住院精神分裂症男性患者吸烟行为与认知功能的关系

目的探索住院精神分裂症男性患者吸烟行为与认知功能的关系。方法收集2010年3月-2012年4月在惠州二院住院的、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准男性患者397例,其中慢性精神分裂症患者315例(吸烟组245例,非吸烟组70例),首发精神分裂症患者82例(吸烟者28例,非吸烟者54例),所有受试者都接受吸烟状况调查:尼古丁依赖量表(FIND),根据FTND分值,把吸烟组分为重度依赖组和轻度依赖组;并接受认知功能检查:连续作业测验(CPT),威斯康星卡片分类(WCST)和重复性成套神经心理状态测验(RBANS)。结果在315例慢性精神分裂症患者中,吸烟组245例(77.8%),非吸烟组70例(22.2%);在82例首发精神分裂症患者中,吸烟者28例(34.1%),非吸烟者54例(65.9%)。①慢性男性精神分裂症患者,吸烟组和非吸烟组在CPT、SWCT、RBANS各项评分差异均无统计学意义(P均0.05);重度依赖组CPT的正确反应数大于轻度依赖组和非吸烟组,且差异有统计学意义(P0.01),轻度依赖组和非吸烟组差异无统计学意义(P0.05)。②首发男性精神分裂症患者,吸烟组和非吸烟组在CPT、SWCT、RBANS各项评分差异无统计学意义(P均0.05)。结论吸烟对于精神分裂症患者的持续注意可能有一定的正性作用,吸烟与认知功能存在一定的相关性。     

吸烟对男性精神分裂症患者的影响

目的分析吸烟对男性精神分裂症患者的影响,探索精神分裂症患者高比例吸烟的原因。方法搜集慢性精神分裂症吸烟患者236例,使用PANSS评定其临床精神病理症状,相关实验室检查了解其健康状况。结果 236例精神分裂症患者中有吸烟行为168例（71.2%）,非吸烟患者68例（28.80%）,前组每日平均吸烟量为（18.6±6.9）支,26.7%患者是在首次发病后开始吸烟,吸烟患者服药剂量高于非吸烟患者。吸烟组PANSS阴性症状分及一般精神病理分得分均低于非吸烟组（P〈0.05）,PANSS阴性症状7个条目得分及其总分,一般精神病理分总分和PANSS总分与患者每天的吸烟量呈负相关（P〈0.05）。吸烟患者空腹血糖高,血脂紊乱和代谢综合征的比例高于非吸烟者。结论吸烟对慢性精神分裂症患者阳性症状的正性作用可能是精神分裂症患者高比例吸烟的原因之一;吸烟对精神分裂症患者的治疗和健康均有一定影响,在制定治疗计划时应加以考虑。     

吸烟行为对男性慢性精神分裂症患者临床结局的影响分析

目的探讨吸烟行为对男性慢性精神分裂症患者的临床结局的影响。方法选取在我院接受长期住院治疗的男性慢性精神分裂症患者95例,根据患者是否吸烟,将这95例患者分为吸烟组(n=65)和非吸烟组(n=30)。使用住院护士观察量表(NOSIE)评价患者的精神状况和日常状况,采用连续作业测验(CPT)对患者进行测试,评价两组患者的认知功能。采用阳性和阴性症状量表评价两组患者的精神症状。结果 NOSIE量表结果显示,吸烟组患者的社会能力、社会兴趣、总积极因子和总分显著高于对照组(P0.05),吸烟组患者的精神病因子、迟缓因子、总消极因子显著低于非吸烟组患者(P0.05),根据尼古丁依赖系数,进一步将吸烟组患者分为重度尼古丁依赖组和轻度尼古丁依赖组,CPT测验结果表明,重度尼古丁依赖组患者的CPT正确反应数显著高于轻度尼古丁依赖组和非吸烟组(P0.05),而轻度尼古丁依赖组和非吸烟组患者的CPT正确反应系数差异无统计学意义(P0.05)。吸烟组患者的PANSS总分和阴性症状量表评分显著低于非吸烟组患者(P0.05)。吸烟组患者绝望情绪得分低于非吸烟组,差异有统计学意义(P0.05)。结论吸烟是一种会给人体健康带来多种危害的行为,但是对慢性精神分裂症患者的认知功能和精神分裂症状可能具有一定的改善作用。     

吸烟对男性精神分裂症患者的影响

目的:探讨吸烟对男性精神分裂症患者的影响。方法:采用横断面调查与现况分析法,以自行设计的一般情况调查表、相关实验室指标,以及心电图,对238例男性住院精神分裂症患者进行检查与评定。结果:238例精神分裂症患者中有吸烟行为者134例(56.3%),每日平均吸烟量(13.4±7.8)支,重度吸烟患者93例(69.4%)。53.8%的患者是在首次发病后开始吸烟。吸烟患者服药剂量高于非吸烟患者,尤以服氯氮平和氯丙嗪患者为著。吸烟患者罹患空腹血糖高、血脂紊乱和代谢综合征的比例高于非吸烟患者。吸烟患者的心电图中QTc长于非吸烟患者。结论:吸烟对精神分裂症患者的治疗和健康均有一定的影响,在制订治疗计划时应当加以考虑。     

男性精神分裂症患者吸烟与临床症状的关系

目的:探讨重庆市,男性,精神分裂症患者的吸烟状况与临床症状的关系.方法:应用耐受问卷修订版(RTQ)、Fagerstr(o)m尼古丁依赖测试问卷(FTND)进行评定,用阳性及阴性症状评定量表(PANSS)评定临床症状.结果:精神分裂症男性患者吸烟率为57.8%,重度尼古丁依赖者占35.8%;复发患者的RTQ及FTND分值显著高于首发组(t=-2.39,P＜0.05;t=-2.21,P=0.03);吸烟组的偏执分值显著低于不吸烟组(t=-2.07,P=0.04).结论:复发和年龄的增长可能会增加精神分裂症患者的吸烟率和尼古丁的依赖程度.吸烟有可能改善患者的偏执症状.     

吸烟对男性住院精神分裂症患者认知功能的影响

目的：探讨吸烟对男性住院精神分裂症患者认知功能的影响。方法采用横断面研究,用精神分裂症认知功能成套测验共识版（M CCB ）对149例吸烟与75例非吸烟男性住院精神分裂症患者进行认知功能评估,同时用PANSS评估两组患者的临床症状。比较两组患者认知功能和临床症状的差异,并分析吸烟与认知功能的相关性。结果吸烟组和非吸烟组患者临床症状的差异无统计学意义。吸烟组M CCB中数字序列[（14．52±5．51）分比（17．39±5．54）分]、言语记忆[（17．11±5．56）分比（19．69±6．05）分]、视觉记忆[（13．41±8．10）分比（16．96±8．06）分]3个分测验得分均低于非吸烟组,差异具有统计学意义（P＜0．05）。吸烟组中,吸烟时间、吸烟量、吸烟指数与认知功能均无相关性（P＞0．05）。结论吸烟可能损害男性精神分裂症患者的认知功能,尤其是记忆力。     

吸烟行为和精神分裂症

吸烟行为与肿瘤、心血管疾病等慢性疾病的关系已获得了多数学者的认同,而精神分裂症患者的吸烟行为比普通人群更为常见,但吸烟对其影响却一直备受争议。鉴于此,本文将分别从阴性症状、阳性症状、认知症状、药物不良反应、血药浓度等多个方面阐述吸烟行为对精神分裂症患者的影响。     

吸烟对精神分裂症男性患者精神病理症状的影响

目的 分析吸烟对精神分裂症临床精神病理症状的影响,探索精神分裂症患者高比例吸烟的原因.方法 收集慢性精神分裂症吸烟患者(332例)和非吸烟患者(95例)共427例,首次发病(以下简称首发)精神分裂症吸烟患者(22例)和非吸烟患者(41例)共63例,均为男性;使用阳性和阴性症状最表(PANSS)评定其临床精神病理症状.结果 (1)在慢性精神分裂症患者巾,吸烟组PANSS阴性症状分量表中的情感交流障碍得分[(3.9±1.5)分]、被动或淡漠得分[(3.6±1.6)分]及其总分[(24.0.±8.2)分]低于非吸烟组[分别为(4.4.±1.7)分、(4.0±1.7)分和(26.3.±9.5)分;P<0.05];PANSS阴性症状分量表7个条目得分及其总分、一般精神病理分量表总分和PANSS总分与患者每天的吸烟量呈负相关(P<0.05～0.01);阴性症状分量表中的情感交流障碍[比值比(OR)=0.832,95%可信区间(95%CI)=0.691～0.980,P=0.029]和一般精神病理分量表中的紧张(OR=0.534,95%CI=0.363～0.786,P=0.001)进入Logistic模型.(2)在首发精神分裂症患者中,吸烟组在阴性症状分量表中的情绪退缩得分[(2.7±1.3)分]、被动或淡漠得分[(2.7 ±1.3)分]低于非吸烟组[分别为(3.5±1.3)分和(3.5±1.4)分;P<0.05];一般精神病理分量表中的动作迟缓与患者每天的吸烟量呈负相关,自知力缺乏与吸烟量呈正相关(均P<0.05);PANSS一般精神病理分量表中的动作迟缓(OR=0.589,95%CI:0.350～0.989,P=0.045)进入Logistic模型.结论 吸烟对阴性症状的正性作用可能是精神分裂症患者高比例吸烟的原因之一.     

吸烟对精神分裂症男性患者精神病理症状的影响

Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P＜0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P＜0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia.     

吸烟对精神分裂症男性患者精神病理症状的影响

Objective To compare the differences of psychopathologic symptoms between smokers and non-smokers in chronic and first-episode,drug-nalve schizophrenics.then it was attempted to explain the reasons why there is higher rate of smoking behavior in schizophrenia.Methods In all.427 male chronic schizophrenic patients(332 smokers and 95 non-smokers)and 63 male first-episode drug-naive patients with schizophrenia(22 smokers and 41 non-smokers)were collected.All patients were assessed with the Positive and Negative Syndrome Scale(PANSS).Results In chronic patients.the item scores of poor rapport and passive/apathetic social withdrawal of PANSS negative subscale were significantly lower in smokers than non-smokers(3.9 ±1.5 vs.4.4±1.7;3.6±1.6 vs.4.0±1.7.respectively,P＜0.05),and so was the total scores of PANSS negative subscale(24.0±8.2 vs.26.3±9.5).In first-episode.drug-ndive patients.the itern scores of emotional withdrawal and passive/apathetic social withdrawal of PANSS negative subscale were significant lower in smokers than non-smokers(2.7±1.3 vs.3.5±1.3:2.7±1.3 vs.3.5±1.4,respectively,P＜0.05).Conclusion It is suggested there are positive effects of cigarette smoking on the psychopathological symptoms of patients with schizophrenia,which misht be one of the mechanisms for higher rates of smoking behavior in schizophrenia.     

Psychiatric diagnosis and school placement: A comparison between inpatients and outpatients

The effects of inpatient vs. outpatient status on change in educational placement were examined for a sample of 185 inpatients and 351 outpatients evaluated at a psychiatric facility. Within thesame diagnostic categories, inpatients tended to receceive higher percentages of changes to more-restrictive educational settings than outpatients following evaluation, although such a downward trend was noted for the latter sample as well. The limitations of psychiatric diagnosis to school personnel when making educational placement decisions was discussed.Acknowledgment: This study was supported by U.S. Office of Education Grant G0080036 to the UCLA Mental Retardation and Child Psychiatry program. The authors would like to acknowledge Dr. Donald Guthrie of the Computer Resources Group for his valuable assistance with this study.     

Determinants of smoking behaviour in outpatients with schizophrenia

The present study is an assessment of the rate and severity of tobacco consumption in outpatients with schizophrenia, and the determinants of smoking behaviour. Sixty-four patients, assessed by the Item Group Checklist section of the SCAN interview and fitting DSM-IV criteria, were evaluated with CGI and the PANSS scales. In addition, they completed STAI (Spielberger), EPQ (Eysenck), and TPQ (Cloninger) questionnaires. Tobacco dependence was assessed by the Fagerstr?m test. One hundred and thirty-seven consecutive outpatients were psychiatric controls. Forty-one out of 64 patients with schizophrenia (64.1%) were current smokers, this rate being significantly higher than in other psychiatric patients and general population. The severity of cigarette consumption in smokers was greater (mean of 22.4 cigarettes/day) than in the general population, but it was not different from that of other psychiatric patients. For patients with schizophrenia, no one variable (except male sex) was different between smokers and non-smokers, but the number of cigarettes/day correlated with state anxiety, trait anxiety, and neuroticism. In the multivariate analysis, the only variable that remained significant was neuroticism. The relationship between clinical features and severity of smoking behaviour may be linked to non-specific variables such as neuroticism and anxiety, but not to psychotic symptoms.     

Prevalence of multiple personality among inpatients and outpatients

A survey of psychiatric inpatients (N = 50) and outpatients (N = 100) indicated that about 10% had multiple personality and an additional 5%-20% had amnesia for early traumatic experiences.     

Satisfaction of inpatients and outpatients with staff, environment, and other patients

The study described here compared levels of satisfaction with staff, environment, and other patients among 420 first-time and long-term patients in psychiatric outpatient and inpatient settings. The demographic, clinical, and outcome variables associated with satisfaction were explored. Patient satisfaction was related to quality of life, social functioning, treatment expectations, and one-year psychological and physical prognoses. Perceptions of other patients were significantly more positive among long-term patients than among first-time patients. The concerns of first-time patients about other patients are of special importance, and they should be addressed during initial treatment.     

Prevalence of smoking among psychiatric outpatients

The prevalence of smoking among psychiatric outpatients (N = 277) was significantly higher than among either local or national population-based samples (N = 1,440 and 17,000) (52% versus 30% and 33%). The higher prevalence was not associated with the age, sex, marital status, socioeconomic status, alcohol use, coffee use, or institutionalization of the psychiatric patients. Smoking was especially prevalent among patients with schizophrenia (88%) or mania (70%) and among the more severely ill patients. Hypotheses about why psychiatric patients are more likely to smoke and why they do not have a high rate of smoking-induced illnesses are presented.     

Diagnostic utility of the Beck Depression Inventory with adolescent psychiatric outpatients and inpatients

The utility of the Beck Depression Inventory (BDI) for differentiating adolescents with depressive disorders from adolescents with non affective psychiatric disorders was examined using a sample of 93 psychiatric outpatients and 26 inpatients. The Diagnostic Interview for Children and Adolescents (DICA) was administered to establish the patients' diagnosis. Psychiatric diagnoses were made by experienced clinicians who used all available information on the patient. The BDI scores discriminated between patients with depressive disorders and patients with non affective psychiatric disorders. This differentiation was true for boys and girls, outpatients and inpatients. The classification accuracy of the instrument was 75% at thresholds of 11 and 16 on the scale. The results indicate that the BDI is a useful instrument for screening for depression in adolescents, and can also be used in conjunction with other tests. However, the BDI by itself is inadequate to establish a diagnosis of depression.     

A legal-questionnaire study of psychiatric inpatients and medical surgical outpatients

Prior to the Vietnam era a high percentage of patients hospitalized in Veterans Administration Hospitals for psychiatric illness could be described as marginal men.¹ These patients are characterized by poor occupational history, poor marital adjustment, a nomadic existence, dependency on an institutional way of life, and alcoholism. Both authors have noted that this type of patient seems to have more than his share of legal problems. Oftentimes the legal problems seem to be of top priority to the patient, i.e., unless they are solved, the patient cannot expect to make an adjustment within the community. A literature review revealed no information on the extent of this problem. The social psychiatric kinds of intervention employed in the treatment of these patients requires that all social factors be considered simultaneously with psychodynamic and biological factors in the patient's course. As part of an attempt to develop more meaningful interventions with this patient population,² we designed a survey to determine the extent of legal problems. It attempts to answer the following questions: Are psychiatric patients more prone to have legal problems than a medical surgical outpatients population? Are there any particular kinds of legal problems which differentiate the psychiatric population from the medical surgical out-patient population?     

Suicidal behavior in child psychiatric inpatients and outpatients and in nonpatients

One hundred one child psychiatric outpatients were assessed using a standard battery of measures to identify factors associated with suicidal behavior. Data on these outpatients were compared to those for psychiatric inpatients and nonpatients previously studied. The frequency of suicidal behavior among the outpatients (24.8%) was less than for a comparable group of inpatients (78.5%) but more than for a comparable group of nonpatients (12%). Four variables--recent general psychopathology, preoccupation with death, and recent and past depression--were significantly associated with suicidal behavior in the three groups of children.