喹硫平、利培酮治疗精神分裂症的1年随访

目的 比较喹硫平与利培酮长期治疗首发精神分裂症患者的疗效及不良反应.方法 研究纳入符合国际疾病分类第十次修订本(ICD-10)精神分裂症或分裂样精神障碍研究用诊断标准的首次发病患者262例,喹硫平组和利培酮组各131例,开放性治疗12个月.疗效评估:以两药的停药率、持续治疗时间为丰要指标,阳性与阴性症状量表(PANSS)减分及减分率为次要指标,PANSS总分减分率≥50%为显效,25%～50%为有效,＜25%为无效.以副反应量表(TESS)、锥体外系副反应量表(RSESE)、不自主运动量表(AIMS)评估不良反应.结果 ①停药率:喹硫平组33.6%,利培酮组35.2%;持续治疗时间:喹硫平组为(9.49±3.83)个月,利培酮组为(9.52±3.84)个月;复发时间:喹硫平组(3.29±2.34)个月,利培酮组(5.11±2.77)个月;两药的停药率、持续治疗时间、复发时间差异无统计学意义(P＞0.05).②治疗第2、6、12个月末时,喹硫平组治疗有效率分别为78.6%(103/131)、86.2%(113/131)、89.3%(117/131),利培酮组有效率为82.4%(108/131)、87.7%(115/131)、85.5%(112/131),二者的总体疗效相当(P＞0.05).③不良反应:利培酮引起的锥体外系不良反应如静坐不能、肌强直、震颤较喹硫平高(X2=14.94,P＜0.05),喹硫平组的头晕和晕厥发生率高丁利培酬组(X2=10.08,P＜0.05).结论 喹硫平和利培酮对首发精神分裂症急性期和长期治疗疗效肯定,两药疗效相当,两药不良反应各有特点但均可耐受.     

利培酮治疗儿童精神分裂症36例的疗效观察

目的 研究应用利培酮治疗儿童精神分裂症的疗效和安全性。方法 对36例9～15岁经CCMD-3诊断为儿童精神分裂症的患者,应用利培酮治疗12周,平均起始剂量(0.86±0.05)mg/日,平均治疗剂量为(3.44±1.08)mg/日,采用简明精神病量表(BPRS)评定疗效,锥体外系症状量表(ESRS)和实验室检查评价不良反应。结果 利培酮对儿童精神分裂症各种症状均有较好疗效,显效率为83％,有效率94.4％,不良反应主要有轻度的睡眠增多和锥体外系反应,其他不良反应少见。结论 利培酮对儿童精神分裂症疗效较好,不良反应少,依从性较好,值得推广使用。     

5种新一代抗精神病药治疗首发精神分裂症的对照研究

目的比较利培酮、喹硫平、奥氮平、阿立哌唑和齐拉西酮治疗首发精神分裂症的疗效、可接受性及安全性。方法将200例首发精神分裂症患者随机给予上述5种之一的新一代抗精神病药治疗;采用《简明精神病量表》评定临床疗效,同时比较5种抗精神病药物的可接受性(合并用药率、换药率及维持原药率)和不良反应。结果 1临床疗效:阿立哌唑、利培酮、喹硫平、奥氮平、齐拉西酮治疗首发精神分裂症患者后BPRS评分较治疗前差异均有统计学意义(P0.01);经方差分析和LSD检验提示,利培酮组BPRS减分率显著高于阿立哌唑组(P0.01)和奥氮平组(P0.05)。2可接受性比较:经χ2检验提示(χ~2=15.55,P=0.049);经过分割χ2检验,奥氮平较阿立哌唑、齐拉西酮差异均有统计学意义(P0.05);同时喹硫平较齐拉西酮差异也有统计学意义(P0.05)。3不良反应比较:在锥体外系反应、ECG改变、肝功能异常、便秘、白细胞减少5个方面差异均无统计学意义(均P0.05)。结论 5种新一代抗精神病药治疗精神分裂症首次发病患者疗效均较好,奥氮平、喹硫平可接受性较好;5种药物之间不良反应类似。     

喹硫平和利培酮治疗精神分裂症的对照研究

目的以利培酮为对照,探讨喹硫平治疗精神分裂症的疗效和副作用。方法将60例符合CCMD-3诊断标准的精神分裂症病人随机分为两组,分别给予喹硫平和利培酮治疗8周。于治疗前和治疗后1、2、4、8周末采用阳性症状和阴性症状量表(PANSS)评定临床疗效,副反应量表(TESS)评定副反应。结果治疗8周后,两组疗效近似(P>0.05),喹硫平组和利培酮组的显效率差异无显著性(P>0.05);喹硫平组的副反应发生率低于利培酮组,但差异无显著性(P>0.05)。利培酮组锥体外系副反应和内分泌改变的发生均明显高于喹硫平组(P<0.05)。结论喹硫平对精神分裂症患者的疗效与利培酮相当,副作用较小。     

利培酮治疗儿童少年精神分裂症的临床应用

目的:了解利培酮治疗儿童少年期首发精神分裂症或分裂样精神病的疗效、安全性和剂量.方法:对2002年至2003年来我院青少儿心理门诊就诊,符合中国精神障碍分类与诊断标准第3版诊 断标准,≤16岁的儿童少年62例,给予利培酮治疗12周,采用简明精神病评定量表(BPRS)评定临床疗效,副反应量表(TESS)及实验室检查评定安全性.结果:利培酮平均起效剂量为(0.86±0.28)mg/d,平均治疗剂量为(3.16±1.08)mg/d,显效率为82.26%,有效率为96.77%.不良反应有锥体外系反应(EPS)和轻度困倦.结论:利培酮可作为儿童少年期精神分裂症或分裂样精神病的一线治疗药物.     

利培酮治疗首发儿童精神分裂症的临床观察

目的了解利培酮治疗儿童少年期首发精神分裂症或分裂样精神病的临床疗效、安全性和药物剂量。方法用利培酮对62例年龄<14岁的儿童精神分裂症患者治疗8周,采用简明精神病评定量表(BPRS)评定疗效,副反应量表(TESS)及实验室相应检查评定安全性及副反应。结果总有效率85%。不良反应主要为锥体外系反应及失眠,平均治疗剂量(3.26±0.88)mg/d。结论利培酮对于首发儿童少年期精神分裂症或分裂样精神病的治疗,用药安全、疗效可靠、副反应小、依从性高。     

盐酸喹硫平治疗首发精神分裂症96例临床疗效分析

目的 探讨盐酸喹硫平对精神分裂症的临床疗效与安全性.方法 将96例首发精神分裂症患者随机分为2组,分别给予盐酸喹硫平和利培酮口服,疗程6周.采用阳性与阴性症状量表(PANSS)评定疗效,采用副反应量表(TESS)评定不良反应.结果 盐酸喹硫平组痊愈率和总有效率分别为45.11%、83.87%,利培酮组为45.39%、90.32%,2组比较差异无显著性(P>0.05) 盐酸喹硫平组在震颤、肌张力增高、静坐不能、月经失调,泌乳及体质量增加方面明显少于利培酮组.结论 盐酸喹硫平能够有效治疗精神分裂症的各种症状,疗效与利培酮相当,具有安全性高、锥体外系反应少、无明显体质量增加趋势等特点,尤其更适合女性精神病患者使用.     

奎硫平与利培酮治疗门诊精神分裂症患者对照研究

目的：探讨奎硫平治疗精神分裂症的疗效及不良反应。方法：50例精神分裂症患者随机分为两组,分别给予奎硫平与利培酮治疗。疗程5周。采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效及不良反应。结果：奎硫平组显效率70．0％;利培酮组显效率73．3％。利培酮组锥体外系反应稍高于奎硫平组。结论：奎硫平与利培酮治疗精神分裂症具有相仿疗效。     

喹硫平治疗神经内科门诊阿尔茨海默病患者精神行为症状的效果分析

目的分析神经内科门诊阿尔茨海默病患者精神行为症状治疗效果。方法选取在我院门诊就诊的伴精神行为症状的阿尔茨海默病患者80例,随机分为喹硫平组和利培酮组各40人,喹硫平组服用喹硫平;利培酮组服用利培酮观察所有患者治疗前后BEHAVE-AD、治疗效果、不良反应出现情况进行记录和分析。结果两组治疗前、治疗后2周BEHAVE-AD与疗效分级差异无统计学意义,P=0.8829,但是治疗后4周,喹硫平组BEHAVE-AD(10.5±5.6)小于利培酮组(12.8±4.3),差异有统计学意义,P=0.0427;喹硫平组出现锥体外系反应比率(5.00%)小于利培酮组(25.00%),差异有统计学意义,P=0.0123。结论喹硫平对于控制阿尔茨海默病患者精神行为症状的短期疗效优于利培酮,安全性也更优,值得推广。     

喹硫平治疗首发老年期精神分裂症对照研究

目的比较喹硫平和奋乃静治疗首发老年期精神分裂症的疗效和安全性。方法将64例首发老年期精神分裂症住院患者随机分为喹硫平和奋乃静组，分别给予喹硫平和奋乃静治疗。疗程8周，采用简明精神病评定量表（BPRS）评定疗效，以副反应量表（TESS）评定药物不良反应。结果喹硫平与奋乃静临床疗效差异无显著性。喹硫平的不良反应以嗜睡、直立性低血压较多，奋乃静锥体外系反应较重。结论喹硫平治疗首发老年期精神分裂症疗效较好，安全性高，有利于长期巩固维持治疗。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.