189例老年住院精神病人分析

目的分析住院老年精神病人的年龄和病种。方法回顾性查阅住院60岁以上老年精神病人的病例资料，对其年龄和病种进行分析。结果60岁以上(含60岁)住院老年精神病人占同期住院精神病人3．12％；60岁及以上住院老年精神病人随年龄增长，比例减少；以精神分裂症(含分裂样精神病)最多，其次为情感性障碍。结论建议加强老年精神病诊断与治疗业务开拓。     

慢性老年精神病人全面检查躯体疾患所见

曾经有人报告,在老年精神病患者中,经详细体格检查和临床检验,发现伴有躯体疾病的大约有60-80%.如此高的躯体疾病发生率,足以说明对老年精神病人经常进行躯体检查和及时给予治疗是十分重要的.为了证实这种观点,作者于1971年8月至12月,对挪威北部某精神病院中长期住院的慢性精神病人进行了研究.共选择41例,女性24例(年龄41～91岁,平均65岁),男性17例(38～89岁,平均55岁).住院时间最短1年,最长40年.其中28例诊断精神     

对住院精神病人用药状况的调查结果

作者采取一日法分别调查了1989年11月10日与1997年11月10日的住院精神病人用药状况,并作对比分析。现报告于后。1　对象与方法1.1　对象　调查对象为1989年11月10日与1997年11月10日分别在我院住院的精神病人(合并严重躯体疾病者除外)。1989年11月10日当日住院病人130例(下称1989年组),其中,男94例,年龄14～63岁、平均(36.48±10.88)岁,病程(8.23±6.56)年;女36例,年龄15～64岁,平均(37.32±12.43)岁,病程(4.58±3.87)年,精神分裂症98例、分裂样精神病4例、心境障碍8例、心因性精神障碍12例、偏执性精神病1例、分裂情感性精神病3例、癫痫性…     

MECT在住院老年精神病患者中的应用情况及相关影响因素分析

目的了解改良电抽搐治疗(MECT)在住院老年精神病患者中的应用情况及相关影响因素,为对其进行MECT提供参考。方法采用回顾性分析方法,从本院电子病历数据库调取2016年在老年精神科病房住院的患者病历共403例,收集患者的社会人口学及临床资料,研究MECT在老年精神病患者中的使用率,采用单因素及多因素方法探索其相关因素。结果 MECT治疗在住院老年精神病患者中的使用率为25.6%。多因素分析显示,60岁≤年龄65岁(OR=0.433)、不合并心脏病(OR=0.362)、有自杀风险(OR=2.980)、诊断为情感障碍(OR=14.265)和精神分裂症(OR=17.260)的住院老年精神病患者更倾向于合并使用MECT。MECT组患者住院天数更少(OR=0.882),住院费用高于非MECT组(OR=5.157)。结论 MECT在精神专科医院老年患者中使用率较高,但年龄大、有心脏疾病及器质性精神障碍的老年患者应谨慎使用。     

住院精神病人并发糖尿病的相关因素分析

目的　探讨精神病人并发糖尿病的相关因素。方法　对 10 4 4例住院精神病人进行糖尿病罹患情况调查 ,将其中的 12 8例并发糖尿病者作为糖尿病组 ;并抽取未并发糖尿病的精神病人按性别、年龄、病程以 1∶1匹配作为对照组。对两组的一般资料、抗精神病药使用状况、体重、血脂及其并发症等进行调查与比较。结果　精神病人并发糖尿病的患病率为 12 2 % ;糖尿病发生与有糖尿病家族史、精神病发病年龄低、抗精神病药使用时间过长有关 (P <0 0 5 ) ,与抗精神病药剂量、用药种类无关 (P >0 0 5 )。糖尿病组的肥胖、血脂及其它并发症均明显高于对照组 (P <0 0 1)。结论　精神病人患糖尿病远高于普通人群 ;有糖尿病家族史、长期服用抗精神病药要定期监测血糖。     

老年精神病人诊治分析

目的了解住院老年精神病人诊疗情况及应对措施。方法采取定点调查法,于2014-07-23记录在我院住院的105例老年精神病人当日用药与康复等治疗情况。结果诊断主要为精神分裂症占39.05%,老年痴呆占42.86%,老年性情感障碍占16.19%;合并躯体疾病者65例(61.90%)。105例患者均参与康复治疗,其中单一用药69例,合并用药36例。以抗精神病药治疗为主,83例使用第二代抗精神病药,1例使用第一代抗精神病药。结论加强老年性精神病的诊断和治疗,同时关注合并躯体疾病的治疗,在药物治疗的同时,加强康复治疗和心理治疗,可改善老年患者的各种功能,提高生活质量。     

精神病人急腹症15例误诊分析

精神病人患急腹症并非鲜见,但由于精神病的特殊性,临床症状复杂多变,常易误诊。现将我院15例误诊情况分析如下: 临床资料 男性11例,女性4例,年龄15～58岁。 1.急腹症病种:胆囊炎3例,胆石症、胆道蛔     

改良无抽搐电休克治疗在老年精神分裂症和抑郁症患者中的应用

鉴于老年人机体代谢功能减退 ,对各种抗精神病药物的耐受性降低 ,易出现药物副作用 ,使抗精神病药物的使用受到限制。改良电休克治疗 (ｍＥＣＴ)是一种安全有效的治疗方法 ,适用于老年精神病患者[1] 。本文拟介绍此疗法在老年精神病患者中的应用。1　资料与方法我们以 1999年 3月～ 2 0 0 0年 4月华西医科大学附一院精神科及广州市精神病医院老年科老年精神病人为研究对象 ,对符合要求的患者进行ｍＥＣＴ治疗。1.1　纳入标准 :(1)符合中国精神疾病分类方案与诊断标准 (ＣＣＭＤ - 2 -Ｒ)精神分裂症或抑郁症诊断标准[2 ] ;(2 )年龄≥ 6 5岁 ;…     

对107例住院老年精神病人日用药的临床调查

目的了解住院老年精神病人使用精神药物情况,分析老年精神病人使用精神药物的合理性。方法对我院2010年3月22日住院老年病人用药情况进行调查。结果临床用药的频度列在前三位依次为抗精神病药物、镇静催眠药及抗抑郁剂。其中抗精神病药物的使用频度列在前三位依次为喹硫平、利培酮及氯氮平;镇静催眠药依次为氯硝西泮、阿普唑仑及唑吡坦;抗抑郁剂依次为帕罗西汀、文拉法辛,西酞普兰及曲唑酮并列第三。结论老年病人目前使用精神药物以新型精神药物为主,低剂量为宜,用药趋于合理。     

440例老年住院精神病患者发病情况调查

４０例老年住院精神病患者发病情况调查郑崇芬向虎李建勋羊礼军罗洁随着生活及医疗保健水平的提高，人类寿命的延长，老年人口明显增多，为探讨老年住院精神病患者的发病情况，特进行本调查，均按年龄在６０岁以上的病例进行统计。１资料和方法所有病例取自我院精神科１９...     

精神科住院患者苯二氮(艹卓)类药物使用现状

目的：调查精神科住院患者苯二氮[艹卓]类药物（BZD）的使用现状。方法：以2005年7月12日至14日为时点调查日，对19家精神疾病专科医院用自制调查表进行调查，被调查的医院包括卫生、民政、铁路、公安4个系统，凡住院号为单数的精神科住院患者接受调查。结果：在2483例患者中，合并使用BZD者为705例（28．4％），各类精神障碍合并使用BZD者分别为：精神分裂症404例（21．4％），心境障碍160例（55．6％），器质性精神障碍43例（51．2％），神经症32例（71．1％），急性短暂性精神病17例（34．7％），癔症15例（55．6％），精神活性物质所致精神障碍10例（31．3％），其他2，4例。BZD使用频率依次为阿普唑仑、氯硝西泮、艾司唑仑、劳拉西泮、地西泮等。使用BZD的时间：〈60d者462例（65．5％），〉60d者243例（34．5％）。结论：精神科住院患者BZD的使用基本规范，但也有不合理用药。     

Promoting "successful aging" in community psychiatric care

Recently, patients with schizophrenia have been progressively aging in a way similar to that of the general population. In Japan, community mental health care has become more active in the context of the policy of promoting the discharge of patients from psychiatric hospitals. Patients with chronic schizophrenia who have been discharged are already approaching old age. "Successful aging" may be a key concept in their community-based psychiatric care. Successful aging does not emphasize a loss of youth, but focuses on gains and growth achieved with aging. In the Sasagawa Project, 78 patients with schizophrenia were gradually transferred from a psychiatric hospital to a community dwelling. Eight years have passed since the project began. Elder patients (>60 years old) showed stable psychiatric symptoms and were rarely readmitted to the psychiatric ward. They were, however, more often readmitted to hospital due to physical disease (for example, lifestyle-related disease or fracture) than were middle -aged patients (<60 years old). Elder patients cannot simultaneously receive mental health services under the Services and Support for Persons with Disabilities Act, and long-term care under the Long-Term Care Insurance Act. We hope that the government will establish a new system and institutions that address the needs of elder psychiatric patients. Elder patients with schizophrenia have an optimistic view of their own aging, but they are not sufficiently prepared for old age. In the mental health care of aging psychiatric patients, it is necessary to not only control psychiatric symptoms, but also promote and improve their quality of life by maintaining their ability to continue living in the community (for example, by supporting their preparations for old age).     

Diagnosis and treatment of mental states at high risk for psychosis

Despite the fact that the need for and possibility of diagnosing and treating schizophrenia in the prodromal phase is as old as the disease category itself. the first controlled studies were published only in the last 15 years. Using structured interviews and rating scales, the development/first episode of psychosis can be forecast only with a modest specificity: 30-60% of the persons with prodromal symptoms based on operationalised criteria develop full-blown psychosis during a 12-month follow-up period. A 6-month, low-dose antipsychotic treatment combined with psychotherapy can reduce this risk of psychosis by 50-60%. The treatment based on the clinical picture can be supplemented with antidepressants and anxiolytics. Despite the successful prevention, patients continue to show considerable residual symptoms and decreased coping abilities. Long-term effects of intervention, false positive cases, and stigmatization are among the most problematic, unresolved issues. According to international results and our own experience, psychosis prevention is currently adequate only in the case of help-seeking patients if the operationalised criteria of the prodrome are present. Detailed patient education and the ensuing informed consent are indispensable. Biological relatives of schizophrenia patients should be assessed with special care. Persons at increased risk of psychosis should be offered long-term follow-up and care and an "open doors" policy in the case of worsening symptoms and crisis.     

Age-at-first-registration for affective psychosis and schizophrenia

We compared the age-at-first-registration for patients with schizophrenia and affective psychosis in a statewide mental health register. After excluding those receiving (1) a diagnosis of both schizophrenia (ICD-9 295.x) and affective psychosis (ICD-9 296.x), or (2) a diagnosis of ICD-9 296.1 (which can cover "major depressive episode"), we adjusted the distributions for the age structure of the background general population. We found that all distributions showed a wide age range of onset, with a similar male modal age group of 20-24 for schizophrenia and 25-29 for affective psychosis. The female modal age group was 50-54 for both diagnoses. Although more individuals were diagnosed with schizophrenia (males = 2,434, females = 1,609) than with affective psychosis (males = 670, females = 913), the shape of the two distributions was similar. This finding suggests that factors influencing age-at-first-registration for schizophrenia and affective psychosis may be similar, especially for females.     

精神科儿少住院患者的42年资料回顾

目的了解从1958年8月本院正式成立儿童精神科以来,42年中儿童住院病人的情况,以掌握及了解儿童和少年精神障碍的发展趋势。方法从1958年8月到2000年9月之间住院的所有病人的病历共1327份,逐一记载所需资料内容,并将所有资料进行分析。结果患儿年龄主要集中在13—14岁,并涉及3—16岁各年龄段。以儿童和少年期最多,文化程度以初中和小学居多。在早期,精神障碍诊断不规范,90年代后,诊断趋于标准化,位于前五位的诊断是：精神分裂症、精神发育迟滞、脑器质性精神障碍、情感性精神障碍、行为障碍。90年代以来,每年住院儿童病人数量均呈增长趋势。结论在住院期间,儿童少年病人既要接受治疗,又需进行儿童间交友训练,而在成人精神科病房,在这一点上不能满足住院患儿的需要,不利于儿童和少年的综合治疗,所以在我院开设儿童青少年病房有重要的意义。     

Ranking of outcome domains for use in real-time outcomes feedback laboratory by patients with schizophrenia

The purpose of this study was to prioritize real-time outcomes from the perspective of patients with schizophrenia. Thirty-eight patients were interviewed and ranked 15 outcome domains according to their preference for communicating these outcomes with their mental health provider in the context of a real-time outcomes feedback laboratory. Subjects with schizophrenia ranked overall physical health as the most important outcome domain that they wanted to communicate to their mental health provider in the context of a real-time outcomes feedback laboratory. The ranking of physical health as the most important outcome domain was true for subjects regardless of total psychosis symptom severity, positive symptom severity, age, or level of insight. Outcomes feedback interventions for patients with schizophrenia should include physical health problems in addition to the usual mental health parameters.     

Increased blink rate in adolescent patients with psychosis

Increased blink rate, a putative correlate of central dopaminergic activity, may be elevated in patients with chronic schizophrenia. In an effort to determine whether this elevation is due to iatrogenic factors, blinking was examined in medication-naive adolescent psychiatric inpatients undergoing their first hospitalization. The mean (+/- SD) blink rate of patients with psychosis (n = 13, 16 +/- 9 blinks/minute) was significantly greater than that of the nonpsychotic control inpatients (n = 35, 10 +/- 6 blinks/minute). Thus, elevated blink rate may be a feature of psychosis that is not necessarily caused by neuroleptic treatment or psychiatric hospitalization.     

Late life psychosis

Psychoses in late life are serious psychiatric disorders. They include schizophrenia (both late onset schizophrenic patients and the more prevalent early onset schizophrenic patients living into middle and old age), delusional disorder, psychosis in patients with dementia, psychosis in patients with depression, and miscellaneous psychoses. This article reviews some of the more recent and interesting findings in late life psychoses. A need for further research is stressed.     

Difference in age of onset of psychosis between epilepsy and schizophrenia

To clarify the nature of psychosis development in epilepsy patients, we studied differences in age of onset of psychosis between epilepsy patients with psychosis (epilepsy-psychosis) and schizophrenia patients. Subjects were 282 patients with epilepsy-psychosis (36 postictal, 224 interictal, and 22 bimodal psychoses) and 612 schizophrenia patients. Age of onset was compared between the schizophrenia group and the whole epilepsy-psychosis group as well as its subgroups. Effects of sex and family history of psychosis on age of onset were also evaluated. Epilepsy patients developed psychosis later (mean age 30.1) than schizophrenia patients (mean age 26.6). Among epilepsy-psychosis subgroups, postictal psychosis and interictal psychosis showed a later onset than schizophrenia. In interictal psychosis, while chronic schizophrenia-like psychosis occurred at similar age compared to schizophrenia, brief episodic psychosis occurred at later age. Epilepsy-psychosis patients showed no sex difference in age of onset, whereas female schizophrenia patients showed a later onset than male schizophrenia patients. Both the epilepsy and schizophrenia patients with family history of psychosis tended to develop psychosis at an earlier age, although this did not reach statistically significant level. The findings of the study suggest that the nature of epilepsy-psychosis is not fully equivalent to that of schizophrenia.     

A follow-up study of a child psychiatric clientele with special regard to the diagnosis of psychosis

A 20-year follow-up of a child psychiatric clientele of 322 patients demonstrates that nearly one third have been admitted to psychiatric departments or mental hospitals in adulthood. One tenth belonged to the group with psychoses either as a child or grown-up. While the incidence of manic-depressive psychosis did not differ from a normal population of the same sex and age, the child psychiatric clientele is overrepresented by psychotic patients later on diagnosed as schizophrenia. The outcome of infantile psychosis was in half of the cases chronic psychosis; five of 10 psychosis proto-infantilis patients were diagnosed schizophrenia in adulthood. This result is not in accordance with the modern view that psychosis proto-infantilis is a special disease with no clinical connection to schizophrenia. The clinical entity of infantile psychosis and borderline psychosis seems to be affirmed by a common clinical and diagnostic course into borderline psychosis or schizoid character disorders. Nine patients with psychosis in adulthood did not belong to the group of psychosis in childhood.