男女儿童青少年精神分裂症患者临床特征的比较

目的:比较儿童青少年精神分裂症男性与女性患者临床特征的差异。方法:对125例男性(男性组)和133例女性(女性组)儿童青少年精神分裂症患者的年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数、简明精神病量表(BPRS)、大体评定量表(GAS)及临床疗效总评量表(CGI)评分等临床特征进行比较。结果:男性与女性患者在年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数方面比较差异无统计学意义(P均0.05)。BPRS评分中敌对性、动作迟缓、情感淡漠、缺乏活力因子分男性组高于女性组(t=2.164,t=3.317,t=2.096,t=2.230;P0.05或P0.01);幻觉、思维障碍因子分女性组高于男性组(t=3.682,t=2.987;P0.01或P0.001)。入院时GAS、CGI-SI评分及出院时CGI-GI评分两组间差异无统计学意义(P均0.05),出院时CGI-EI评分女性组高于男性组(t=2.466)、自知力评分男性组高于女性组(t=2.403),差异有统计学意义(P均0.05)。结论:男性儿童青少年精神分裂症患者的临床特征以情感淡漠、缺乏活力等阴性症状为主,女性则以幻觉、思维障碍等阳性症状更突出;女性临床疗效优于男性。     

精神分裂症患者性别差异

探讨精神分裂症性别差异 ,报告如下。1　对象和方法系近 5年住院患者共 2 94例 ,其中男 130例 ,女 16 4例 ,均符合中国精神疾病分类方案与诊断标准第 2版精神分裂症诊断标准 ,排除合并精神发育迟滞、药物依赖、酒依赖、人格障碍和严重躯体疾病。对入组患者的年龄、性别、文化、职业、胎次、家族史、首次发病年龄和病程等进行分析。2　结果发现男性患者文化程度较高 ,首次发病年龄早 ,偏执型较多 ,病程较长 ,疗效较差 ;女性文化程度较低 ,首次发病年龄较迟 ,病程较短 ,疗效较好 (P均 <0 0 5 )。而职业、胎次、家族遗传史、阳性或阴性症状为…     

首发精神分裂症患者临床特点的性别差异

目的:探讨首发精神分裂症患者临床症状及社会功能的性别差异.方法:164例首发精神分裂症患者在治疗前和治疗后12周及1年时分别主定简明精神病评定量表(BPRS),阴性症状评定量表(SANS),功能大体评定量表(GAF),Simpson锥体外系副反应量表(SAEPS)及社会功能缺陷筛选量表(SDSS),结果:男女精神分裂症患者起病年龄,病程,受教育年限及阳性家族史的比例差异无显著性,但女性的已婚率(57.1%),显著高于男性(20.7%),治疗前后阴阳性症状及治疗后SAEPS总分,药物剂量男女差异皆无显著性,治疗前后女性的社会功能(尤其在躯体活动和家庭职能方面)显著优于男性,结论:首先精神分裂症患者的临床特征在治疗前和治疗后一年中无性别差异.但女性的社会功能优于男性.     

家族性与散发性精神分裂症的病原学研究

目的 :研究家族性与散发性精神分裂症相关因素。方法 :采用病历记载和家属核实的方法 ,对 5 0 1例精神分裂症患者的家族史 (限于一级亲属 )、性别、发病年龄进行对比分析研究。结果 :FH +较FH -组发病年龄早 ,FH -女性组较FH +女性组及FH +、FH -男性组发病年龄晚 ,均有统计学意义 ,而FH +男性组与女性组发病年龄无差异。结论 :家族性与散发性精神分裂症在发病年龄上的性别现象为 :有阳性家族史者发病年龄早 ,家族史阴性男性较女性发病年龄早。     

有无家族史精神分裂症患者的临床比较

本文对200例首次住院的有无家族史的精神分裂症患者进行临床比较,发现有无家族史的两组患者在起病年龄、病前社会功能及性格、临床症状、病程、疗效等方面有明显差异。     

精神分裂症家族史性别差异调查

目的 了解不同性别精神分裂症遗传的差异及父系、母系阳性家族史的差异.方法 对长沙市城、乡在我院住院的及同时段各社区进行免费药物求助的共1938例精神分裂症患者进行精神障碍遗传的问卷调查,发现精神分裂症阳性家族史患者253例,其中男性139例,女性114例.对家族史阳性率,先证者父系、母系、同胞子女患病情况作统计分析.结果 男性阳性家族史比率较女性稍低,但无统计学意义;父系、母系、同胞子女的阳性家族史无明显性别差异;母系阳性家族史明显高于父系.结论 遗传因素对精神分裂症有很大的影响,不同性别精神分裂症的阳性家族史无明显差异.精神分裂症中母系后代比父系后代有更高的发病风险.     

酒依赖伴发精神分裂症的临床特征对照研究

目的探讨酒依赖伴发精神分裂症的临床特征。旨在为临床鉴别诊断提供参考。方法采用回顾性调查方法，将患者分为酒依赖伴发精神分裂症组及酒精所致精神障碍组，并对两组饮酒情况、家族史、诱因、临床特征、实验室检查等资料进行比较。结果两组在饮酒量、家族史、诱因、幻觉、妄想症状持续时间、神经系统症状、脑电图、疗效方面有显著差异。结论酒依赖伴发精神分裂症饮酒量相对较少，家族史阳性率高，无明显诱因，幻觉妄想症状持续时间较长，伴有分裂症其它特征性症状，自知力缺乏，智能无明显缺损、无明显神经系统阳性体征，脑电图多数正常，疗效相对较差，可与慢性酒中毒相鉴别。     

精神分裂症受累同胞临床特征的研究

目的：探讨精神分裂症受累同胞的临床特征,为进一步的分子遗传研究提供材料和信息。方法：应用一系列标准化诊断和评定工具对318例精神分裂症同胞患者（148个家系）进行了评估。结果：精神分裂症受累同胞的临床特征按性别、家族史和发病年龄的分组检验,差异无显著性;同一家系中,受累同胞间的临床特征具有相似性,年长患病同胞的阴性症状更突出,病程更长,而年幼同胞比年长同胞发病年龄早。逐步回归分析显示,阳性症状与发病年龄、病程、病损程度有关,而阴性症状只与病程,病损程度有关。结论：精神分裂症患者同胞间的临床特征具有相似性。     

家族性与散发性精神分裂症的病原学研究

目的：研究家族性与散发性精神分裂症相关因素。方法：采用病历记载和家属核实的方法。对501例精神分裂症患者的家族史（限于一级亲属）、性别、发病年龄进行对比分析研究。结果：FH 较FH-组发病年龄早，FH-女性组较FH 女性组及FH ，FH-男性组发病年龄晚，均有统计学意义，而FH 男性组与女性组发病年龄无差异。结论：家族性与散发性精神分裂症在发病年龄上的性别现象为：有阳性家族史者发病年龄早，家族史阴性男性较女性发病年龄早。     

情感性精神病的性别差异

目的 作者对1981～1991年连续住院的370例(男212,女158)情感性精神病例进行临床对比分析,发现男性阳性家族史比率低于女性,首次以躁狂发病者男多于女,首次抑郁相发病者女多于男;男性患者双相型比女性多,而女性患者单相超过男性。在双相患者中,男性首发年龄显著高于女性,且男性双相的首次住院年龄大于女性。男性病例的病程、住院次数和发作次数均高于女性,男性精神病性症状发生率明显高于女性,而女性自杀率高于男性。这些结果提示情感疾病在临床上存在明显的性别差异。作者对产生这种差异的机制进行了讨论。     

Are there clinical differences between familial and nonfamilial Alzheimer's disease?

OBJECTIVE: The purpose of the study was to determine whether there are differences in clinical characteristics in two groups of patients with Alzheimer's disease, those reported to have a family history of dementia and those without a family history of dementia. METHOD: Using a data set from an Alzheimer's disease patient registry, funded as part of a National Institute on Aging cooperative agreement, the authors made comparisons of sociodemographic and clinical variables in a group of 462 patients with Alzheimer's disease, 172 reported to have at least one first-degree relative with dementia and 290 classified with no family history. RESULTS: Patients with a presumptive family history differed from those without a family history in two ways: the course of dementia was described as having a fast rather than a slow progression from onset of symptoms to diagnosis, and caregivers reported a higher prevalence of family history of psychiatric disorders. There were no significant differences in age at onset, duration, female gender, aphasia and apraxia, handedness, family history of Down's syndrome, or number of children, brothers, and sisters. CONCLUSIONS: The association of faster course and family history of psychiatric disorders in the patients with a family history of dementia is consistent with the hypothesis of heterogeneity, but the overall results could also be explained by a genetic-environmental model of Alzheimer's disease.     

抑郁症的性别差异

目的：比较男女住院抑郁症患者的起病年龄、症状等的差异。方法：收集抑郁症患者临床资料和评定汉密尔顿抑郁量表（HAMD，17），进行性别间的比较分析。结果：女性患者首发年龄早于男性，且20岁以前发病者多于男性；女性患者病程长于男性，发病次数也多于男性；男性患者未婚比例显著高于女性；男性患者在迟滞、疑病、自知力缺乏和阻滞等症状突出，而女性患者以激越、全身症状、躯体焦虑和睡眠障碍等为主。女性患者发病前生活事件多于男性。结论：男性和女性抑郁症患者在发病年龄、发病诱因、症状特点等方面存在一定的差异。     

The clinical phenotype of familial and sporadic late onset Alzheimer's disease

BACKGROUND: Familial factors are clearly associated with an increased risk of developing late onset Alzheimer's disease (LOAD). However, there is emerging evidence to suggest that familial factors may also influence clinical phenotype. To date, most studies have focussed on familial influences upon age of onset or duration of illness and few studies have compared the frequency of non-cognitive symptoms between familial and sporadic LOAD. OBJECTIVE: To describe the clinical phenotype, with an emphasis on non-cognitive symptoms, of patients with LOAD and to explore familial differences. METHOD: 374 patients with LOAD were recruited from the community based Camberwell Dementia Case Register and a comparison made of the clinical phenotype of patients with and without a first degree family history of dementia. RESULTS: A first degree family history of dementia was found in 27% of fully ascertained cases. An earlier age of onset was found in familial cases (77.2 years compared to 78.3 years, p<0.05). However, no other differences in clinical phenotype, including the rate of cognitive decline, duration or the frequency of non-cognitive symptoms, were found between familial and sporadic cases. CONCLUSIONS: Apart from an earlier age of onset, patients with familial LOAD, as a group, do not have major differences in their clinical phenotype compared to patients with sporadic LOAD.     

Psychopathology and outcome in first-admission schizophrenia: a 13-year follow-up study at a medical school hospital]

BACKGROUND: The course and outcome of 'dementia praecox' have attracted considerable attention since it was first described. However, studies in which schizophrenic patients have been followed for more than ten years are rare. In this study, the course and outcome of first-admission schizophrenic patients in Jichi Medical School Hospital was investigated. METHOD: The subjects were 62 schizophrenic patients, 29 females and 33 males (the mean age at first hospitalization was 25.2 +/- 7.4 years), who were consecutively discharged from the Department of Psychiatry, Jichi Medical School Hospital, between June 1983 and May 1988. The mean interval between first-admission and follow-up was thirteen years. The social outcome was measured using Eguma's Social Adjustment Scale. The subjects were divided into two groups according to Eguma's Scale: a favorable outcome group and an unfavorable outcome group. The following data were obtained from clinical records and analyzed: sex, family history of mental disorders, educational background, job experience, marital status, age at first contact to a psychiatrist, age at first hospitalization, type of onset, subtype of schizophrenia (paranoid, catatonic, hebephrenic types) and symptoms at the time of first hospitalization. Symptoms at the time of first hospitalization included delusions, hallucinations, disorders of ego consciousness, thought disorders, emotional disturbances, lack of spontaneity, catatonic symptoms, hypochondriac-cenestopathic symptoms, disorganized behavior, and suicide attempts. RESULT: Fifty-six of the 62 patients were followed-up. Six patients could not be contacted. Nine of the 56 patients follow-up were dead; two had died suddenly and seven had committed suicide. Forty-seven patients were alive, eight of which were not under psychiatric treatment, while 39 patients were receiving treatment (33 as outpatients, 6 as inpatients). The 47 patients who were still living were divided into two groups: 22 were included in the favorable outcome group, and 25 in the unfavorable outcome group. No significant differences in premorbid status were found. The unfavorable outcome group had an earlier age at first contact and age at first admission than the favorable outcome group. In the favorable outcome group, acute onset was more common than chronic onset. A comparison of psychopathological symptoms at the time of first hospitalization between the favorable and unfavorable outcome groups revealed significant differences in lack of spontaneity and hypochondriac-cenestopathic symptoms. No significant differences were found for any other symptoms. In the favorable outcome group, paranoid type was more common than hebephrenic type. DISCUSSION: Lack of spontaneity may reflect negative symptomatology, which has been suggested to be a predictor of an unfavorable outcome. While hypochondriac-cenestopathic symptoms may reflect an insufficient psychic container for the body, which has been hypothesized to work as an enabler of body image or imaginary body and an enabler of ego function as well. CONCLUSION: First-admission schizophrenic patients followed up after a mean period of thirteen years, and of this group data could be obtained on 90% of them. Two symptoms (a lack of spontaneity and hypochondriac-cenestopathic symptoms) present at the time of first hospitalization were observed more frequently in the unfavorable outcome group than in the favorable outcome group.     

Clinical observations on familial cluster headache

Cluster headache (CH) has traditionally been considered a sporadic disease. Recently, an Italian study pointed out a risk of developing CH in the affected patients' firstdegree relatives that was increased 39-fold compared with the general population. The aims of this study were to investigate any possible differences in mean age at onset, clinical features and lifestyle between familial and non-familial CH cases. Among all CH patients referred to the Parma Headache Centre (n=691), we considered those who reported at least a first-degree relative with a probable diagnosis of CH in their family histories (n=30). CH diagnosis in the relatives was confirmed for 19 of the 30 patients. Each one of the 19 "familial cases" was matched by sex and age at the first visit (within 2 years) to two CH patients who did not report any family history for CH. The male:female ratio was 1.4:1 in the familial cases. Mean age at onset was significantly lower in women with familial CH than in those with non-familial CH. The study did not show any significant differences in symptoms between the two CH groups, such as pain location, accompanying symptoms, duration and frequency of attacks, and active periods. Our study seems to suggest that genetic factors play a role in the female gender, affecting age at onset of headache without modifying the clinical features. Received: 15 December 2002 / Accepted: 22 February 2003 Correspondence to: P. Torelli     

奎硫平治疗精神分裂症疗效有关因素分析

目的：分析影响奎硫平治疗精神分裂症疗效的有关因素。方法：对50例住院经奎硫平治疗〉8周的精神分裂症患者作回顾性分析。结果：经过单因素回归分析发现年龄大、病程长、有家族史、病情反复发作及以阴性症状为主等因素均影响奎硫平的疗效，最后得到包括有家族史、反复发作和阴性症状为主的主效应方程，回顾性评判正确率达到86％。结论：患者的年龄偏大、病程长、病情反复发作和以阴性症状为主等因素均会影响奎硫平的疗效。     

The role of gender in identifying subtypes of schizophrenia: a latent class analytic approach

Past literature suggests that schizophrenic men and women may be at different risks for developing different subtypes of schizophrenia. This hypothesis was tested using data from the well-known retrospective cohort family studies, the Iowa 500 and the Iowa non-500. The sample consisted of 171 male and 161 female DSM-III schizophrenic patients and 713 of their first-degree relatives. First, bivariate tests for gender differences were conducted regarding family morbidity, age of onset, premorbid history, season of birth, and expression of deficit and affective symptoms. Restricted maximum likelihood latent class analysis was then used to test whether there was a subgroup of schizophrenic men who were more likely to have a low familial risk for schizophrenia or schizophrenia spectrum disorders, deficit symptoms, poor premorbid history, and birth in the winter months, suggesting possible early environmental insults, compared to schizophrenic women. Results showed that although men were more likely to meet these criteria, women also met them, thus suggesting gender differences in the prevalence of the subtype. Schizophrenic women were more likely to express a form of the illness characterized by dysphoria, persecutory delusions, and a higher family morbidity risk for schizophrenia than schizophrenic men. Results for spectrum disorders among relatives were equivocal with regard to gender.     

Do Women without a Family History of Schizophrenia Have a Later Onset of Schizophrenia ?

Abstract: The relation among age at onset of schizophrenia, sex and the presence or absence of first-degree relatives with schizophrenia was investigated in 2,417 inpatients meeting the DSM-111 criteria for schizophrenia. The mean age at onset of female schizophrenic patients without a family history of this illness was slightly later than that of any of the other three groups (male familial, female familial and male nonfamilial groups). The female nonfamilial group developed schizophrenia after the age of 25 and 30 more frequently than the male familial group and female familial or male nonfamilial group, respectively.     

425例高血压脑出血患者血压变化分析

目的 探讨广州市高血压脑出血患者发病及血压变化情况与高血压家族史、性别、年龄、病程等因素之间的关系.方法 回顾性分析广州市南方医院高血压脑出血425例临床资料,对其在不同家族史、性别、年龄、病程的发病情况及其与血压之间的关系进行分析.结果 青年组、中年组及老年组高血压脑出血男女发病比例分别为1.08∶1;2.04∶1;1.87∶1.男性有高血压家族史者明显高于无家族史者,女性有无高血压家族史对发病无明显影响.青年组男性收缩压及舒张压均明显高于女性;中年组及老年组收缩压及舒张压在两性间比较差异无统计学意义.所有患者收缩压及舒张压的分布情况均为急性期大于亚急性期大于恢复期.结论 高血压应区分年龄、性别、病程给予不同防治策略,最大限度降低脑出血的发生.