乐观。给予小剂量抗精神病药，合并心理治疗尤为重要。     

一组与迷信巫术相关的精神障碍报告

近年来,随着我国经济的发展,封建迷信活动沉渣泛起,危害不浅。精神病学家注意到与迷信巫术相关及民间健身术引起的精神障碍越来越多。此类精神障碍相对其它精神疾病较少,但危害很大,易引起一般群众的恐慌,需高度重视。此病近年来报道不少,但家族群体性发病,伴残     

Books Received

Mc. Alpine, D., C. E. Lumsden, E. D. Acheson , A re-appraisal.
Smith, B. H. , Principles of Clinical Neurology
M. Mumenthaler, H. Schliack, Torben Fog , Läsionen periphärer Nerven
E. Ettlinger , Functions of the Corpus Callosum
J. C. Scotto , L'hyperostose frontale interne
D. Ingvar, N. Lassen , Regional Cerebral Blood Flow
Michaelis, L. , Orthopaedic surgery of the limbs in paraplegia
Adolf Juba , Pathologie des Ballismus
I. Taylor , The neurological mechanisms of hearing and speech in Children
F. Mellerio , L'electroencéphalographie dans les intoxications aigués
T. W. Farmer , Pediatric Neurology
P. Bourret, R. Louis , Anatomie du systéme nerveux central
M. Brazier , Brain Function. Vol. II. RNA and brain function; memory and learning
E. Gutmann, P. Hnik , The effect of use and disuse on neuromuscular functions
R. G. Siekert, J. P. Whisnant , Cerebral Vascular Disease
Excerpta Medica Foundation , Third International Congress of Neurological Surgery, Copenhagen, August 1965
H. W. Delank , Das Eiweissbild des Liquor cerebrospinalis und seine klinische Bedeutung
Schadé, J. P., D. H. Ford , Basic Neurology
C. Bernhard, E. Bohm , Local Anaesthetics as Anticonvulsants
M. Singer, J. Schadé , Degeneration Patterns in the Nervous System
K. Akert, C. Bally, J. Schadé, H. Pakkenberg , Sleep Mechanisms     

IIIrd International Symposium On Neural Transplantation from Molecular Bases to Clinical Application

IIIrd International Symposium On Neural Transplantation from Molecular Bases to Clinical Application(6th - 11th August 1989, Cambridge, U.K.)International Organising Committee: A. Aguayo, A. Bj?rklund, S.B. Dunnett, WJ. Freed, F.H. Gage, D.M. Gash, S.D. Iversen, R.D. Lund, C.D. Marsden, L. Olson, J. Sladek, C. Sotelo.Local Organising Committee: L.E. Annett, DJ. Clarke, S.B. Dunnett, P.C. Emson, B.J. Everitt, O. Isacson, S.D. Iversen, S.-J. Richards, J.D. Rowell, D.J.S. Sirinathsinghji.     

Brainstem neurons with descending projections to the spinal cord of two elasmobranch fishes: Thornback guitarfish,Platyrhinoidis triseriata,and horn shark,Heterodontus francisci

We studied two cartilaginous fishes and described their brainstem supraspinal projections because most nuclei in the reticular formation can be identified that way. A retrogradely transported tracer, horseradish peroxidase or Fluoro-Gold, was injected into the spinal cord of Platyrhinoidis triseriata (thornback guitarfish) or Heterodontus fransisci (horn shark). We described labeled reticular cells by their position, morpohology, somatic orientation, dendritic processes, and laterality of spinal projections. Nineteen reticular nuclei have spinal projections: reticularis (r.) dorsalis, r. ventralis pars α and β, r. gigantocellularis, r. magnocellularis, r. parvocellularis, r. paragigantocellularis lateralis and dorsalis, r. pontis caudalis pars α and β, r. pontis oralis pars medialis and lateralis, r. subcuneiformis, r. peduncularis pars compacta, r. subcoeruleus pars α, raphe obscurus, raphe pallidus, raphe magnus, and locus coeruleus. Twenty nonreticular nuclei have spinal projections: descending trigeminal, retroambiguus, solitarius, posterior octaval, descending octaval, magnocellular octaval, ruber, Edinger-Westphal, nucleus of the medial longitudinal fasciculus, interstitial nucleus of Cajal, latral mesencephalic complex, periventricularis pretectalis pars dorsalis, central pretectal, ventromedial thalamic, posterior central thalamic, posterior dorsal thalamic, the posterior tuberculum, and nuclei B, F, and J. The large number of distinct reticular nuclei with spinal projections corroborates the hypothesis that the reticular formation of elasmobranches is complexly organized into many of the same nuclei that are found in frogs, reptiles, birds, and mammals. J. Comp. Neurol. 403:534–560, 1999. © 1999 Wiley-Liss, Inc.     

Intranasal sumatriptan for the acute treatment of migraine

Two double-blind, placebo-controlled, randomised, multicenter, multinational, parallel-group studies were carried out to identify the optimum dose of intranasal sumatriptan for the acute treatment of migraine. Study medication was taken as a single dose through one nostril in the first study, and as a divided dose through two nostrils in the second study. Totals of 245 and 210 patients with a history of migraine were recruited into the one-and two-nostril studies, respectively. In both studies, headache severity had significantly improved at 120 min after doses of 10–40 mg sumatriptan compared to placebo (P < 0.05) and the greatest efficacy rates were obtained with 20 mg sumatriptan. With 20 mg sumatriptan 78% and 74% of patients experienced headache relief in one- and two-nostril studies respectively. Sumatriptan was generally well tolerated, the most frequently reported event being taste disturbance. The results of the two studies are similar and indicate that administering sumatriptan as a divided dose via two nostrils confers no significant advantage over single-nostril administration. The publication committee members were as follows: Prof. C. Dahlöf Gothenburg; Prof. N. E. Gilhus, Bergen; Dr. V. Lüben, Giessen; Dr. R. Salonen, Tampere; Prof. J. M. Warier, Strasbourg; Ms E. Ashford, Glaxo Group Research Limited, Greenford; Mr. R. Dawson, Glaxo Group Research Limited, Greenford; Mrs D. Noronha Glaxo Group Research Limited, Greenford.Principal investigators were as follows: One nostril study France: Dr. N. Brion, Le Chesnay; Prof. G. Chazot, Lyon; Dr. P. Dano, Marseille; Prof. A. Destee, Lille; Dr. M. Schwob, Paris; Prof. J.M. Warter, Strasbourg. Germany: Dr. J. Brand, Konigstein; Dr. R. Enkelmann, St. Goar; Prof H. D. Langohr, Fulda; Dr. V. Lüben, Giesssen; Dr. M. Mockesch, Weinheim; Dr. H Pistauer, Preetz; Dr. Schimek, Giegen; Dr. E. Siegel, Munich. Norway: Dr. J. S. Aasen, Fredrikstad; Prof. N. E. Gilhus, Bergen; Dr. I. Monstad, Elverum; Dr. T. Mörland, Skien; Dr. K. Nestvold, Nordbyhagen; Dr. O. Roald, Oslo; Dr. R. Salvesen, Bodö; Prof. O. Sjaastad, Trondheim; Dr. B. Stadnes, Drammen; Dr. K. A. Tjörstad, Stavager.Two Nostril study Eire: Dr. A. Rynne, Dublin. Finland: Dr. M. Farkkila, Helsinki; Dr. H. Havanka, Kemi; Dr. T. Jolma, Pori; Dr. H. Kilpelainen, Savonlinna; Dr. E. Koivunen-Tapio, Jyvaskyla; Reunanen, Oulu; Dr. E. Sako, Turku; Dr. R. Salonen, Tampere. Sweden: Dr. B. Andersson, Gävle; Dr. C. Behring, Vasteras; Prof. C. Dahldf, Gothenburg; Dr. S. E. Eriksson, Falun; Dr. Hindfelt, Malmö; Dr. H. Hultberg, Osmo; Dr. F. Johansson, Umea; Dr. C. Muhr, Uppsala     

The process of care in residential facilities

Background Although residential facilities (RFs) have largely replaced mental hospitals (MHs) in most developed countries for the long-term residential care of severely impaired patients, the process of care in RFs has not been well studied. The aim of this paper is to investigate the process of care in 265 RFs, representing 19.3% of all RFs in Italy, and to devise a classification of RFs based on process characteristics.Methods Structured interviews were conducted with the manager and staff of each RF. Residents were evaluated using standardized rating instruments.Results Most RFs had specific admission criteria, with one third having a waiting list that averaged about 3 months. There was no formal limitation to the length of stay in three quarters of RFs, and turnover rates were very low. Although a homelike atmosphere was found in many RFs, most facilities had restrictive rules on patients’ daily lives and behaviours. RFs carried out several external activities targeted at integrating patients within the local community. Standardized assessment instruments and written treatment plans were rarely used. A cluster analysis based on the levels of restrictiveness and the standardization of the process of care classified RFs into five groups that differed with respect to daily staff coverage, size, geographical distribution and proportion of former MH residents. No significant intercluster differences were associated with the current clinical and psychosocial characteristics of residents, or with several other outcome variables.Conclusions This study provides naturalistic evidence of the heterogeneity of the process of residential care on a large scale. Future efforts should focus on developing an empirical classification of RFs, as well as on national and international standards of care and staffing to address patients’ needs.The PROGRES Group includes: National Coordinators: G. de Girolamo, A. Picardi, P. Morosini (National Mental Health Project, National Institute of Health); Biostatistician: R. Micciolo (University of Trento); Regional Coordinators: P. Argentino, M. Casacchia, P. Ciliberti, G. Civenti, A. Colotto, G. Dell’Acqua, W. Di Munzio, G. Fagnano, A. Fioritti, N. Longhin, M. Miceli, M. Nicotera, M. Pisetta, R. Putzolu, E. Rossi, M. E. Rotunno, G. Borsetti, D. Semisa, R. Tomasi, P. Tulli, E. Zanalda; Researchers: C. Barbini, F. Basile, G. Bazzacco, R. Bracco, A. Calvarese, G. Canuso, E. Caroppo, L. Caserta, M. Colangione, S. Damiani, T. De Donatis, F. Di Donato, V. Di Michele, R. Esposito, M. Facchini, S. Ferraro, P. Fracchiolla, P. Gabriele, D. Gallicchio, G. Giardina, A. Greco, F. Grilletti, S. Guzzo, A. M. Lerario, M. R. Marinelli, C. Marino, E. Monzani, F. Picoco, L. Pinciaroli, C. A. Rossetti, P. Rubatta, G. Santone, F. Scorpiniti, V. Scrofani, M. Stefani, A. Svettini, A. Zaffarano, M. Cellini, A. Galli, K. Pesaresi, G. Pitzalis, L. Tarantino; Scientific Consultants: F. Amaddeo, I. Falloon     

Methods to induce primary and secondary traumatic damage in organotypic hippocampal slice cultures

Organotypic brain slice cultures have been used in a variety of studies on neurodegenerative processes [K.M. Abdel-Hamid, M. Tymianski, Mechanisms and effects of intracellular calcium buffering on neuronal survival in organotypic hippocampal cultures exposed to anoxia/aglycemia or to excitotoxins, J. Neurosci. 17, 1997, pp. 3538-3553; D.W. Newell, A. Barth, V. Papermaster, A.T. Malouf, Glutamate and non-glutamate receptor mediated toxicity caused by oxygen and glucose deprivation in organotypic hippocampal cultures, J. Neurosci. 15, 1995, pp. 7702-7711; J.L. Perez Velazquez, M.V. Frantseva, P.L. Carlen, In vitro ischemia promotes glutamate mediated free radical generation and intracellular calcium accumulation in pyramidal neurons of cultured hippocampal slices, J. Neurosci. 23, 1997, pp. 9085-9094; L. Stoppini, L.A. Buchs, D. Muller, A simple method for organotypic cultures of nervous tissue, J. Neurosci. Methods 37, 1991, pp. 173-182; R.C. Tasker, J.T. Coyle, J.J. Vornov, The regional vulnerability to hypoglycemia induced neurotoxicity in organotypic hippocampal culture: protection by early tetrodotoxin or delayed MK 801, J. Neurosci. 12, 1992, pp. 4298-4308.]. We describe two methods to induce traumatic cell damage in hippocampal organotypic cultures. Primary trauma injury was achieved by rolling a stainless steel cylinder (0.9 g) on the organotypic slices. Secondary injury was followed after dropping a weight (0.137 g) on a localised area of the organotypic slice, from a height of 2 mm. The time course and extent of cell death were determined by measuring the fluorescence of the viability indicator propidium iodide (PI) at several time points after the injury. The initial localised impact damage spread 24 and 67 h after injury, cell death being 25% and 54%, respectively, when slices were kept at 37 degrees C. To validate these methods as models to assess neuroprotective strategies, similar insults were applied to slices at relatively low temperatures (30 degrees C), which is known to be neuroprotective [F.C. Barone, G.Z. Feuerstein, R.F. White, Brain cooling during transient focal ischaemia provides complete neuroprotection, Neurosci. Biobehav. Rev. 1, 1997, pp. 31-44; V.M. Bruno, M.P. Goldberg, L.L. Dugan, R.G. Giffard, D.W. Choi, Neuroprotective effect of hypothermia in cortical cultures exposed to oxygen glucose deprivation or excitatory aminoacids, J. Neurochem. 4, 1994, pp. 387-392; G.C. Newman, H. Qi, F.E. Hospod, K. Grundhmann, Preservation of hippocampal brain slices with in vivo or in vitro hypothermia, Brain Res. 1, 1992, pp. 159-163; J.Y. Yager, J. Asseline, Effect of mild hypothermia on cerebral energy metabolism during the evolution of hypoxic ischaemic brain damage in the immature rat, Stroke, 5, 1996, pp. 919-925.]. Low temperature incubation significantly reduced cell death, now being 9% at 24 h and 14% at 67 h. Our results show that these models of moderate mechanical trauma using organotypic slice cultures can be used to study neurodegeneration and neuroprotective strategies.     

Book reviews

Book Reviewed in this article:
Llinas R, ed The workings of the brain. Development, memory and perception.
Thomas D, ed. Neuro-oncology. Primary malignant brain tumours.
Sandler M, Collins G, eds. Migraine. A spectrum of ideas.
Kazner E, Wende S, Grumme T, Stochdorph O, Felix R, Clausen C, eds. Computed tomography and magnetic resonance tomography of intracranial tumors. A clinical perspective.
Winlow W, ed. Neuronal communications.
Hofferberth H, Brune A A, Sitger G, Weger H D, eds. Vascular brain stem diseases.
Dolenc V. Anatomy and surgery of the cavernous sinus.
Kolb B, Whishaw I O, eds. Fundamentals of human neuropsychology.
Scherzer A L, Tscharnuter I, eds. Early diagnosis and therapy in cerebral palsy.
Bartako D, Gerttenbrandt F, Turcani P , eds. Neurology in Europe I.     

Reference values of hemostasis related factors of healthy Japanese adults. I: Circadian fluctuation

The circadian fluctuation of hemostasis related parameters was examined on 16 healthy Japanese adults (male 9, female 7). Twenty one parameters were measured in this study, i.e. fibrinogen, the activity of F.II, F.V., F.VII, F.VIII, F.IX, F.X., F.XI, F.XII, antithrombin III, plasminogen, alpha 2-antiplasmin, as well as the antigen level of F.IX, von Willebrand Factor, protein C, tissue-type plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), beta-thromboglobulin, platelet factor 4, fibrinopeptide A, plasmin-alpha 2-antiplasmin complex and FDP. Fluctuation was not significant in almost all of the parameters except F.VIII, F.IX, beta-thromboglobulin, platelet factor 4, tPA and PAI-1. Although the fluctuations of F.VIII, F.IX, beta-thromboglobulin and platelet factor 4 were statistically significant, they remained within the normal ranges. On the other hand, tPA and free PAI-1 showed significant circadian fluctuation, of which levels were highest at 9:00. It was postulated that the significant circadian fluctuation of fibrinolytic activity will be regulated by the balance between tPA and PAI-1 in plasma.     

Organizational structure and effectiveness in general hospital psychiatry departments

The relationship between organizational structure and effectiveness was examined in 33 psychiatry departments in general hospitals in Texas. Data were collected on 23 measures of organizational structure and 2 indices of effectiveness. The effectiveness measures were predesigned by the researchers and submitted to a nationwide panel of mental health experts to determine their practicality. The results of the study indicated that role specialization, centralization, standardization, and mode of conflict resolution were the most important predictors of effectiveness. Implications for administration of mental health services are discussed.Maxine L. Weinman, M.S.W., Dr. P.H., is Research Specialist, Texas Research Institute of Mental Sciences, 1300 Moursund, Houston, Texas. Richard M. Grimes, Ph.D., is Associate Professor of Health Services Administration, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas. Bartholomew P. Hsi, Ph.D., is Professor of Biometry, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas. Blair Justice, Ph.D., is Professor of Social Psychology, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas. Joseph C. Schoolar, Ph.D., M.D., is Director, Texas Research Institute of Mental Sciences, Houston, Texas.     

南京地区多发性硬化的临床与病理

对４例多发性硬化的临床和病理进行了研究。男、女各２例；年龄分别为２０岁、２６岁、２８岁及６２岁。病程分别为３２天、４５天、８年及２０年。临床表现多发病灶，主要症状和体征是视力障碍、肢体瘫痪及截瘫等，缓解复发１～４次不等。研究发现其病理改变为中枢神经系统白质多发性脱髓鞘病灶，视神经、视交叉及脊髓损害严重，脊髓又以后索及侧索损害为多见，有对称倾向。在较新鲜的病灶中发现明显的星形胶质增生，而在陈旧性病灶扩展的边缘部可见到血管周围淋巴细胞浸润。对此病的诊断标准、命名及临床病理特征等进行了讨论