缓解期躁狂症性格特征对照研究

本文应用卡特尔１６种人格因素测量量表对４６例缓解期躁狂症患者、１００例精神分裂症患者与１００名正常人进行了对照研究，结果发现躁狂组性格外向型居多，明显高于正常人及精神分裂症组。另外有１０个因素与正常人相比有明显差异；有５个因素与精神分裂症组比较有明显差异。     

精神分裂症患者及其亲属免疫学研究

目的 :了解散发性首发精神分裂症患者及其一级亲属免疫球蛋白及补体成份与正常人是否存在差异。　方法 :用免疫透射比浊法测精神分裂症患者及其一级亲属及健康者血清中免疫球蛋白及补体成份的含量 ,并相互比较。　结果 :精神分裂症患者及其一级亲属IgA、IgG及C4显著高于正常人(P <0 .0 5～ 0 0 1)。　结论 :精神分裂症患者及其一级亲属存在同样免疫学异常 ,遗传因素可能是构成精神分裂症免疫学异常的基础     

首发精神分裂症患者缓解期神经认知功能和社会认知功能的研究

目的:探讨首发精神分裂症患者缓解期神经认知功能和社会认知功能的特点。方法:采用霍普金斯词汇学习测验-修订版(HVLT-R)和中国人面孔情绪测验系统(CFET)评估65例首发精神分裂症缓解期患者(缓解组)、45例首发非缓解期患者(非缓解组)和58名正常人(正常对照组)的神经认知功能和社会认知功能。结果:除保持百分比外,缓解组和非缓解组HVLT-R中各项成绩明显低于正常对照组(P均0.05);但缓解组即刻记忆和延迟记忆成绩明显优于非缓解组(P均0.05);缓解组和正常对照组CFET成绩差异无统计学意义;且负性情绪(悲、恐、厌、怒)的正确识别数明显高于非缓解组(P均0.05);结论:首发精神分裂症患者缓解期社会认知功能基本恢复,而神经认知功能恢复不全。     

肇事肇祸精神分裂症患者父母人格特征与应对方式调查及干预效果的2年随访

目的:探讨首发精神分裂症肇事肇祸患者父母的人格特征与应对方式及采取针对性干预措施对于降低精神分裂症患者肇事肇祸发生率的价值。方法:选取我院2012年1月至2014年1月收治的首发精神分裂症肇事肇祸患者87例作为病例组,采用随机数字表法将病例组分为干预组44例、非干预组43例。选取同期健康人40名(对照组),采用艾森克个性问卷及简易应对方式问卷对病例组和对照组父母进行调查;根据调查结果针对性地对干预组父母进行指导,改善其应对方式,非干预组不给于指导,对比两组患者随访2年中肇事肇祸的发生率。结果:病例组父母的EPQ问卷中E维度评分低于对照组父母(t=3. 079,P 0. 05),N维度评分高于对照组父母(t=4. 037,P 0. 05);两组父母的P、L维度评分差异无统计学意义(t=1. 337、t=0. 945,P 0. 05);病例组父母的SCSQ量表中积极应对评分低于对照组父母(t=7. 142,P 0. 05);两组父母的消极应对评分差异无统计学意义(t=1. 351,P0. 05);随访2年间,干预组的肇事肇祸率15. 91%低于非干预组的39. 53%,差异具有统计学意义(χ2=6. 077,P=0. 014)。结论:根据精神分裂症患者父母的人格特征对父母进行针对性干预,有利于降低患者的肇事肇祸率。     

精神分裂症脑功能不平衡视觉P300研究

目的　从神经生理学角度探索精神分裂症患者脑区域功能的不平衡。方法　对 2 1例精神分裂症患者在发病期及两年缓解期后 ,采用视觉图像辨认作业引出Fz、Cz、Pz、Oz、T3 、T4 点P3 0 0 ,并与 2 4名正常人对比P3 波幅值。结果　病例组发病期与缓解期六个采样点 (Oz 例外 )均有P3 波幅下降 ;两颞侧相比 ,仅发病期存在P3 波幅左 <右的偏侧性 ,且有统计学意义。结论　精神分裂症存在普遍稳定的认知电位异常。左右采样点的异常不对称性可能是功能性的 ,决定于受检时的临床状态     

脑源性神经营养因子基因C270T多态性与精神分裂症临床表型的关联研究

目的探讨脑源性神经营养因子（BDNF）基因C270T多态性与精神分裂症临床表型的关系。方法对130例身体健康的精神分裂症患者（研究组）及144例正常人（对照组）应用聚合酶链反应、琼脂糖凝胶电泳结合溴乙锭染色技术检测脑源性神经营养因子基因C270T多态性;采用阳性与阴性症状量表（PANSS）评定精神分裂症临床表型。用χ^2检验和单因素方差分析脑源性神经营养因子基因与精神分裂症临床表型的关系。结果两组BDNF基因型分布及等位基因的频率分布差异无统计学意义（P〉0．05）,但是患者组中C／C和C／T两组基因型患者的PANSS阴性分量表得分有显著性差异（P〈0．05）。结论BDNF C270T的基因多态性可能与精神分裂症易感性没有直接关系,但是,BDNF的基因变异可能与精神分裂症的病理症状有关。     

精神分裂症患者家庭关系和父母教养方式的对照研究

目的 研究精神分裂症患者家庭人际关系和父母教养方式的特点。方法 采用家庭环境量表中文版和父母养育方式评价量表,对处于缓解期的100例精神分裂症患者（研究组）与按1：1配对原则挑选的100名正常人（对照组）进行测试。结果 （1）与对照组比较,研究组的家庭关系表现为低亲密度、低情感表达、低成功性及低组织性,以及高矛盾性及控制性差（P＜0．05或P＜0．01）。（2）在教养方式上,患者的父亲表现为低情感温暖、高惩罚严厉、过分干涉和拒绝否认（P＜0．01或P＜0．05）;患者的母亲表现为低情感温暖、高拒绝否认和惩罚严厉（P＜0．01）。（3）Logistic回归分析,研究组的家庭环境及父母教养方式的风险因素为家庭成员的控制性差,以及父亲的过分干涉、拒绝及否认（P＜0．01－P＜0．05）。结论 精神分裂症患者的家庭人际关系和父母养育方式存在多方面问题,可能对精神分裂症的发病起重要作用。     

精神分裂症患者心理防御机制及人格特征

目的 探讨精神分裂症患者的心理防御机制和人格特征以及二者之间的关系.方法 分别运用防御方式问卷(DSQ)和明尼苏达多项个性调查袁(MMPI)对46例精神分裂症患者和45例正常人对照进行防御方式评定和人格特征测定.结果 精神分裂症组同对照组相比,不成熟及中间型防御机制差异有显著性(P＜0.05).精神分裂症患者MMPI中9个量表得分均高于正常对照组;精神分裂症患者的不成熟防御机制同精神病态、偏执、精神分裂、轻躁狂存在显著正相关(P＜0.05);成熟防御机制同社会内向存在负相关;中间型防御机制同癔症呈负相关(P＜0.05),同偏执、轻躁狂呈正相关(P＜0.05).结论 精神分裂症患者更多地使用不成熟防御机制和中间型防御机制,存在病态的人格特征,且二者之间存在明显的相关性.     

精神分裂症患者住院时间与认知功能

为探讨精神分裂症患者末次持续住院时间长短对认知功能的影响 ,我们对此进行了研究。1　对象和方法患者组为我院男性住院病人 ,符合 CCMD- 2 - R精神分裂症诊断标准 ,均服用经典抗精神病药物 ,共 96例。对照组为从未使用过精神药物 ,无精神症状的正常人 ,共 2 0名。两组在年龄、受教育年限方面差异均无显著性 (P均 >0 .0 5 )。评定工具采用韦氏成人智力量表 (WAIS- R) ,韦氏记忆量表 (WMS) ,语言流利性测验 (L F) ,手指敲击测验 (FTT) ,简明精神病评定量表 (BPRS)。统计方法 :对结果进行χ2 检验。2　结果患者组的认知测查指标同…     

精神分裂症患者事件相关电位P300与临床症状关系的研究

目的　探讨精神分裂症P3 0 0 主要指标尤峰间潜伏期的变化及其与临床症状的关系。方法　检测 4 0例精神分裂症患者 (患者组 )和 36名正常人 (对照组 )CZ、C3 、C4电极位置的P3 0 0 ,并用阳性和阴性症状量表 (PANSS)评定患者临床症状。结果　与正常对照组相比 ,在CZ、C3 、C4三点 ,患者组P3波幅低 (P <0 0 1) ,并与阴性症状分呈负相关 (r=- 0 4 0 3,- 0 4 30 ,- 0 35 7) ;N2 潜伏期长 (P <0 0 1) ;P2 N2 峰间潜伏期长 (P <0 0 5和P <0 0 1) ,并与PANSS量表总分、阳性症状、思维障碍、激活性等多种症状分呈负相关 (P <0 0 1～ 0 0 5 ) ;N2 P3 峰间潜伏期短 (P <0 0 1) ,在CZ 点与PANSS量表总分(r=- 0 36 3)和一般症状分 (r=- 0 392 )呈负相关。结论　精神分裂症患者的P3 波幅、N2 潜伏期、P2 N2 、N2 P3 峰间潜伏期有明显异常 ,其中P3 波幅、P2 N2 、N2 P3 峰间潜伏期与多种临床症状呈相关性     

精神分裂症一级亲属情感表达与人格特征的相关性

目的:探讨精神分裂症一级亲属情感表达与人格特征的相关性。方法:对130例精神分裂症一级亲属与117例对照组采用坎伯威尔家庭问卷中文版(CFI-CV)和分裂型人格问卷(SPQ)进行评估,根据CFI-CV评分,将样本分为高情感表达组和低情感表达组,对样本的人格特征进行比较。结果:在精神分裂症一级亲属中高情感表达组SPQ阴性分裂型评分显著高于低情感表达组(t=2.634,P<0.01),其余各维度差异均无统计学意义(P>0.05);精神分裂症一级亲属中高情感表达组SPQ阴性分裂型评分显著高于对照组中高情感表达组(t=2.687,P<0.01),其余各维度差异均无统计学意义(P>0.05)。结论:精神分裂症健康一级亲属的情感表达与人格特征有极高的相关性。     

Temperament and character personality profile in relation to suicide attempts in patients with schizophrenia

Introduction

Schizophrenia is associated with a significant risk of suicide, and suicide still remains one of the main causes of death in schizophrenic patients. Beside classic risk factors for suicidality, temperament and character traits have been researched and considered as risk factors for suicidal behavior in recent years.

Method

Subjects were 94 patients with schizophrenia who were under treatment. All patients were in a stable phase of the illness. Patients with lifetime suicide attempt (n = 46) and without suicidal attempt (n = 48) were compared with each other in terms of temperament and character traits by using the Temperament and Character Inventory.

Results

Harm avoidance and persistence scores were higher in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. The scores of self-directedness and cooperativeness were lower in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. These 4 variables remained significant predictors of lifetime suicidal attempts in a logistic regression model.

Conclusion

To the best of our knowledge, the present study is the first that specifically compares schizophrenic patients with and without suicidal behavior by the Cloninger temperament and character model. Our data indicate that schizophrenic patients will show a greater risk for suicide according to certain personality configurations. However, to establish causal relationships between personality and suicidality in schizophrenia, longitudinal studies are warranted within a multifactorial interactive framework of biologic and clinical variables.     

Swedish Universities Scales of Personality: Relation to Other Personality Instruments

ObjectiveTo investigate associations between Swedish universities Scales of Personality (SSP) and scales of the following personality instruments: Structured Clinical Interview for DSM-III-R axis II screening questionnaire (SCID-II screen), revised NEO personality inventory (NEO-PI-R), revised Chapman scales (Chapman) and the psychotic traits questionnaire (STQ). MethodsHealthy individuals (n=406) completed self-report personality questionnaires including SSP and at least one more personality inventory. Correlations were calculated between the 13 different SSP subscales as well as SSP’s three factors and factors and scales/subscales in SCID-II screen, NEO-PI-R, Chapman and STQ. The main factors of the various instruments were factor analysed. ICC were calculated. ResultsSSP Neuroticism factor correlated with SCID-II cluster C (r=0.71), NEO Neuroticism (r=0.80) and Chapman Social anhedonia (r=0.62). SSP Extraversion factor correlated with NEO Extraversion (r=0.63) and SSP Aggressiveness factor with NEO Agreeableness (r=-0.62). Strong correlations between SSP factors and scales and scales of the other instruments were sparse, although weaker correlations were common. ConclusionSSP is a useful investigation tool when measuring personality traits related to temperament-like features. SSP partly correlates well to especially three of the NEO-PI-R factors. The different personality inventories are not completely comparable to each other. Instead, they measure personality aspects in partly different ways.     

人格障碍评估量表在精神分裂症患者中的临床应用

目的探讨人格障碍评估（PDA）在精神分裂症患者中的临床应用价值。方法用PDA和PDQ-4^＋分别对39例精神分裂症患者和80例正常人进行评估。结果在PDA中,精神分裂症组的9种类型的人格障碍项目分和总分均高于正常组,都达到极显著性差异,精神分裂症组各人格障碍类型的发生率分布中,C类群占有相当的比例,其中回避型占53．85％,强迫型占41．02％,A类群中,偏执型占18．42％,在PDQ-^4＋中,也是回避型和强迫型所占的比例最高,分别为42．10％,和36．80％,在因素分析中,采用主成份分析及方差极大旋转的方法,提取了3个公因子,它们的方差累计贡献率为63．54％,旋转前的因子距陈显示9个分量表都有中等以上的负荷。结论PDA可反映出精神分裂症患者的人格障碍共病情况,有临床应用价值。     

Thyroid stimulating hormone response after thyrotropin releasing hormone in depressed, schizophrenic and normal women.

(1) Thyroid stimulating hormone (TSH) response after injection of thyrotropin releasing hormone (TRH) was studied in 23 depressed, 9 schizophrenic and 40 normal women. (2) In no group was TSH response correlated with age. (3) In the depressed patients, no relationship was found between TSH response and (i) severity of illness, (ii) clinical subtypes (unipolar/bipolar) and (iii) clinical remission. (4) There were no statistically significant differences in TSH baseline values between the groups. (5) Neither of the two patient groups showed reliable differences from controls regarding TSH response. However, depressed patients tended to show lower values than controls, while schizophrenic patients tended to show higher values than normal controls. (6) Significant differences were found between depressed and schizophrenic patients in regard to TSH response. In three depressed patients a TSH response below 5 μU/ml was found. This deficient TSH response occurred in unipolar depressed patients and was not seen in bipolar depressed patients, schizophrenic patients or normal controls. (7) These data provide evidence for a fault in hypothalamic pituitary regulation in some depressed patients but not in schizophrenic patients.     

Search for the influence of the tyrosine hydroxylase (TCAT)(n) repeat polymorphism on personality traits

A putatively functional tetranucleotide repeat polymorphism in the tyrosine hydroxylase gene (TH) has been investigated with regard to different aspects of psychopathology. We investigated whether reported associations of this TH polymorphism may reflect associations with common personality traits. Personality was assessed by the NEO Personality Inventory-Revised version (NEO PI-R), in 205 healthy Caucasian volunteers. Tendencies for higher scores in the neuroticism (N) facets, Angry hostility (P=0.008) and Vulnerability (P=0.021), were observed among carriers of one of the alleles (T8). Healthy women with the T6/T10 genotype had significantly higher scores (P=0.001) in the Deliberation and Dutifulness facets (P=0.031) (the Conscientiousness dimension, C) and lower scores (P=0.031) in the Feelings facet (the Openness dimension, O). We concluded that: (1) higher mean scores in the Neuroticism facets among T8 allele carriers are consistent with previous data and warrants further research; (2) the T6/T10 genotype may influence personality among women; (3) these data should be cautiously interpreted in the absence of corroborating data.     

具有暴力行为的精神分裂症患者病情缓解阶段事件相关电位N270的变化

目的 初步分析事件相关电位N270在具有暴力行为精神分裂症患者病情缓解阶段中的变化特点.方法 采用颜色匹配和冲突的图片刺激对随机呈现给受试者.应用美国EGI 256导联高密度脑电仪器记录24例具有暴力行为精神分裂症患者(患者组)和25名年龄、性别匹配的健康对照(对照组)在颜色匹配和冲突图片刺激下的事件相关电位,并收集受试者在判断每对刺激的颜色是否匹配时所作出相应按键反应的正确率和反应时.结果 (1)无论在颜色匹配还是颜色冲突时,患者组和对照组正确率的差异均无统计学意义(P＞0.05),患者组的反应时长于对照组[匹配:患者组(774.17±231.25)ms,对照组(642.28±185.56)ms,t=2.206,P=0.032;冲突:患者组(835.35±246.79)ms,对照组(681.19±207.87)ms,t=2.369,P=0.022].患者组和对照组在颜色冲突状态下的反应时均长于颜色匹配状态的反应时(P＜0.05).(2)与对照组相比,患者组在F3、F4、C3、C4、Fz、Cz脑区的N270潜伏期延长(P＜0.05),波幅降低(P＜0.05).(3)与对照组相比,患者组在F3、F4、C3、Fz、Cz脑区的N270差异曲线的波幅降低(P＜0.05),F3、F4、C3、C4、Fz、Cz脑区的潜伏期延长(P＜0.05).结论 具有暴力行为精神分裂症患者在病情缓解阶段对冲突信息的加工过程存在损害,可用N270来监测和评价.     

Anxiety and depressive disorders and the five-factor model of personality: a higher- and lower-order personality trait investigation in a community sample

We describe in detail normal personality traits in persons with psychiatrist-ascertained anxiety and depressive disorders in a general population sample. We investigated Revised NEO Personality Inventory traits in 731 community subjects examined by psychiatrists with the Schedules for Clinical Assessment in Neuropsychiatry. All of the lifetime disorders of interest (simple phobia, social phobia, agoraphobia, panic disorder, obsessive-compulsive disorder (OCD), generalized anxiety disorder, major depressive disorder (MDD), and dysthymia) were associated with high neuroticism. Social phobia, agoraphobia, and dysthymia were associated with low extraversion, and OCD was associated with high openness to experience. In addition, lower-order facets of extraversion (E), openness (O), agreeableness (A), and conscientiousness (C) were associated with certain disorders (specifically, low assertiveness (E) and high openness to feelings (O) with MDD, low trust (A) with social phobia and agoraphobia, low self-discipline (C) with several of the disorders, and low competence and achievement striving (C) with social phobia). Neuroticism in particular was related to acuity of disorder. Longitudinal study is necessary to differentiate state versus pathoplastic effects.     

二甲双胍对住院精神分裂症伴糖耐量减低患者干预的3年随访

目的:观察二甲双胍干预对糖耐量减低(IGT)的住院精神分裂症患者糖尿病发病率的作用. 方法:对符合《中国2型糖尿病防治指南2007》诊断标准的78例IGT住院精神分裂症患者,随机分为对照组、饮食+运动组和二甲双胍组,每组26例,随访观察3年. 结果:初访时3组基线资料无统计学差异.3年末,对照组糖尿病发生率为73.1％( 19/26);饮食加运动组为45.5％ (10/22);二甲双胍组为16.7％ (4/24),组间存在统计学差异(X2=15.998,P=0.000),二甲双胍组与对照组比较,存在统计学差异(X2=15.987,P=0.000);二甲双胍组与饮食加运动组比较,存在统计学差异(X2=4.493,P=0.034);饮食加运动组与对照组比较,无统计学差异(X2=3.802,P=0.051).二甲双胍组3年末糖化血红蛋白( GHbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与饮食+运动组和对照组比较均存在统计学差异(P＜0.05). 结论:二甲双胍与行为干预单一或联合治疗均对减轻精神分裂症患者IGT发展到糖尿病(DM)可能有一定效果,二甲双胍联合行为干预的疗效更好.     

Relationship between neuroticism personality trait and serotonin transporter binding.

BACKGROUND: Personality trait is thought to be one of the important factors for vulnerability to depression. The relation between serotonin transporter (5-HTT) polymorphism and anxiety-related personality has been investigated in genetic research. In this study, we investigated the relation between in vivo regional 5-HTT binding in the brain and personality inventory measures in normal male volunteers. METHODS: Thirty-one healthy male volunteers underwent positron emission tomography scans with (11)C-labeled 3-amino-4-(2-dimethylaminomethyl-phenylsulfanyl) benzonitrile ([(11)C]DASB) to measure 5-HTT and completed revised NEO Personality Inventory. Correlation of [(11)C]DASB binding potentials (BP) with personality inventory measures was calculated using region-of-interest analysis and statistical parametric mapping based on the BP images. RESULTS: Neuroticism was positively correlated with 5-HTT binding in the thalamus (p = .004). No significant correlation was observed in any other brain region. Within the neuroticism dimension, the facet of depression was positively correlated with 5-HTT binding in the thalamus (p = .001). CONCLUSIONS: Subjects with higher thalamic 5-HTT binding are more likely to express higher levels of neuroticism and depressive feeling. Serotonin transporter binding in the thalamus might be a marker of vulnerability to depression.