酒精中毒和精神分裂症患者自杀行为的比较分析

对２９例酒精中毒和３４例精神分裂症（对照组）患者自杀行为和病态心理动因进行了对照分析。结果酒精中毒患者中自杀行为发生率２２．１％，较对照组１６．７％高；两组精神症状比较以听幻觉，思维散漫和易激惹有显著差异（Ｐ＜０．０５）；幻觉是酒精中毒患者出现自杀行为的主要原因。     

A psychopathological study of aggression in schizophrenic patients]

For some schizophrenic patients violent behavior occurs during acute phases of their illness. Some of these patients who exhibit violent behavior recover quickly from this phase. Further, there is a marked improvement in the quality life during remission. In this study the psychopathological features of aggression in 24 schizophrenic patients were considered. All of these patients were involuntary emergency admissions due to an uncontrollable violent episode. The interaction between aggression and delusion was categorized as follows: convergent type, aggression due to delusion; reactive type, aggression instigated by hallucination or delusional perception; and divergent type, random outbursts of violence and aggression. The intensity of catatonic features and fixed targets of violence distinguishes convergent type violent schizophrenic patients from reactive and divergent type patients. Convergent aggressive behavior can be more easily treated then the other two types and should have significant bearing over the course of treatment.     

精神分裂症首次发病患者冲动和自杀行为与血浆瘦素及总胆固醇的相关性研究

目的 探讨精神分裂症患者冲动、自杀行为与血浆瘦素及胆固醇之间的相关性.方法 106例精神分裂症首次发病患者用简明精神病评定量表(BPRS)、阳性和阴性症状量表(PANSS)、汉密尔顿抑郁量表(HAMD24)及Beck绝望量表(BHS)进行评定;按有无冲动、自杀行为分为自杀组(24例)、冲动组(31例)、非自杀非冲动组(以下简称患者对照组,51例),32名体检职工为正常对照组,所有入组对象(患者在服药前)测定体质量指数(BMI)、血浆瘦素和总胆固醇.结果 (1)正常对照组[(4.8±0.9)mmol/L]和患者对照组[(4.3±1.1)mmol/L]总胆固醇均高于自杀组[(3.7±1.0)mmol/L]及冲动组[(3.6±1.0)mmoL/L;P<0.05～0.01],而冲动组与自杀组之间、正常对照组与患者对照组之间的差异无统计学意义(P>0.05);正常对照组血浆瘦素[(13.4±6.7)μg/L]高于患者对照组[(8.9±3.8)μg/L]、自杀组[(6.7±2.6)μg/L]及冲动组[(5.6±4.2)μg/L;P<0.05～0.01],患者对照组高于自杀组及冲动组(P<0.05),而自杀组与冲动组的差异无统计学意义(P>0.05).(2)4组的血浆瘦素及总胆固醇均与BMI呈正相关(r=0.49～0.64;P<0.01);自杀组、冲动组的血浆瘦素和总胆固醇与PANSS阳性分、PANSS攻击分、BPRS分、HAMD分、BHS分均呈显著负相关(r=-0.35～-0.72;P<0.05～0.01);患者对照组的血浆瘦素、总胆固醇与PANSS攻击分、BPRS分、HAMD分、BHS分均呈显著负相关r=-0.29～-0.48;P<0.05～0.01).结论 精神分裂症患者的冲动、自杀行为及疾病严重程度与血浆瘦素及总胆固醇有一定的相关性.     

Blood serotonin levels in suicidal schizophrenic patients

A decrease in central serotonin metabolism has been found in suicidal patients. In schizophrenic patients suicidality is predominantly observed as a transient phenomenon being most pronounced during an acute psychotic episode. We investigated blood serotonin levels as a paradigm for serotonin metabolism in suicidal schizophrenic women who were psychotic and compared their data with those of nonsuicidal psychotic schizophrenic women and healthy controls. Blood serotonin was lower in suicidal female schizophrenic patients (0.44 +/- 0.05 mumol/l, n = 17) than in nonsuicidal female schizophrenic patients (0.94 +/- 0.07 mumol/l, n = 17; P less than 0.001) or in healthy women (0.90 +/- 0.02 mumol/l, n = 26; P less than 0.001). These findings support the hypothesis that decreased serotonin metabolism may be associated with suicidal behavior in schizophrenic women.     

精神分裂症患者子女行为问题的对照研究

目的探讨精神分裂症患者子女的行为问题及其相关因素。方法采用Achenback儿童行为量表（CBCL）对精神分裂症患者子女（研究组）及正常人子女（对照组）进行测试,两组各为108人,对其家庭教育状况和在学校表现进行对照研究。结果研究组行为问题的出现率为32．5％,多于对照组（11．1％）;研究组CBCL平均得分为26．32±9.35高于对照组（9．22±5．65;t=16．27,P＜0．01）。研究组的家庭教育状况及在学校表现与对照组比较,差异有显著性。结论精神分裂症患者子女发生行为问题较多,为遗传及环境因素共同作用的结果。     

67例抑郁障碍伴自杀行为的临床对照研究

探讨抑郁障碍患者发生自杀行为的相关因素与预测。方法对６７例有自杀行为和１０８例无自杀行为的抑郁障碍进行了临床对照分析。结果高文化程度和城镇居民抑郁障碍患者自杀行为发生率高。结论Ｈａｍｉｌｔｏｎ抑郁量表总分不能作为预测抑郁障碍自杀危险性的有效指标，而焦虑／躯体化与绝望感因子分对抑郁障碍自杀危险性的预测有一定价值。     

A型行为与精神分裂症（附200例临床分析）

采用问卷法评估２００例精神分裂症患者与１２０例健康人的行为类型，结果显示，精神分裂症患者以Ｂ型行为多见，对Ａ型和Ｂ型行为患者的临床上差异进行比较，结果表明Ａ型行为患者具有起病晚而急，阳性家族较少，社会心理因素明显，临床表现以敌对猜疑等阳性症状多见，以及疗效较好等特点。     

精神分裂症患者攻击行为的相关因素对照研究

目的　通过对住院精神分裂症有和无攻击行为患者资料的对照研究来探讨与精神分裂症患者攻击行为相关的因素。方法　收集住院精神分裂症患者的人口学和住院资料、BPRS、WCST、T3、T4、TSH等因子 ,用MOAS评定攻击行为并在有和无攻击行为组间分别进行显著性检验 ,然后通过回归分析 ,考察影响精神分裂症病人攻击行为的相关因素。结果　两组精神分裂症病人在BPRS、TSH、WCST等因子上存在显著差异 ,其中BPRS的敌意猜疑因子、诊断分型、TSH及WCST的持续错误数能够用于预测精神分裂症病人的攻击行为。结论　精神分裂症患者的攻击行为可能有精神病理学、神经心理学和神经内分泌学基础。     

阿立哌唑治疗晚发性分裂症的临床研究

目的 探讨阿立哌唑治疗晚发性分裂症的临床疗效和不良反应.方法 将符合CCMD-3诊断标准的72例首发未服药的晚发性分裂症患者随机分为两组,分别给予阿立哌唑和奋乃静治疗,疗程8周;采用简明精神病评定量表(BPRS)于治疗前后评定疗效,治疗中出现的不良反应量表(TESS)评定不良反应.结果 阿立哌唑与奋乃静疗效无显著性差异,阿立哌唑引致的锥体外系反应显著低于奋乃静.结论 阿立哌唑、奋乃静治疗晚发性分裂症的疗效相当,前者不良反应轻,安全性高.     

Association study of T102C 5-HT(2A) polymorphism in schizophrenic patients: diagnosis, psychopathology, and suicidal behavior

The objective of this study was to examine the association between the serotonin (5-HT)2A gene polymorphism (102T/C) and suicidal behavior in schizophrenic inpatients. We studied 129 subjects who met the diagnostic criteria for schizophrenia according to a structured clinical interview (MINI-PLUS). Patients underwent a semistructured interview to assess suicide attempt history and its characteristics. In addition, at least one close relative of the patient was interviewed to assess proband and family suicidal behavior. Healthy controls were students and hospital staff members free of psychiatric and medical illness. Genotypes were determined after polymerase chain reaction amplification of the region of 5-HT(2A)/T102C containing the polymorphic site and digestion with the restriction enzyme Hpall. We found no association between suicidal attempt history and suicide attempt characteristics and genotypic or allele frequencies. Suicidal behavior was also not associated with demographic or psychopathological characteristics. These results suggest that the 5-HT(2A) gene polymorphism (102T/C) is not involved in genetic susceptibility to suicidal behavior, but further studies in a larger sample are needed.     

伴自杀行为抑郁症患者的多导睡眠图研究

目的观察伴有自杀行为抑郁症患者的多导睡眠图(PSG)变化。方法对29例伴有自杀行为抑郁症患者(以下简称抑郁组)的PSG进行整夜测试,并与30名健康成人(NC组)进行对照。结果与NC组相比,抑郁组PSG改变主要为快眼动睡眠睡眠潜伏期(RL)缩短及非眼快动睡眠(NREM)变异(P<0.05)。结论 PSG可用于对伴有自杀行为抑郁症患者的检测。     

Suicidal behavior in chronic schizophrenic patients: a follow-up study

A follow-up study was carried out of suicidal behavior among 127 chronic schizophrenic patients. We were able to obtain follow-up information for 100 of the 127 patients (78.7%). Over the mean follow-up time of 4 1/2 years, 6 of these 100 patients (6%) had committed suicide and 16 other patients (16%) had attempted suicide. Chronic schizophrenic patients who attempted suicide during the follow-up period, compared with those who did not, had had significantly more psychiatric admissions. Using the data obtained at the time of the index admission we were unable to accurately predict the 6 schizophrenic patients who were known to have subsequently committed suicide.     

精神分裂症子女的行为问题及相关因素分析

目的 探讨精神分裂症子女的行为问题及相关因素。方法 以Achenbach儿童行为量表(CBCL)为工具，对260名精神分裂症患者的子女(研究组)行为问题及其影响因素进行调查，并与正常健康者的子女(对照组)进行对照。结果 精神分裂症子女行为问题检出率为31．2％。显著高于对照组的12．3％；其主要影响因素为儿童健康状况差、孕产期不利因素、家庭教育方式不当、亲子关系差、居住地社会风气差和学习成绩差。结论 精神分裂症子女的行为问题发生率较高，为生物、心理及社会因素共同作用的结果，并需全面干预。     

Ethological study of facial behavior in nonparanoid and paranoid schizophrenic patients

This investigation addressed the question of affective disturbance in schizophrenia by applying quantitative measurement techniques to patients' facial behavior. The subjects were medication-free male inpatients: nine nonparanoid and six paranoid schizophrenic patients and 12 drug- or alcohol-abuse rehabilitation control patients. Two judges scored the subjects' behavior, which was recorded on videotape, according to a system that included 16 different types of facial movements. Eye blinks, eye contact, and words spoken were also scored. Compared to the control patients, the nonparanoid schizophrenic patients spoke significantly fewer words and had significantly less eye contact, while the paranoid schizophrenic patients had significantly fewer eyebrow and lower facial movements.