精神分裂症患者的攻击行为与甲状腺轴

目的：探索甲状腺激素与精神分裂症患者冲动攻击行为的关系。方法：以既往史和外显攻击行为量表（MOAS）评分区分,有攻击行为者为研究组,无攻击行为者为对照组,比较两组的血清甲状腺激素水平,并对其与精神症状、攻击行为型之间的相关性进行检验。结果：研究组促甲状腺激素（TSH）水平较对照组升高,甲状腺素（T4）水平与言语攻击、对财产的攻击行为有显著性相关,三碘甲状腺原氨酸（T3）水平与焦虑抑郁症状有关。结论：甲状腺激素水平可能与精神分裂症患者的贡献行为有关。     

首发青少年抑郁症血清甲状腺激素水平研究

目的探讨首发青少年抑郁症与血清甲状腺激素水平的相关性。方法将82例首发青少年抑郁症患者设定为病例组,70例健康青少年设定为对照组。比较两组患者的血清促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平,并用HAMD-24量表对病例组患者进行评定。结果病例组患者的FT3、T3和T4水平低于对照组,TSH水平高于对照组(P0.05);男性病例组患者T3、T4水平低于男性对照组(P0.05),女性病例组患者FT3、FT4、T3、T4水平低于女性对照组,TSH水平高于女性对照组(P0.05);女性病例组患者TSH水平高于男性病例组(P0.05),FT3水平低于男性病例组(P0.05);病例组患者FT3水平与绝望感呈正相关(P0.05)。结论青少年抑郁症的发病可能与甲状腺激素水平变化相关。FT3水平可能是青少年抑郁症患者的生物学标记。     

非典型抗精神病药对精神分裂症患者血清甲状腺激素水平的影响

目的探讨非典型抗精神病药利培酮、奥氮平对精神分裂症患者甲状腺功能的影响。方法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的54例精神分裂症患者,采用随机数字表法分成服用利培酮和奥氮平两组,其中利培酮组29例,给药初始剂量为4 mg/d,2周内逐渐加至6 mg/d,观察至8周末;奥氮平组25例,给药初始剂量为10 mg/d,2周内逐渐加至15mg/d,观察至8周末。分别在治疗前、治疗第8周末测血清总三碘甲状腺原氨酸(TT3)、血清总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)及促甲状腺激素(TSH)水平。结果利培酮组治疗前后血清TT3、TT4、FT3、FT4、TSH水平差异均无统计学意义(P0.05),奥氮平组治疗前后血清TT3、TT4、TSH水平差异无统计学意义(P0.05),治疗前后FT3、FT4差异有统计学意义[(3.01±0.28)pg/mlvs.(2.81±0.26)pg/ml,(0.91±0.2)pg/mlvs.(0.77±0.14)pg/ml,P0.05]。利培酮组治疗后血清TT3、FT3水平升高,较奥氮平组差异有统计学意义(P0.05)。结论利培酮对精神分裂症患者甲状腺功能无实质影响,奥氮平能影响精神分裂症患者血清FT3、FT4的水平,在治疗中应注意监测服用奥氮平的精神分裂症患者的甲状腺激素水平。     

男性癫癎患者服用抗癎药物后血清甲状腺激素水平及临床意义

目的研究接受卡马西平(CBZ)、鲁米那(PB)和丙戊酸钠(VPA)单药治疗的成年男性癫(疒间)患者的甲状腺激素水平及意义.方法应用放免法测定63例男性癫(疒间)患者(22例服用CBZ,18例服用PB,23例服用VPA)及20名健康对照者血清中的总甲状腺素(TT4)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)水平.结果 CBZ组TT4、FT4和FT3较对照组明显降低(均P＜0.05),TT3和TSH水平无变化;PB组的TT4和FT4较对照组明显降低(均P＜0.05),TT3、FT3和TSH水平无变化;且PB组的TT4、FT4降低程度均较CBZ组轻;VPA组各项指标均无变化.结论 CBZ、PB可通过肝酶诱导等多种途径导致甲状腺激素水平发生改变,二者的作用不完全相同;VPA对甲状腺功能无影响,有必要对服用抗(疒间)药物,尤其是CBZ患者的甲状腺激素水平进行监测.     

抑郁症患者甲状腺激素水平的特征、治疗前后的变化及疗效性分析

目的:探讨抑郁症患者血清甲状腺激素水平的特征、治疗前后的变化及疗效性分析。方法:于2013年5月至2015年12月入组抑郁症患者40例、健康对照者47名。抑郁组予选择性5-羟色胺再摄取抑制剂治疗4周,分别于治疗前后检测血清甲状腺激素水平,评估抑郁、焦虑症状严重程度。结果:抑郁组治疗前血清甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平明显低于对照组;治疗后HAMD-17总分、HAMA总分、T4、FT4水平显著下降(P0.05或P0.01)。临床痊愈组治疗前后血清三碘甲状腺原氨酸(T3)、治疗后游离三碘甲状腺原氨酸(FT3)水平低于非临床痊愈组(P0.05或P0.01)。抑郁组治疗前,T4与HAMD-17有罪感因子分、工作和兴趣因子分、总分呈负相关;FT4与躯体性焦虑因子分呈正相关,与总分呈负相关;TSH与体质量减轻因子分呈负相关(P0.05或P0.01)。结论:抑郁症患者血清T4、FT4、TSH水平均低于健康正常人,与抑郁症状及严重程度具有相关性。治疗前T3水平低的患者可能对抗抑郁药更敏感,疗效更好。     

精神分裂症患者血清甲状腺激素水平及其治疗前后变化和相关因素分析

目的探讨精神分裂症患者血清甲状腺激素水平及其治疗前后甲状腺激素水平变化和相关影响因素。方法选取住院首发或复发近一年内未用过药物治疗的精神分裂症患者80例(研究组),采用化学免疫发光法于入组时、治疗后8周检测血清甲状腺激素水平,采用相同方法对50例健康对照者进行检测。研究组于入组时、治疗8周末评定阳性症状量表(SAPS)、阴性症状量表(SANS)。根据SAPS和SANS评定结果将研究对象分为阳性与阴性症状组以及治疗有效与无效组。结果研究组TT4治疗前(5.99±1.33)μg/dl与治疗后(6.53±2.10)μg/dl及对照组(6.78±1.91)μg/dl比较差异有统计学意义(P0.05);FT3治疗前(2.75±0.83)u Iu/ml与对照组(3.30±1.05)u Iu/ml比较差异有统计学意义(P0.01)。TSH治疗前(1.04±0.60)ng/dl与治疗后(1.27±0.43)ng/dl及对照组(1.23±0.51)ng/dl对比差异有统计学意义(P0.01)。治疗前后阴性和阳性症状组FT3、TT4、FT3、FT4水平对比差异无统计学意义(P0.05)。无效组在治疗前后TT4和有效组在治疗前后TSH差异有统计学意义(P0.05或0.01)。结论精神分裂症患者在HPT轴功能方面存在一定的异常,以TT4、FT3及TSH降低为主;甲状腺激素水平变化可能与临床症状表现、疗效无关。     

男性癫痫患者服用抗痫药物后血清甲状腺激素水平及临床意义

目的　研究接受卡马西平 (CBZ)、鲁米那 (PB)和丙戊酸钠 (VPA)单药治疗的成年男性癫疒间 患者的甲状腺激素水平及意义。方法　应用放免法测定 6 3例男性癫疒间 患者 (2 2例服用CBZ ,18例服用PB ,2 3例服用VPA)及 2 0名健康对照者血清中的总甲状腺素 (TT4)、游离甲状腺素 (FT4)、总三碘甲状腺原氨酸 (TT3 )、游离三碘甲状腺原氨酸 (FT3 )和促甲状腺激素 (TSH)水平。结果　CBZ组TT4、FT4和FT3 较对照组明显降低 (均P<0 .0 5 ) ,TT3 和TSH水平无变化 ;PB组的TT4和FT4较对照组明显降低 (均P <0 .0 5 ) ,TT3 、FT3 和TSH水平无变化 ;且PB组的TT4、FT4降低程度均较CBZ组轻 ;VPA组各项指标均无变化。结论　CBZ、PB可通过肝酶诱导等多种途径导致甲状腺激素水平发生改变 ,二者的作用不完全相同 ;VPA对甲状腺功能无影响 ,有必要对服用抗疒间 药物 ,尤其是CBZ患者的甲状腺激素水平进行监测     

双相障碍躁狂发作患者血清甲状腺激素和垂体泌乳素水平的研究

目的:探讨双相障碍躁狂发作患者血清甲状腺激素和垂体泌乳素水平及与疾病的相关性。方法:40例双相障碍躁狂发作患者及40名健康对照进行促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、垂体泌乳素(PRL)血液浓度的检测,优势比(OR)计算双相障碍躁狂发作的甲状腺激素、PRL的相关程度。结果:甲状腺激素、PRL水平异常的男性病例组和女性病例组的OR分别为0.44/1.42和5.67/10.23。与男性正常组比较,男性病例组TT4水平降低(F=2.03,P0.05),差异有统计学意义;与女性正常组比较,女性病例组TSH和PRL水平升高(Z=2.19,Z=2.03),TT3和TT4降低(F=8.66,F=6.11),差异有统计学意义(P均0.05)。结论:双相障碍躁狂发作的女性患者TSH、PRL水平增加可能与双相障碍躁狂期发病有关,男性未发现上述现象。     

女性精神分裂症患者垂体-甲状腺轴和垂体-肾上腺轴功能研究

目的:探讨女性精神分裂症患者神经内分泌的病理生理及其与临床症状的相关性。方法:采用病例-对照研究方法将106例女性精神分裂症急性期发作患者(精神分裂症组)及40名性别、年龄相匹配的健康对照者(健康对照组)进行血液促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、三碘甲状腺原氨酸(TT3)、甲状腺激素(TT4)、促肾上腺皮质激素(ACTH)及皮质醇(COR)水平检测和比较;分析患者神经内分泌与年龄、病程、阳性与阴性症状量表(PANSS)评分的关系。结果:精神分裂症组TSH[(2.71±1.98)m IU/L]、COR[(478.03±225.26)nmol/L]较健康对照组[(1.83±0.94)m IU/L、(365.83±92.52)nmol/L]显著升高(t=3.613,3.816;P均0.05);患者的病程与甲状腺激素水平呈正相关(r=0.211~0.305,P均0.05);PANSS的阴性症状分与TT3水平呈负相关(r=-0.389,P0.05),与FT4水平呈正相关(r=0.363,P0.05);一般精神病理分与TT3、FT3水平呈负相关(r=-0.542,r=-0.426,P均0.05),与COR水平呈正相关(r=0.477,P0.05)。结论:女性精神分裂症急性期发作患者的甲状腺激素水平降低,肾上腺激素水平升高;神经内分泌改变可能与疾病病程、精神症状相关。     

首发男性精神分裂症患者暴力倾向与血清甲状腺素及泌乳素水平的关系

目的 探讨首发男性精神分裂症患者的暴力倾向与血清甲状腺素及泌乳素水平的关系,为探讨精神分裂症患者暴力行为倾向的相关危险因素提供线索.方法 采用免疫化学方法对36例有暴力倾向的首发男性精神分裂症患者及对照组34例无暴力倾向的精神分裂症男性患者的血清三碘甲状腺原氨酸（T3）,甲状腺素（T4）,游离三碘甲状腺原氨酸（FT3）,游离甲状腺素（FT4）,促甲状腺激素（TSH）,血清泌乳素（PRL）进行了检测和比较.结果 有暴力倾向的首发男性精神分裂症患者血清PRL水平较对照组低,差异有统计学意义（P＜0.01）;而血清T3,T4,FT3,FT4,TSH水平与对照组比较,差异无统计学意义（P＞0.05）.结论 有暴力倾向的首发男性精神分裂症患者血清泌乳素水平可能更低.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.