苯丙胺类兴奋剂滥用情况调查

目的了解苯丙胺类兴奋剂(ATS)的滥用情况.方法从自愿戒毒者中寻问出ATS使用者,采用目的抽样方法收集滥用者,以包含定式和开放性问卷进行晤谈.结果被调查者中有95%在酒吧、俱乐部使用AATS,绝大部分为口服.80%的人近1年的使用次数少于10次.摇头丸每次平均使用量约0.86±0.25片,多随啤酒、红酒送服.85%的人使用ATS是为了提高情绪使自己快乐.75%以上者使用ATS后出现焦虑、紧张、疲劳、食欲减退等不舒服感.40%者不打算再使用ATS.结论在内陆地区ATS的滥用尚未形成规模化.     

自愿戒毒机构使用苯丙胺类兴奋剂住院患者的临床特征和诊疗情况

目的探讨自愿戒毒机构苯丙胺类兴奋剂（ATS）使用者的临床特征及诊疗情况。方法对上海某自愿戒毒机构5年内所有住院的ATS使用者的病史资料进行回顾性调查,包括药物滥用史、临床特征、诊断、治疗及疗效。结果共纳266例ATS使用者,男性患者有事实婚姻比例更高（P〈0．05）,女性中既往曾经使用过其他物质比例更高（P〈0．05）。约50％的ATS患者入院时有幻觉、妄想、活动增加、易激惹、睡眠障碍等临床症状,其中81．2％患者被诊断为ATS所致精神病性障碍,经过约10d住院治疗（如抗精神病药物等）,95．8％患者能够好转出院。结论自愿戒毒机构住院的ATS使用者存在丰富的精神病性症状,治疗后患者症状改善明显,ATS患者在临床特征、滥用情况上存在性别差异,今后应开发有针对性的干预措施,提高ATS患者的就诊率利于其长期康复。     

天津地区工具性和娱乐性使用苯丙胺类兴奋剂的对照研究

1999年 11月由世界卫生组织 (ＷＨＯ)确定对苯丙胺类兴奋剂 (ａｍｐｈｅｔａｍｉｎｅｔｙｐｅｓｔｉｍｕｌａｎｔ,ＡＴＳ)使用快速增长的三个亚洲国家 (包括中国 )和一个非洲国家进行多中心研究 ,本研究是为该研究的一部分 ,即天津地区工具性和娱乐性使用ＡＴＳ的对照研究。对象和方法　设计方案由ＷＨＯ专家组统一制定 ,调查时间为 2 0 0 0年 11月至 2 0 0 1年 2月。调查对象为工具性或娱乐性使用ＡＴＳ者 ,其中工具性使用者 (Ａ组 ) 33例 ,年龄17～ 4 6岁 ,源于天津市公安局、医疗部门 (如减肥门诊 ) ,以及色情业者 ;娱乐性使用者 (Ｂ组 )…     

脑室-腹腔分流术后修正原因分析(附46例报告)

目的 :探讨脑室—腹腔分流术后修正原因及其预防。方法 :对 46例调整手术病例的修正原因及预防方法结合文献进行回顾性分析。结果 :分流管阻塞最多见 ,占 6 3 % (2 9/ 46 ) ,其中以近端阻塞者多 ,占阻塞病例的 6 5 5 % (19/ 2 9)。其次为感染占 10 9%(5 / 46 ) ,颅内出血 3例 ,分流管接头脱离及老化 4例 ,过度分流 2例 ,皮下积液 2例。结论 :严格掌握手术适应症及正确操作技术是提高手术成功的关键。     

苯丙胺类兴奋剂所致精神障碍临床及随访观察

目的:了解苯丙胺类兴奋剂(ATS)所致精神障碍的易感人群,临床症状,误诊原因和复发等情况.方法:回顾性分析28例ATS所致精神障碍的I临床资料并进行随访.结果:患者平均年龄为(29.7±6.1)岁,其中未婚占71.4%,初中以下文化程度占67.8%,无固定工作者居多,门诊误诊率达96.3%,入院后误诊率达25.0%,主要误诊为精神分裂症,78.6%表现为幻觉-妄想状态,痊愈35.7%,再发21.7%.结论:无业、未婚的青年人为ATS易感人群,使用ATS可造成严重的精神障碍,仅凭临床症状很容易误诊为精神分裂症,早期发现,早期治疗尤为重要.     

妥泰治疗儿童癫癎60例临床疗效观察

目的　观察妥泰单药或添加治疗儿童癫。方法　观察部分性发作及继发性全身性发作 15例 ,West综合征 18例 ,Lennox -Gastaut综合征 2 7例 ,对其中已应用传统抗癫药物治疗控制不理想的病例添加妥泰治疗 ,而对新诊断病例应用妥泰单一治疗 ,进行自身对照研究。结果　①妥泰治疗儿童癫 60例 ,平均疗程 6个月 ,其总的疗效为发作减少≥ 5 0 % ,占 43例 (71 7% ) ,发作减少≥ 75 % ,占 3 2例 (5 3 3 % )。发作控制占 2 4例 (4 0 0 % )。②妥泰治疗部分性发作及继发性全身性发作 15例 ,发作减少≥ 5 0 %者 13例 (86 7% ) ,发作减少≥ 75 %者 9例 (60 0 % ) ,未发作 8例 (5 3 3 % ) ;West综合征组 18例 ,发作减少≥ 5 0 %者 13例 (72 2 % ) ,发作减少≥ 75 %者 9例 (5 0 0 % )。未发作 6例 (3 3 3 % ) ;Lennox -Gastaut综合征组 2 7例 ,发作减少≥ 5 0 %者 17例 (63 0 % ) ,发作减少≥75 %者 14例 (5 1 9% ) ,未发作者 10例 (3 7 0 % ) ;③添加妥泰治疗对丙戊酸钠和卡马西平的添加治疗前后的血浓度没有明显影响。④不良反应 :嗜睡 12例 (2 0 0 % ) ,反应淡漠 4例 (6 7% ) ,纳差 15例 (2 5 0 % )。结论妥泰对部分性发作及继发性全身发作 ,West综合征和Lennox -Gastaut综合征治疗有效、安全、副作用     

低钾性周期性麻痹65例临床分析

1　临床资料1.1　一般资料 :本组 6 5例 (男 6 1例、女 4例 ) ,年龄 19～ 6 0岁 ,平均 33岁 ,其中 4 0岁以下 4 9例 (75% )。发病季节为 5～ 9月份者 51例 (78% )。伴有甲状腺功能亢进者 9例 ,有阳性家族史者 4例。1.2　临床表现 :(1)诱发因素 :发病前有上呼吸道感染 2 1例 ,腹泻 7例 ,合计 2 8例 (4 3% ) ;发病前有剧烈活动、劳累 12例 (19% ) ;饱餐、饮酒 8例 (12 % ) ;无明显诱因 17例 (2 6 % )。 (2 )症状与体征 :所有病例均有四肢肌力减退 ,近端重于远端 ,下肢重于上肢。腱反射减低或消失 ,病理征阴性。伴有呼吸肌受累者 5例 (8% )。1.…     

大学生网络成瘾调查

目的:了解大学生网络使用的现状及行为特点,探讨大学生网络成瘾发生的特点及如何预防。方法:对江苏省4所不同类型的高校抽取550名学生作为被试,以网络成瘾量表及自编的大学生上网一般情况调查表进行问卷调查,共获得有效问卷517份。结果:网络成瘾量表评分无≥80分者,50~79分为网络成瘾倾向者23名(占4.4%);31~49分为网络使用过度者85名(占16.4%);≤30分为正常网络使用者409名(占79.1%)。结论:性别、上网时间、网络的可获得性、网络的使用功能等与网络成瘾密切相关。有必要对大学生进行网络成瘾的预防干预。     

老年慢性心脏病患者的情感障碍与预后的关系

作者对老年慢性心脏病患者的情感障碍与预后的关系进行了分析 ,现报道于后。1　对　　象作者收集了 1998年至 2 0 0 0年 5月来院求治的慢性心脏病患者共 2 2 6例 ;年龄均在 6 0岁以上 ;住院者 81例 ,门诊者 14 5例 ;病种包括冠心病 115例 ,肺心病 5 6例 ,风心病 33例 ,心肌病2 0例 ,其它 2例。2　方　　法采用问卷调查。内容包括 :性别、年龄、工作性质、病种、病程、发病诱因、情感障碍表现、心理疏导及预后等。在半年至 2年后完成门诊随访者 16 9例 ( 74.34% ) ,脱落 (未来院复诊者 ) 5 7例 ( 2 5 .6 6 % )。本文病例除给予常规的药物治疗…     

精神病患者猝死的相关因素分析

目的　探讨精神病患者猝死的相关因素。方法　选取 1997年 1月至 2 0 0 1年 12月在北京回龙观医院住院治疗中发生猝死的 6 5例精神病患者作为猝死组 ,以 2 0 0 2年 2月 2 0日所有在院的 110 7例精神病患者作为对照组。收集两组病例的主要人口学资料 (年龄、性别、精神障碍种类和病程 )和主要临床资料 (如合并躯体疾病种类、心电图特征、QTc间期、抗精神病药种类及剂量、合并其他精神药物的种类及剂量 ,主要不良反应等 ) ;对猝死组收集死因的临床判断及任何可能与猝死有关的资料。结果　 (1)猝死组与对照组患者在抗精神病药剂量及QTc间期 (总体 )的差异均无显著性 (均P >0 0 5 )。 (2 )两组中接受氯氮平治疗者的QTc间期 [(0 36± 2 5 4 )ms]均长于非氯氮平治疗者 [(0 35±3 2 3)ms],差异有非常显著性意义 (P =0 0 0 ) ;其中 ,猝死组和对照组用氯氮平治疗者的QTc间期分别为 [(0 39± 1 31)ms和 (0 36± 2 4 6 )ms],未用氯氮平治疗者的QTc间期分别为 [(0 33± 3 2 3)ms和(0 35± 3 2 1)ms]。 (3)猝死组慢性起病者 (96 9% )多于对照组 (87 7% ;P =0 0 3) ,合并躯体疾病的比例 (89 2 % )高于对照组 (39 1% ;P =0 0 0 ) ,心电图异常率 (5 8 5 % )也高于对照组 (2 5 8% ;P =0 0 0 )。经非参数检     

Multiple adverse outcomes over 30 years following adolescent substance misuse treatment

Objective: To compare outcomes over 30 years experienced by individuals who as adolescents entered substance misuse treatment and a general population sample. Method: All 1992 individuals seen at the only clinic for substance misusing adolescents in Stockholm from 1968 to 1971 were compared to 1992 individuals randomly selected from the Swedish population, matched for sex, age and birthplace. Death, hospitalization for physical illness related to substance misuse, hospitalization for mental illness, substance misuse, criminal convictions and poverty were documented from national registers. Results: Relative risks of death, physical illness, mental illness, substance misuse, criminal convictions and poverty were significantly elevated in the clinic compared to the general population sample. After adjustment for substance misuse in adulthood, the risks of death, physical and mental illness, criminality and poverty remained elevated. Conclusion: Adolescents who consult for substance misuse problems are at high risk for multiple adverse outcomes over the subsequent 30 years.     

Functional disability of mental disorders and comparison with physical disorders: a study among the general population of six European countries

OBJECTIVE: To examine the association of mental and physical disorders with multiple domains of functioning and compare the two. METHOD: Data were derived from the European Study of the Epidemiology of Mental Disorders, a general population study in which adults (n > 21,000) from Belgium, France, Germany, Italy, the Netherlands and Spain were assessed using the Composite International Diagnostic Interview (mental disorders), World Health Organization Disability Assessment Schedule second edition (functional disability) and self-report (physical disorders). Means in different groups were compared using the Mann-Whitney U-test and multiple regression analyses. RESULTS: Mental disorders were related to disability in all domains of functioning: anxiety disorders the most, followed by mood disorders, and finally alcohol disorders. The findings suggest that mental disorders are associated with similar or higher levels of disability in all domains, except getting around, than arthritis and heart disease. CONCLUSION: Mental disorders are associated with a similar or higher negative impact on daily functioning than arthritis and heart disease.     

儿童焦虑性情绪障碍筛查量表的临床应用

目的研究儿童焦虑性情绪障碍筛查量表SCARED在儿童及青少年情绪障碍中的应用。方法随机抽取上海市精神卫生中心儿童心理门诊符合CCMD-3诊断标准的焦虑症患儿35例,多动障碍患儿31例,随机抽取上海市某中小学45例健康儿童为对照组。研究组患儿及父母均填写SCARED量表,对照组填写SCARED量表并在一周后重测,多动症组评估SCARED量表。结果研究组SCARED量表总分及各因子分均分别显著高于对照组、多动症组。患儿自评与父母评定的相关系数在0．618至0．839之间。重测信度在0．451～0．872之间,各因子分与总分相关系数在0．331～0．852之间,Cronbach‘s a系数在0．2331至0．8032之间。SCARED量表总分与焦虑自评量表总分相关系数为0．661。结论SCARED量表信、效度良好,可作为临床辅助诊断及科研的筛查工具。     

Addiction,stigma and movies

OBJECTIVE: To identify common character stereotypes of alcohol and other drug users as portrayed in motion pictures. METHOD: A selective review of a number of movies prominently portraying alcohol and other drug use and misuse. RESULTS: The great majority of popular films portray alcohol and drug use whether as a routinized background, routinized foreground or exceptional foreground. Four main stereotypes of alcohol and other drug users appear to be prevalent - the tragic hero, the demonized user, the rebellious free spirit and the comedic user. A number of movies are selected which portray alcohol and other drug use as a prominent theme. CONCLUSION: Movies, as a medium for mass communication, have a powerful influence on the public and perpetuate popular mythologies regarding alcohol and other drug use.     

A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders

Baker AL, Hiles SA, Thornton LK, Hides L, Lubman DI. A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders. Objective: Excessive alcohol consumption is common among people with psychotic disorders. While there is an extensive literature on the efficacy of psychological treatments for excessive drinking, few studies have examined interventions addressing this issue among people with psychotic disorders. Method: Systematic searches in PubMed and PsycINFO were conducted to identify randomized controlled trials comparing manual-guided psychological interventions for excessive alcohol consumption among individuals with psychotic disorders. Of the 429 articles identified, seven met inclusion criteria. Data were extracted from each study regarding study sample characteristics, design, results, clinical significance of alcohol consumption results, and methodological limitations. Results: Assessment interviews, brief motivational interventions, and lengthier cognitive behavior therapy have been associated with reductions in alcohol consumption among people with psychosis. While brief interventions (i.e. 1-2 sessions) were generally as effective as longer duration psychological interventions (i.e. 10 sessions) for reducing alcohol consumption, longer interventions provided additional benefits for depression, functioning, and other alcohol outcomes. Conclusion: Excessive alcohol consumption among people with psychotic disorders is responsive to psychological interventions. It is imperative that such approaches are integrated within standard care for people with psychosis.     

An Evaluation of beyondblue,Australia's National Depression Initiative

beyondblue is a five-year Australian initiative which takes a populationhealth approach to combating depression. This paper's aim is to describe the findings of an evaluation of beyondblue, conducted four years into its existence.The achievements of beyondblue were examined in the light of its objectives, using synthesised data from 15 secondary sources. Many of beyondblue's lower-level objectives have been completely achieved, with a plethora of key initiatives in place that have led to greater availability of information about depression, improvements in consumer networks, better support for mental health care delivery in primary care settings and increases in targeted research. Most of its intermediate-level and high-level objectives have been partly achieved, with headway made in terms of the community's ‘depression literacy’, acknowledgement of the consumer/carer perspective, the degree to which the health workforce is equipped to deal with depression, the likelihood that individuals will seek help, the range of prevention and early intervention options, the role of primary care practitioners in mental health care, and scientific knowledge about depression. However, in all these areas, ongoing efforts are required. beyondblue's vision, or highest-level objective, has not yet been realised. Society does not optimally understand, respond to or work actively to prevent depression. beyondblue has begun to make an impression, but it is unrealistic to expect systemic and cultural change of this magnitude to occur quickly. beyondblue has partly achieved its goals, and careful consideration should be given to what action is necessary to foster sustainable positive change.     

阻塞性睡眠呼吸障碍与神经衰弱

目的探讨由于阻塞性睡眠呼吸障碍（０－ＳＲＢＤ）引起的神经衰弱状态的临床特点、原因、发病机制和治疗方法。方法根据７４例临床表现为神经衰弱患者的多导睡眠图所见，结合临床症状进行分析。结果５７例（７７０％）有不同程度的Ｏ－ＳＲＢＤ，已可确诊为阻塞性睡眠呼吸暂停综合征的１９例（２５７％）。肥胖、响鼾、白日思睡和晨起即有症状，为本病神经衰弱状态的主要特点。睡眠低氧血症及其继发的病理生理改变引起的脑缺氧为发病的主要机制。根治Ｏ－ＳＲＢＤ的病因即各种原因所致的上气道狭窄，以改善睡眠低氧血症，为治疗的关键。结论应警惕并重视Ｏ－ＳＲＢＤ引起的神经衰弱状态或加重的神经衰弱