Retroviruses and schizophrenia in Jamaica

Reports of an 18-fold higher incidence of schizophrenia among second-generation Afro-Caribbeans, and especially Jamaican migrants in the United Kingdom were soon called “an epidemic of schizophrenia,” with the inference that a novel virus, likely to be perinatally transmitted, was a possible etiological agent. This intriguing observation led us to explore a possible link with human T-cell lymphotropic virus type one (HTLV-I), because it is a virus that is endemic in the Caribbean Islands, is perinatally transmitted, known to be neuropathogenic, and the cause of a chronic myelopathy (tropical spastic paraparesis/ HTLV-I associated myelopathy). We therefore examined inpatients at the Bellevue Mental Hospital, Kingston, Jamaica and did standard serological tests for retroviruses HTLV-I and HTLV-II and HIV-I and HIV-II on 201 inpatients who fulfilled ICD-9 and DSM III-R criteria for schizophrenia. Our results produced important negative data, since the seropositivity rates for HTLV-I, the most likely pathogen, were no greater than the seropositivity range for HTLV-I carriers in this island population, indicating that HTLV-I and the other retroviruses tested do not play a primary etiological role in Jamaican schizophrenics.     

精神分裂症患者乙型肝炎病毒感染与代谢综合征的关系

目的探讨精神分裂症患者乙型肝炎病毒(HBV)感染与代谢综合征(MS)的关系。方法收集600例住院精神分裂症患者人口学资料和病史资料,测量身高、体质量、腰围、血压等生理指标,采集血清样本检测其HBV携带情况以及空腹血糖、总蛋白、白蛋白、球蛋白、肌酐、尿素氮、尿酸、甘油三酯、总胆固醇、高密度脂蛋白(HDLC)和低密度脂蛋白(LDL-C)等生化指标,按2007年颁布的《中国成人血脂异常防治指南》中MS诊断标准诊断。结果 600例精神分裂症患者乙型肝炎表面抗原(HBsAg)阳性有71例,阳性率为11.83%。MS组HBsAg阳性率为19.78%,非MS组10.41%,差异有统计学意义(P0.05)。HBV感染和MS相关的粗OR为2.121,95%CI为(1.342～3.324),调整年龄和性别后,其调整OR为2.068,95%CI为(1.322～3.228)。结论 HBV感染可能会增加精神分裂症患者MS的患病风险。     

博尔纳病毒感染与精神分裂症的相关研究

目的 探讨博尔纳病毒(Borna disease virus,BDV)感染与精神分裂症的相关性,分析感染BDV的精神分裂症患者临床特征.方法 采用荧光定量巢式逆转录聚合酶链式反应方法检测86例精神分裂症患者(患者组)和84名健康体检者(对照组)外周血单个核细胞中BDVp24和BDVp40基因片段,以β-肌动蛋白作为内参照,将BDVp24和BDVp40基因片段均为阳性的标本基因进行测序分析,外周血进行抗BDV抗体滴度测定,对患者的精神症状采用PANSS进行量化评分,并总结阳性患者的临床特征.结果 86例精神分裂症患者中外周血标本BDV p24基因片段阳性检出率11.6％ (10/86),BDVp40基因片段检出率13.4％ (12/86),拷贝数均＞102 kb/μl.对照组检测BDVp24、BDVp40基因片段均为阴性,两组阳性率比较差异有统计学意义(x2=9.26,P＜0.05).对BDV p24和BDVp40基因片段均为阳性的标本测序后,与马源的BDV病毒株亲缘关系最近.阳性标本的精神分裂症患者精神症状主要以幻觉、妄想等阳性症状为主,PANSS量表评分均＞40分.结论 精神分裂症发病与BDV感染有一定的相关性,是否是唯一的相关性还有待进一步研究,BDV感染的精神分裂症患者主要以阳性精神症状为主.     

Theory-based research in schizophrenia

TOPIC: Theoretical models to guide research into schizophrenia. PURPOSE: To review the most commonly used biological and environmental models of schizophrenia. SOURCES: Published literature and research conducted by the author. CONCLUSIONS: The vulnerability model includes both biological and environmental variables that impact the course of schizophrenia and treatment. RESPONSES: Thus, it may be a useful framework for nursing research examining responses to various psychosocial treatments in schizophrenia.     

精神分裂症的抑郁症状分析

对１２０例精神分裂症患者抑郁症状的分析表明，抑郁症状与ＳＡＰＳ、ＳＡＮＳ、ＢＰＲＳ、ＴＥＳＳ分值呈显著的正相关，与文化程度、住院时间呈负相关，说明抑郁症状在多数患者中系疾病本身症状的组成部分，但也不排除心因性及药源性抑郁的可能性。     

Repeated naloxone administration in schizophrenia

A double-blind study of repeated subcutaneous administrations of 20 mg naloxone was performed in 10 schizophrenic patients as part of a World Health Organization collaborative project. No clinically obvious treatment effects were observed. None of the analyzed psychopathological symptoms, including hallucinations and unusual thought content, showed a distinct improvement during the 4 consecutive days of naloxone treatment. A slight but statistically significant decrease of symptomatology was found shortly after placebo injection on the first 2 days of treatment. This effect was not present following naloxone treatment. These findings are discussed in view of the hypothesis that increased endorphin activity contributes to the symptomatology of schizophrenic syndromes.     

精神发育迟滞并发精神分裂症与精神分裂症症状特点比较

目的 探讨精神发育迟滞(MR)并发精神分裂症与精神分裂症症状特点比较。方法 100例MR并发精神分裂症患者按智商(IQ)≥50和IQ≤49分成两组进行临床特征分析,并与100例智力正常的精神分裂症患者比较。结果 MR并发精神分裂症患者IQ≥50和IQ≤49两组间临床症状差异无显著性(P>0.05);MR并发精神分裂症组与正常智力的精神分裂症组的一级症状、逻辑推理障碍、妄想、情感平淡、思维贫乏、愚蠢行为的差异有非常显著性(P<0.01)。结论 MR并发精神分裂症患者一级症状明显减少,有助于鉴别诊断。     

精神分裂症患者自知力与智力的关系

目的：了解精神分裂症患者自知力与智力的关系。方法：对７５例精神分裂症患者出院前１周内做智力测验并测定症状及自知力恢复情况,在背景材料一致下比较自知力与智力的关系。结果：患者自知力恢复越完全,其言语ＩＱ、操作ＩＱ及总ＩＱ显著高;右力差者中４５．９％属智力障碍。结论：自知力恢复受智力水平的影响。     

精神分裂症不同症状的MRI对照研究

选择４０例住院精神分裂症病人（其中阳性症状组３０例，阴性症状组１０例），和正常对照组２０例检测头颅ＭＲＩ。结果：精神分裂症脑结构异常率为３２．５％，其中脑软化７．５％，海马回梗塞１７．５％，脑白质变性１５％，额颞皮层萎缩２５％，阴性症状组病人的两侧脑室前角，三角区间距，三脑室宽径，大脑纵裂前半间距，左、右侧裂池宽距比正常对照组明显扩大，阳性症状组病人的两侧脑室三角区间距，三脑室宽径亦比正常对照组明     

汕头市精神分裂症流行病学调查

采用全国精神疾病流调统一方法，调查了汕头市城乡户口各５００户，１５岁以上总人口３３２０人，查出精神分裂症３１例，现患２６例，总患病率９．３４‰，时点患病率７．８３‰，标化率７．８１‰，高于全国１２地区精神分裂症平均患病率。调查结果发现，经济发达地区精神分裂症患病率高，而经济水平低，无支持系统者有较高的患病率。     

晚发与非晚发精神分裂症对照研究

对４个医疗单位精神科住院病人中的晚发性精神分裂症２４７例进行观察，以非晚发性精神分裂症病人２６４例为对照。结果发现，晚发组女性显著较多，病前性格内向者显著较少，家族精神病遗传史显著较少。发病诱因以晚发组显著较多，起病急或亚急者亦然。两组文化程度相仿，近期疗效以晚发组显著较好。作者认为，不仅有年龄的不同，晚发组病例在其他方面也有不少特点，精神分裂症应有晚发型为独立的亚型。     

精神分裂症伴高催乳素血症与抗精神病药物关系的研究进展

许多抗精神病药物可导致精神分裂症患者合并高催乳素血症疾病,经典抗精神病药物不仅能使PRL水平明显升高,而且药物的效价强度与催乳素呈正相关。非经典抗精神病药对5-HT受体及多巴胺D2受体的亲和力具有相对特异性,锥体外系副作用轻,临床疗效显著,对催乳素水平影响小,但临床应用过程中不同药物对催乳素的影响存在差异,药理机制复杂还有待于进一步的探讨。     

事件相关电位在精神分裂症中的应用及研究进展

事件相关电位（event related potentials,ERP）是根据现代心理学原理发展起来的一种与刺激事件呈“锁时”关系的脑电活动分析技术,临床常规ERP包括失匹配负波（MMN）、P300、关联负变（CNV）、感觉门控（P50）等,现就近年来事件相关电位在精神分裂症方面的研究作一综述。     

精神分裂症患者血清催乳素和生长激素水平的观察

为研究精神分裂症患者血清中催乳素（ＰＲＬ）、生长激素（ＧＨ）的基础水平与正常人的差异，及精神分裂症患者治疗前后ＰＲＬ、ＧＨ水平的变化，以及与临床疗效的关系，采用放射免疫法，测定２０例精神分裂症患者治疗前和治疗后第２，４，６，８周末的ＰＲＬ、ＧＨ水平，并与１０名正常人对照，同时进行治疗前和治疗后第２，４，８周末简明精神病评定量表（ＢＰＲＳ）的评定。结果显示：精神分裂症患者的基础ＰＲＬ水平较正常对照组低，而ＧＨ水平较高，但无统计学意义；用抗精神病药治疗后ＰＲＬ升高，ＧＨ下降，ＰＲＬ水平的升高与ＢＰＲＳ减分值明显相关，支持精神分裂症的多巴胺功能亢进的假说。提示ＰＲＬ对治疗的反应可能是预测临床疗效的一个指标。     

Polypharmacy in schizophrenia

In contrast to research studies that limit the use of concomitant psychotropic medications in the treatment of schizophrenia, polypharmacy is common in real-world, clinical practice. The use of psychotropic medications as an adjunct to antipsychotic agents is often necessitated by the poor response to monotherapy with one antipsychotic agent. This paper discusses the prevalence of polypharmacy in clinical settings, reviews the evidence for the adjunctive use of antipsychotics, anticonvulsants, lithium, antidepressants, benzodiazepines and other psychotropics in the treatment of schizophrenia, and offers suggestions toward use of polypharmacy in difficult and practical clinical settings.     

Pathological Observations in HTLV-I Associated Myelopathy

Abstract: The following are the clinical and autopsy findings in a 63-year-old woman with myelopathy associated with the human T-cell lymphotropic virus Type I (HTLV-I). HTLV-I antibody was positive in both the serum and cerebrospinal fluid (CSF). In the lower thoracic region, demyelination and the loss of axons were accompanied by a proliferation of astrocytes, and gliosis was found in the lateral columns. Perivascular and parenchymal infiltrations of macrophages, lymphocytes, and plasma cells were also observed, but neither viral inclusion bodies nor atypical lymphocytes were found.     

免疫功能失调与精神分裂症

精神分裂症的确切病因和病理机制尚未完全阐明。免疫遗传可能在精神分裂症的发病机制中起关键作用。母孕期或发育期的某些病毒感染可能导致大脑结构损伤和功能改变。抗精神病药物合并免疫抑制剂治疗,可能提高疗效。将来研究方向可以包括有治疗作用的抗体以及新型的免疫调节药物。     

Class drift and schizophrenia

ABSTRACT– This study is part of an ongoing analysis of 207 children with schizophrenic mothers (high-risk subjects) and 104 low-risk controls begun in 1962 by Mednick & Schulsinger. The purpose of this study was to examine class mobility in schizophrenics, using a prospective paradigm. In the present study, 14 high-risk schizophrenics were matched with 14 high-risk non-schizophrenics and 14 low-risk non-schizophrenics on age, sex and social class origin. Groups were compared on highest class attainment and socio-economic status in 1972. Results indicated that while high-risk non-schizophrenics were comparable in class attainment to low-risk non-schizophrenics, the high-risk schizophrenics were downwardly mobile in comparison to their non-schizophrenic high-risk counterparts. The class drift hypothesis was thus supported.     

Depressive syndrome in schizophrenia

A depressive syndrome, closely resembling melancholia, was found in a large proportion of chronic schizophrenic men. Depression was most prominent during acute psychotic phases and was characterized by a delusional core of worthlessness and guilt. The depressive syndrome may persist throughout the patient's psychotic life and appears to be an integral component of schizophrenic psychopathology.     

精神分裂症患者性激素水平动态观察

对９０例精神分裂症男性病人做了性激素水平的动态变化测定，并与一组正常人（３３例男性）进行了比较，研究结果显示，病人组疗后睾酮（Ｔ）水平显著低于疗前，其变化与疗后简明精神病量表（ＢＰＲＳ），阴性症状量表（ＳＡＮＳ），阳性症状量表（ＳＡＰＳ）亦显著低于疗前，均有密切关系，病人组疗前和疗后Ｔ均显著低于正常对照组，而未婚者疗后促卵泡激素（ＦＳＨ）水平又显著低于已婚和离婚，丧偶者。