儿童期与青少年期首发精神分裂症临床特征比较

目的 了解儿童期和青少年期起病的精神分裂症临床特征及差异.方法 选取2005年8月1日～2007年7月31日在安徽省精神卫生中心住院的147例首次发病、资料完整、均符合中国精神障碍分类与诊断标准第3版中的诊断标准确诊为精神分裂症的住院患者,按首发年龄(<18岁)分为儿童组(<13岁,59例)和青少年组(≥13岁,88例),采取回顾性研究方法,就两组临床资料进行对照分析.结果 两组起病形式与出院疗效相比结果差异有显著性(P<0.05).青少年组出现思维内容障碍高于儿童组,两组比较差异有显著性(x2=0.019,P<0.05).儿童组出现行为障碍及情感障碍高于青少年组,两组比较差异有显著性(P<0.05).结论 精神分裂症的起病形式、疗效及临床症状与发病年龄有关.     

首发精神分裂症患者临床特征、认知功能的性别差异

目的比较住院男性及女性首发精神分裂症患者临床特征、认知功能等指标的差异。方法选择符合美国精神障碍诊断与统计手册第4版（DSM—IV）诊断标准的首发精神分裂症住院病人90例,其中男性48例,女性42例。收集临床资料,并使用阳性和阴性症状量表（PANSS）、汉密尔顿抑郁量表（HAMD）评定临床症状;威斯康星卡片分类测验（WCST）、重复性神经心理测查系统（RBANS）检测认知功能。结果男性患者比女性患者首次出现精神症状年龄要早2．8岁,首次住院男性患者年龄比女性患者早3．0岁,差异有统计学意义（P均〈0．05）;吸烟在男性患者中比例显著高于女性,差异有统计学意义（P〈0．001）;男性患者单身（未婚或离异）比例显著高于女性,差异有统计学意义（P〈0．05）。RBANS、WCST测查两性之间差异不显著,无统计学意义（P均〉0．05）;在精神症状方面,男性患者的夸大症状及情感交流障碍比女性更突出,差异具有统计学意义（P〈0．05）,但PANSS总分、各分量表分及HAMD评分在两者之间差异不显著,无统计学意义（P均〉0．05）。结论首发精神分裂症患者男性发病年龄要早于女性;在精神症状方面男性于女性之间存在着一定的差异;认知功能两者之间无差异;男性患者单身比例显著高于女性。     

老年期首发精神分裂症42例临床分析

本文对42例首次发作的老年期精神分裂症患者进行了临床分析，就其症状、诊断及治疗等问题进行了探讨。结果表明：男性患者略多于女性，农村患者多于城市患者；年龄越大，住院治疗人数越少；男女患者之间，城乡患者之间疗效比较无差异性。提出临床上要注意患者躯体疾病，治疗药量不宜过大，尽量单一用药，以减少药物的副作用。     

利培酮对儿童期首发精神分裂症的临床应用

目的:了解利培酮治疗儿童期首发精神分裂症患者的疗效及安全性。 方法:对40例年龄<14岁患儿以利培酮治疗8周,以简明精神病评定量表(BPRS)评定疗效,以副反应量表(TESS)及实验室监测评价安全性。 结果:利培酮平均治疗剂量为(2.84±O.71)mg/d,总有效率为87.5％,不良反应主要为锥体外系反应。 结论:对儿童期首发精神分裂症,利培酮疗效较好,安全性高。     

首发精神分裂症患者的头部CT图像特征

目的 探讨首发精神分裂症（FES）的电子计算机断层扫描仪（CT）图像脑形态改变特征。方法 将我院2020年1月～2021年1月期间收治的37例FES患者作为病例组,同期接受体检的36例作为健康组,所纳入本研究的患者均接受头部CT扫描。比较两组患者脑区差异、第三脑室变化、脑侧室相关指数、脑室扩大及脑萎缩的相关指数。结果 病例组第三脑室体部最大宽度、前角指数、侧脑室脑比率、侧脑室前角间最小宽度、侧脑室前角间最大宽度、侧脑室颞角最大宽度（左侧）、侧脑室颞角最大宽度（右侧）、第三脑室体部最大宽度高于健康组（P<0.05）;右内侧眶额叶、右侧额上回、左侧额上回、左侧额极、左侧中央旁小叶、左侧扣带回峡部、第三脑室外侧壁至同侧脑岛面距离（左侧）、第三脑室外侧壁至同侧脑岛面距离（右侧）、室中央指数、前额叶萎缩指数低于健康组（P<0.05）。结论 CT检查发现FES患者存在脑体积减小、脑室扩大、脑萎缩异常等脑形态,可为研究FES的发病提供影像学依据。     

利培酮口服液治疗首发精神分裂症临床分析

本研究观察利培酮口服液治疗首发精神分裂症的疗效及不良反应，报告如下。     

分裂样精神病与首发精神分裂症临床特征比较

目的:比较分裂样精神病与首发精神分裂症的临床特征。方法:选取同期出院的分裂样精神病、首发精神分裂症患者各45例进行临床特征比较。结果:分裂样精神病与首发精神分裂症在思维贫乏、懒散、紧张恐惧和冲动破坏方面差异显著。结论:分裂样精神病与首发精神分裂症相比,某些症状有显著差异。     

门诊首发儿童期精神分裂症病人的治疗情况调查

目的 调查门诊首发儿童期精神分裂症病人的继续治疗情况。方法 对1999、2000、2001年的3、4月份门诊诊为首发儿童期精神分裂症的继续治疗方式及连续周内用药情况进行调查。结果 首发儿童期精神分裂症继续治疗情况一为安排住院,二为继续门诊,三为中断治疗,门诊用药多为合并用药。结论 门诊继续治疗以利培酮为主要治疗药物。     

利培酮治疗首发精神分裂症临床观察

对我院应用利培酮治疗首发精神分裂症进行分析。1　对象和方法为我院 1999年 5月至 2 0 0 3年 2月门诊及住院患者 ,符合中国精神障碍分类与诊断标准第 3版精神分裂症诊断标准。共 184例 ,男 99例 ,女 85例 ;3例因经济原因、2例因迁移脱落 ,179例患者完成治疗。以利培酮治疗 ,起始剂量 0 5～ 1mg/d ,逐步加量 ,平均剂量 4 5mg/d。疗程 8周。以简明精神病评定量表 (BPRS)和副反应量表 (TESS)在治疗前及治疗 1、2、4、8周进行评定。实验室检查包括血常规 ,肝功能 ,心电图 ,胸透等。统计采用SPSS软件作t检验。2　结果经利培酮治疗 ,179例…     

利培酮治疗儿童期首发精神分裂症的疗效比较

有报道[1] ,利培酮对于不同年龄的首发精神分裂症是一个安全有效的药物。本文的目的是了解利培酮对儿童期首发精神分裂症患者的疗效 ,ＥＰＳ发生率以及服药的依从性 ,并与舒必利作比较 ,并报道于后。1　对象与方法1 1　对象　对象系 2 0 0 1年 2月～ 2 0 0 2年 1月期间住我院 ,年龄 <14岁的首发精神分裂症患者 ,且符合ＣＣＭＤ - 2 -Ｒ中精神分裂症诊断标准的 4 6例入组 ;简明精神病量表[2 ](ＢＰＲＳ)总分 >35分 ;性别不限 ;排除有明显自伤、伤人、自杀、极度兴奋躁动及严重躯体疾病者 ;随机分为利培酮组及舒必利组 ,每组各 2 3例 ;以上两…     

首次发作精神分裂症患者出院服药情况1年调查

目的 了解首次发作(以下简称首发)精神分裂症患者出院服用抗精神病药的特点.方法 对137例首发精神分裂症患者出院后的服药情况进行问卷式跟踪随访调查1年,并比较服用第1代抗精神病药患者(64例)和第2代抗精神病药患者(73例)的差异.结果 首发精神分裂症患者服药依从性随时间推延逐渐降低,与所服药物类型无关.第1代抗精神病药组出院后第1、3、6、12个月的停药率分别为0%、7%、18%、50%,第2代抗精神病药组的停药率依次为3%、11%、21%、55%,2组各时点的差别无统计学意义.第1代抗精神病药锥体外系不良反应明显多于第2代抗精神病药,随访第12个月时分别为30%、7%, χ2=12.310,P<0.01.而后者在随访第12个月时出现内分泌系统不良反应比例(40%)高于第1代抗精神病药(5%)(χ2=13.433,P<0.05).结论 如何提高首发精神分裂症长期维持治疗的依从性是精神卫生服务的重要内容.     

Neurological soft signs, clinical symptoms and treatment reactivity in patients suffering from first episode schizophrenia

OBJECTIVE : (a) To investigate the correlation between clinical symptoms and neurological soft signs in patients suffering from their first episode of schizophrenia and (b) to examine the relationship between soft signs and the reactivity of first episode treatment. METHODS: The trial included 92 male patients undergoing a first episode of schizophrenia. The clinical symptoms of the patients were rated on the positive and negative syndrome scale (PANSS). The PANSS scale was used to provide a measure for three syndromes: psychomotor poverty, disorganisation, and reality distortion. Neurological soft signs were assessed with the help of the neurological evaluation scale. RESULTS: The findings corroborated significant positive correlations between soft neurological signs on the one hand and negative symptoms and reduced treatment response on the other. CONCLUSION: Our study of the population of patients with first episode schizophrenia has corroborated the findings of those trials that found a correlation between neurological soft signs and the negative symptomatic dimension of schizophrenia. Another finding of the trial is that neurological soft signs were associated with poorer response to treatment of the first episode of schizophrenia.     

Familial sinistrality and handedness in patients with first episode schizophrenia: The EUFEST study

The population with schizophrenia is characterised by a leftward shift in handedness—sinistrality. However, findings are inconsistent in chronic patients, and familial sinistrality (FS), defined as the presence of left-handed close relatives, might contribute to the discrepancies. Therefore the aim of this study was to investigate the strength of manual lateralisation in patients with first episode schizophrenia, taking into account familial sinistrality. The Edinburgh Inventory (EI) allowed us to categorise 179 patients from the EUFEST study and 189 controls presenting “strong handedness” (SH: EI absolute value between ∣81∣ and ∣100∣) or “weak-handedness” (WH: EI value between ?80 and +80). The nominal logistic regression did not show an FS effect, but a nearly significant interaction between illness and FS (p =.07). There were fewer participants without FS presenting SH among patients (99/151: 65.6%) than among controls (134/164: 81.7%, p =.001). In contrast, the number of participants with FS presenting SH was similar between controls (68%) and patients (75%, p =.57). The presence of left-handed relatives (FS + ) tended to reduce manual lateralisation, but only in controls. This supports the notion that reduced manual lateralisation in schizophrenia is related to the illness rather than to familial left-handedness.     

Psychiatric comorbidity in first episode schizophrenia: a 2 year, longitudinal outcome study

OBJECTIVE: We have previously documented a high prevalence of Axis I psychiatric comorbidity in our patients with first episode psychosis. This study sought to determine the longitudinal impact of Axis I psychiatric comorbidity on patients with first episode schizophrenia (FES) and we hypothesised that patients with psychiatric comorbidity were associated with poorer clinical and functional outcomes. METHOD: One hundred and forty two consecutively hospitalized FES patients were included. Socio-demographic information was obtained and the PANSS, SUMD, GAF, WHOQOL-Bref were used to assess psychopathology, insight, social/occupational functioning and quality of life respectively at baseline and at 6, 12, 18 and 24 months after discharge. RESULTS: Over time and compared with baseline scores, patients with Axis I psychiatric comorbidity (n=46, 32.4%) had significantly less reduction of their PANSS total and subscale scores, less improvement in their awareness of their psychiatric illnesses and symptoms at 12, 18 and 24 months and poorer insight into the consequences of their illness at 18 and 24 months. Poor insight at baseline was correlated positively with PANSS negative symptom subdomain, and negatively with GAF at 24 months. CONCLUSION: Axis I Psychiatric comorbidity was associated with worse prospective outcomes in hospitalized patients with first episode schizophrenia, and this highlights a greater need towards the early recognition and management of these conditions.     

首发未服药精神分裂症患者血清血管内皮生长因子水平的研究

目的探讨首发未服药精神分裂症患者血清血管内皮生长因子(VEGF)水平。方法选取2014年10月-2015年10月就诊于宁波市康宁医院的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的首发未服药精神分裂症患者73例为研究组,采用阳性和阴性症状量表(PANSS)评定其精神症状的严重程度;选取与研究组性别、年龄及BMI相匹配的60例健康人为对照组,采用酶联免疫吸附法测定两组血清VEGF水平。结果研究组和对照组血清VEGF水平差异有统计学意义[(351.96±85.31)pg/m L vs.(280.98±77.54)pg/m L,P0.01]。精神分裂症患者组血清VEGF水平与PANSS评分、年龄和BMI无线性相关(P0.05)。结论首发未服药精神分裂症患者血清VEGF水平稍高于健康对照组,精神分裂症患者血清VEGF与PANSS评分、年龄和BMI无关联。     

奥氮平治疗首发精神分裂症的疗效分析

目的 评价奥氮平治疗首发精神分裂症的疗效及安全性。方法 用奥氮平治疗首发精神分裂症32例,疗程8周;用简明精神病评定量表(BPRS)和副反应量表(TESS)评定疗效及副反应。结果 完成8周治疗的32例首发精神分裂症患者,显效18例(56.2％)、有效11例(34.4％)、无效3例(9.4％),总有效率为90.6％,副作用轻微,无明显心血管系统不良反应。结论 奥氮平治疗首发精神分裂症安全有效。     

Social support and three-year symptom and admission outcomes for first episode psychosis

This paper presents the first published findings examining the relationship of social support to three-year symptom outcome and hospitalizations for a group of first episode patients with psychotic disorders. Social support was measured using items from the provider version of the Wisconsin Quality of Life Scale as assessed at the time of initiation of treatment for 113 patients. Outcome was assessed by level of positive and negative symptoms at three-year follow-up and number of psychiatric admissions during those three years. Higher levels of social support were found to correlate with lower levels of positive symptoms and few hospitalizations at follow-up. The relationship of social support to follow-up symptoms and hospitalization was independent of other potential predictors such as gender, age, premorbid adjustment and duration of untreated illness.     

精神分裂症的强迫症状及临床特征的分析

目的 为探讨精神分裂症的强迫症状及其临床特征。方法 采用MMOCI、Y－BOCS、PANSS评定了符合CCMD－2－R中精神分裂症诊断标准的住院精神分裂症病人812例。并将其中合并有强迫症状者75例随机分为两组进行8周的对照治疗,同时进行Pearson相关分析。结果 精神分裂症的强迫症状发生率为9．24％,其中只有强迫思维者占64．0％,强迫思维与强迫行为均有者占36．0％。前者的PANSS、MMOCI、Y－BOCS评分、强迫症状所占的时间、对社会功能的影响,以及所带来的痛苦分都较低,而抵抗分较高,两组比较有显著差异。利培桐安慰剂组和利培酮合并氯丙咪嗪组的疗效都很明显,尤以后者较好。治疗前后强迫症状的评分都与PANSS、阳性症状及一般病理分呈显著的正相关,而与阴性症状分无关。结论 作者认为,强迫症状是精神分裂症的常见症状,可能是精神分裂症固有症状的成份之一。     

Metabolic syndrome in first episode schizophrenia - a randomized double-blind controlled, short-term prospective study

BACKGROUND: Although the treatment of schizophrenia, arguably one of the most devastating diseases today, has been immensely helped by the advent of second-generation antipsychotics, they have come at a considerable cost - the metabolic syndrome (MetS). This adverse effect has been described with several antipsychotics to range between 20%-60%, at least double the prevalence in the general population. METHODS: All consecutive patients with first episode schizophrenia at our referral psychiatric hospital were recruited in an extensive prospective randomized, double-blind controlled study including measures of waist circumference (WC), blood pressure (SBP/DBP), triglyceride (TGL), high-density lipoproteins (HDL) and fasting blood sugar (FBS) levels and randomized to receive either, haloperidol, olanzapine or risperidone. The prevalence of MetS was assessed based on two criteria- ATP IIIA and criteria of International Diabetes Federation (IDF). This was compared with a gender, age, exercise and diet matched healthy control group. RESULTS: The analysis of 99 patients showed a prevalence of MetS as 10.1% and 18.2% as assessed by ATP IIIA and IDF criteria respectively. The prevalence of MetS in our sample of patients with schizophrenia is at least five times as high when compared to the matched healthy control group. Olanzapine had maximum prevalence of MetS at 20-25% followed by risperidone at 9-24% and haloperidol at 0-3%. DISCUSSION: Metabolic syndrome is highly prevalent among treated patients with first episode schizophrenia. Early monitoring of patients on atypical antipsychotics can possibly play an important role in early detection and hence prevention of the metabolic syndrome.