兰州市药物依赖流行病学调查

目的：了解兰州市药物滥用现状。方法：从1326户中抽出15岁及以上的10949人作为调查对象，采用线索调查和入户调查相结合的方法，逐户逐人面对面调查。结果：在实查10910人群中，查出阿片类物质使用者339人，终生曾用率为3．1％；符合美国精神障碍诊断与统计手册第3版修订本药物依赖诊断标准者144例，符合物质滥用诊断标准119例，总患病率为2．1％，现患54例，时点患病率为0．5％。结论：海洛因滥用对健康、社会功能，尤其对家庭和社会安定造成严重危害。     

兰州市成瘾物质使用第二次流行学调查

目的：了解兰州市的成瘾物质滥用情况。方法：于1996年7月对1993年7月调查过的相同流行地区的阿片类药物用情况再次进行调查。采用整群抽样、挨户，线索和机构调查相结合。结果：12807人中有成瘾物质滥用者161例（1．26％）。使用方法以烫吸为主。结论：与1993年7月调查结果相比，该地区成瘾物质滥用情况呈上升趋势，滥用物质以海洛因为主。     

成都地区180例阿片类物质依赖临床分析

成都地区１８０例阿片类物质依赖临床分析成都精神病防治院（６１００３１）谭平章我院于１９９２年４月至１９９３年１２月之间共收治鸦片类依赖２０４例。其中，家住成都地区者共１８０例，占收治总数的８９％。本文病例均符合ＣＣＭＤ－２中鸦片类物质依赖的诊断标准。...     

不同年代迟发性运动障碍患病率的比较分析

作者在１９８８年４月和１９９３年７月两次应用同样的方法对住院精神病人进行迟发性运动障碍（ＴＤ）流行病学调查，结果发现ＴＤ患病率从８８年的１３．５％降至９３年的５．５％（Ｐ＜０．０１）。９３年所查出１４例ＴＤ中有１２例在８８年就被确诊，新查出有２例。ＴＤ患病率下降与氯氮平广泛地应用于临床，而易引起锥外副作用的吩噻嗪类及丁酰苯类药物应用减少且剂量偏低等有关。     

广州市海珠区二龙街海洛因滥用者的状况调查

作者采用问卷方式，对广州市二龙街部分居民委员会的海洛因滥用者进行了药物滥用调查。在调查发现的７８例滥用者中有５９例（７５．６４％）采取静脉注射或静脉注射加烫吸，首次吸毒年龄１７～４１岁，平均２６．１７岁。首次滥用的主要原因是“好奇心”，以及被亲戚、朋友、同学、同事引诱。４５例（５７．６９％）有违法犯罪纪录。作者认为有必要提出更具针对性的措施、降低重吸率、减少海洛因滥用带来的社会问题。     

海洛因依赖者的麻醉、镇静药物滥用

目的：了解海洛因依赖者麻醉、镇静药物滥用情况。方法：对137例首次人院的自愿戒毒者的麻醉、镇静药物滥用情况进行调查。结果：海洛因依赖者入院前麻醉、镇静药品滥用现象很普遍，住院戒毒期间偷吸海洛因及滥用麻醉、镇静药物问题十分突出。结论：麻醉、镇静药品管理亟待加强；自愿戒毒模式不宜提倡。     

格林—巴利综合征是中国急性软瘫的常见类型：北京郊区流…

采用病例监测方法，于１９９３年１月１日至１２月３１日在北京市平谷县和通县进行格林－巴利综合征（ＧＢＳ）和急性软瘫（ＡＦＰ）的流行病学调查。根据ＮＩＮＤＳ的标准，１９９３年该两县确诊为ＧＢＳ者１３例，年发病粗率１．３／１０万人口，发病年龄专率高峰见于５０￣５９岁（３．６／１０万）。７￣９月发病者占５４％。全部患者临床和／或电生理表现均符合周围神经脱髓鞘为主的特点。ＡＦＰ分类构成以ＧＢＳ最多，占５７％     

抗精神病药物对心电图的影响（附560例分析）

报告抗精神病药物对心电图的影响。５６０例中单用氯丙嗪１３８例（２４．６％），剂量２００～６００ｍｇ／日．平均４１７．４ｍｇ／日．氯丙嗪合并氯氮平９５例（１７．０％），氯丙嗪与其他精神药物以及其他单用或合用者３２７例（５８．４％）．在入院时，入院后１月和２月各做一次心电图。结果首次检查窦速者１０３例次（１８．４％）．窦缓７例次（１．３％），部分Ｔ波和Ｔ波改变５１例（９．１％），Ｔ波和ＳＴ段改变１８例次（３．２％），在第２、３次检查时心电图改变有所减少。     

氯氮平对精神分裂症血流液变学的影响

精神分裂症患者自杀行为临床分析王鹏李业平杨祥金何思忠吴明飞调查１９７０～１９８７年期间住字的精神分裂症患者，符合ＣＣＭＤ－２诊断标准者３６０５例，其中有过自杀行为者４２１例（１１．７％）。男性２１１４例中有２１７例（１０．３％），女性１４９１例中有２...     

微弹簧圈栓塞治疗脑动静脉畸形

自１９９２年１２月至１９９３年８月，我们采用国产微弹簧圈与其它栓塞材料联合使用，栓塞治疗脑动静畸形５６例，５６例中有７例完全闭塞；栓塞范围占７０％－９５％者３４例，栓塞范围５０％－７０％者１２例，有３例栓塞范围３０％－５０％，占本组病例的５％。这种微弹簧围的优点是：（１）在荧屏上清晰可见，避免了线段栓塞的盲目性；（２）表面粗糙，易诱发血栓形成；（３）比重大，易停留在ＡＶＭ畸形病灶内，不易被血流冲走     

Prevalence and correlates of epileptic seizure in substance-abusing subjects

Life-time prevalence of epileptic seizures was assessed in 626 consecutive patients treated for substance abuse. Seizures were reported in 8.63% (9.2% in alcohol abusers, 12.5% in opioid abusers). A total of 64.8% of the seizures were associated with substance use. These occurred during withdrawal in the alcohol cohort and during intoxication with dextropropoxyphene and withdrawal from heroin or poppy husk in the opioid cohort. Results indicate that seizures may be more common in older patients with longer duration of dependence among those abusing alcohol.     

Sex, ethnicity, age and education effects on the Trail Making Test in a sample of heroin abusers.

Sex, ethnicity, age and education effects on the Trail Making test (TMT), a test often used for screening for cognitive impairment, are examined in a sample of heroin abusers in drug abuse treatment programs. A mixed race sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of heroin abusers with TMT scores available for analysis was 1548. Data were analyzed to determine the effects of sex, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of heroin abusers. The variables of sex, age, ethnicity and education were statistically significant for both parts A and B of the TMT. Nonetheless, R-Square values for overall models were quite weak (A = .08, B = .13) suggesting that sex, ethnicity, age and education effects on the TMT, while clearly present, account for relatively little overall variance in terms of heroin users' TMT performance. These results are consistent with earlier research using a more heterogenous drug abuse treatment sample.     

Longitudinal studies of drug abuse in a fifteen-year-old population. 4. Chronic drug abusers

In the Gothenburg year cohort of 1953 1% of the men and 0.2% of the women were registered for chronic drug abuse through 1979. An early début and a polydrug abuse with emphasis on intravenous abuse of central stimulants but not opiates were found. Compared with matched individuals who were unregistered for drug abuse, chronic drug abusers had a large over-consumption of psychiatric and social care. Their registered criminality was higher, they were more often sick-listed and had lower incomes than the controls. The prevalence and overall impairment of chronic abusers are similar to those of schizophrenics.     

Trail making test cut-offs for malingering among cocaine,heroin, and alcohol abusers

The Trail Making Test (TMT) is frequently used to screen for cognitive impairments in substance abusers; however, an existing problem is that substance abusers may give poor effort and the TMT results may not be valid. In this study, cutting scores for malingering were developed from three samples drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS), a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 drug abuse treatment programs in 11 cities in the United States. The DATOS enrolled 7689 substance abusers. The three drawn samples were for subjects with primary drugs of abuse. Number of subjects were as follows: alcohol-1000, cocaine/crack-4306, heroin-1548. Data were analyzed to determine number of substance abusers that fell beyond the upper end of the distribution of TMT scores at the ten, five, and one percentiles. These percentiles were set for alcoholics, cocaine abusers, and heroin abusers. The proper use of the cut-off scores is to alert clinicians to the increasingly higher probability of poor effort when a substance abuser in one of the three groups scores beyond the one percent cut-off or his or her sample of primary drug of abuse. Clearly, the use of these cut-offs needs further empirical validation.     

TRAIL MAKING TEST CUT-OFFS FOR MALINGERING AMONG COCAINE,HEROIN, AND ALCOHOL ABUSERS

The Trail Making Test (TMT) is frequently used to screen for cognitive impairments in substance abusers; however, an existing problem is that substance abusers may give poor effort and the TMT results may not be valid. In this study, cutting scores for malingering were developed from three samples drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS), a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 drug abuse treatment programs in 11 cities in the United States. The DATOS enrolled 7689 substance abusers. The three drawn samples were for subjects with primary drugs of abuse. Number of subjects were as follows: alcohol-1000, cocaine/crack-4306, heroin-1548. Data were analyzed to determine number of substance abusers that fell beyond the upper end of the distribution of TMT scores at the ten, five, and one percentiles. These percentiles were set for alcoholics, cocaine abusers, and heroin abusers. The proper use of the cut-off scores is to alert clinicians to the increasingly higher probability of poor effort when a substance abuser in one of the three groups scores beyond the one percent cut-off or his or her sample of primary drug of abuse. Clearly, the use of these cut-offs needs further empirical validation.     

Reduced grey matter in the posterior insula as a structural vulnerability or diathesis to addiction

A number of neuroimaging studies have shown that drug addiction is associated with morphological differences in several brain areas, including orbito-frontal and limbic structures. Most of these studies have investigated patients with addiction to cocaine. The neurobiological mechanisms which play a role in drug addiction are not fully understood, however, and the causal factors remain under investigation. The present study investigated morphological differences between patients with history of cocaine (N=14) and heroin (N=24) abuse and healthy matched controls (N=24). A 3D T1W MRI scan was acquired for all participants and the grey matter images of each patient group compared with those of controls. A direct comparison of the two addiction groups was also carried out. When compared with controls cocaine dependent patients had lower grey matter values in the left middle occipital gyrus, right putamen and insula, whereas heroin abusers had lower grey matter values in the right insula. The direct comparison between the two addiction groups showed that cocaine abusers had less grey matter in the right posterior cingulate, medio-temporal and cerebellar regions, whereas heroin abusers showed less grey matter in parietal regions on both sides, including postcentral gyrus and inferior parietal lobule. Reduced right posterior insular cortex was commonly found in both cocaine and heroin dependent patients. This morphological difference might represent a structural marker of addiction, which is independent of the discrete regional effects of each psychotropic substance of abuse, and might constitute a possible neurobiological vulnerability or diathesis to addiction. Equally, the discrete structural differences emerging from the direct comparison of cocaine and heroin abusers might reflect the effects of differential drug binding in the brain and/or express a form of neurobiological vulnerability which might explain individual drug choice.     

Psychiatric residents' views on their training and experience regarding issues related to child abuse.

OBJECTIVE: To explore the views of psychiatric residents regarding the prevalence and impact of child physical, sexual, and emotional abuse; the adequacy of their training in these areas; and the sufficiency of treatment resources for abused children and their abusers. METHOD: A 97-item survey questionnaire was distributed to 189 psychiatric residents as a section of the 1997 Coordinators of Postgraduate Education (COPE) self-assessment examination. RESULTS: Estimations of prevalence of child sexual, physical, and emotional abuse among men and women in both general and psychiatric populations were generally accurate according to the literature. Residents appeared to be aware of the multifactorial nature of child abuse and identified the particular importance of social-environmental factors such as parental drug abuse and a violent social environment. Residents also recognized the significant association of posttraumatic stress disorder, borderline personality disorder, and dissociative disorders with child sexual abuse. Seventy-five percent of respondents felt that instruction on the topic of child abuse during their psychiatric residency was insufficient. Sixty-four percent of respondents felt that resources for the treatment of effects of child abuse were insufficient; 83% felt that treatment resources for child abusers were insufficient. CONCLUSION: Although psychiatric residents appear to be aware of the prevalence of child abuse and its varied effects on the victims' mental health, the majority felt that their medical training in this area had been insufficient. For this reason, medical school curricula and training experiences might require reevaluation. Increasing the profile of child abuse and its impact on mental health might also result in enhanced prevention programs and treatment resources available to abused children and their abusers.     

Derived trail making test indices in a sample of heroin abusers: demographic effects

Derived indices on the Trail Making test (TMT), a test often used for screening cognitive impairment, are examined in a sample of heroin abusers in drug abuse treatment programs. A mixed race sample of 1548 subjects was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of demographic variables on derived indices created by adding, subtracting, multiplying, and dividing parts A and B of the TMT in this large treatment sample of heroin abusers. The variables of sex, age, ethnicity, and education were strongly statistically significant for the total (A + B) and interaction (A x B/100) derived indices of the TMT. Similarly, the difference score (B - A) was significant for race/ethnicity and education, but the ratio score (B/A) was not significant for any demographic variable.     

DERIVED TRAIL MAKING TEST INDICES IN A SAMPLE OF HEROIN ABUSERS: DEMOGRAPHIC EFFECTS

Derived indices on the Trail Making test (TMT), a test often used for screening cognitive impairment, are examined in a sample of heroin abusers in drug abuse treatment programs. A mixed race sample of 1548 subjects was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991 1993 in 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of demographic variables on derived indices created by adding, subtracting, multiplying, and dividing parts A and B of the TMT in this large treatment sample of heroin abusers. The variables of sex, age, ethnicity, and education were strongly statistically significant for the total (A + B) and interaction (A B/100) derived indices of the TMT. Similarly, the difference score (B A) was significant for race/ethnicity and education, but the ratio score (B/A) was not significant for any demographic variable.