分裂样精神病106例随访研究

目的探讨分裂样精神病诊断及转归的影响因素。方法对１０６例首次住院诊断为分裂样精神病的患者进行１～６年随访，将资料作分析研究。结果１０６例患者中维持分裂样精神病诊断３０例（２８３％），改诊为精神分裂症７２例（６８％），情感性精神病４例（３７％）。分裂样精神病改诊为精神分裂症或情感性精神病与其病前性格、社会功能恢复状况、思维形式及情感障碍等因素有关，而与家族遗传史、起病形式以及精神症状中幻觉、妄想、行为障碍关系不大，治疗效果两者差异亦较大。结论分裂样精神病作为过渡诊断仍有保留之必要     

首诊分裂惰感性精神病50例随访结果分析

目的 探讨首诊分裂情感性精神病(SAP)人的转归及预后。方法 按CC-MD-2-R标准纳入50例首次住院诊断为SAP的病人,经5年随访观察进行对照研究。结果 19例改诊为情感性精神障碍(MA),10例改诊为精神分裂症(SCH),21例维持原诊断。以上三组对照研究发现,在病前性格及发病诱因方面,三者之间差异显著。在近期疗效、缓解时间及5年后社会功能恢复情况看,MA最好,SAP次之,SCH最差。结论 SAP是一个发病率较低,预后较好的独立的疾病单元。     

分裂样精神病前驱症状的调查分析

本研究探讨前驱症状对分裂样精神病和精神分裂症的诊断价值。对３０例首次诊断分裂样精神病，复发后改诊为精神分裂症的病人（改诊组）与５０例维持诊断分裂样精神病的病人（维持组）的前驱症状进行比较分析。结果显示，前驱症状的发生率，尤其是不恰当行为，工作学习能力下降。孤僻退缩、讲话离题模糊，不寻常感觉，及怪异想法等的发生率在改诊组显著高于维持组，预示真正的分裂样精神病与精神分裂症的前驱症状有所差别。     

首诊分裂情感性精神病50例随访结果分析

目的 探讨首诊分裂情感性精神病（SAP）的人的转归及预后。方法 按CC－MD－2－R标准纳入50例首次住院诊断为SAP的病人，经5年随访观察进行对照研究 。结果19例改诊为情感性精神障碍（MA），10例改诊为精神分裂症（SCH），21例持原诊断。以上三组对照研究发现，在病前性格及发病诱因方向，三者之间差异显著。在近期疗效、缓解时间及5年后社会功能恢复情况看，MA最好，SAP次之，SCH最差。结论 SAP是一个发病率较低，预后较好的独立的疾病单元。     

精神分裂症与分裂样精神病前躯症状对照分析

为探讨精神分裂症和分裂样精神病前躯症状诊断价值，对80例首次诊断为分裂样精神病，复发后改诊为精神分裂症病人(SC组)与60例维持诊断分裂样精神病的病人(SCF组)的前躯症状进行了比较分析。结果显示：前躯症状的发生率，尤其是不恰当行为、性格改变、讲话离题、躲避亲人或与人疏远、敏感、多疑、怪异想法、无端恐惧、强迫症状等发生率SC组显高于SCF组。提示精神分裂症一分裂样精神病的前躯症状确有差异。     

分裂样精神病120例随访研究

为探讨分裂样精神病（ＳＦＰ）的结局及其作为诊断亚型的临床应用价值，作者对１２０例ＳＦＰ患者进行５～７年随访，并将维持原诊断组与改诊为精神分裂症组的临床情况进行比较。结果发现维持ＳＦＰ诊断者３１例（２５．８３％），改诊为精神分裂症者７０例（５８．３３％），改诊为情感性精神障碍者１５例（１２．５％），改诊为分裂情感性精神病４例（３．３３％）；继续维持ＳＦＰ诊断组与改诊业为精神分裂症组比较有如下特点、起     

首诊分裂情感性精神病50例随访报告

目的：探讨首疹为分裂情感性精神病（ＳＡＰ）患者的转归及预后。方法：对５０例首次住院诊断为ＳＡＰ的患者,经５年随访观察进行对照研究。结果：５０例ＳＡＰ患者中,１９例改诊为情感性障碍（Ｍａ）,１０例改诊为精神分裂症（Ｓｃ）,２１例维持原诊断,以上３组在病前性格及发病诱因方面有显著差异。在近期疗效、缓解时间及５年后社会功能恢复情况看,Ｍａ最好,ＳＡＰ次之,Ｓｃ最差。结论：ＳＡＰ是一个发病率较低、预后较地的独立的疾病单元。     

精神分裂症与分裂样精神障碍前躯症状对照分析

目的 为探讨精神分症和分裂样精神病前躯症状的诊断价值。方法 对８０例首次诊断为分裂样精神病，复发后改诊为精神分裂症的病人（ＳＣ组）与６０例诊断精神分例症的病人（ＳＣＦ组）的前躯症状进行了比较分析。结果 前躯症发生率，尤其是不恰当行为、性格改变、讲话离题、躲避亲人或与人疏远、敏感多疑、怪异想法、无端恐惧、强迫症状等发生率，ＳＣ组显著高于ＳＣＦ组。结论 提示精神分裂症与分裂样精神病的前躯症状确有差异。     

分裂情感性障碍23例随访研究

本文前瞻性研究了23例分裂情感障碍的临床随访,与精神分裂症及情感性精神病比较,发现其SDSS、GAS评分、工作恢复情况介于两者之间。相当数量的病人有残留症状,其复发率与情感性精神病相近。本研究提示分裂情感障碍的预后并不十分良好。     

分裂样精神病205例随访调查

对205例分裂样精神病（SFP）进行了5－10年的随访调查,结果显示：91例（44.4%）改诊为精神分裂症,108例（52.6%）维持SFP诊断,6例（3%）改诊为情感性精神病。作认为通过5－10年的随访调查,仍有52.6%维持SFP诊断,因此,SFP是否可作为一个独立的疾病单元,还有待于进一步研究。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.