奎硫平与氟哌啶醇治疗脑血管病所致精神障碍患者对照研究

目的:探讨奎硫平与氟哌啶治疗脑血管病所致精神障碍的临床疗效与不良反应. 方法:脑血管病所致精神障碍患者各30例,分别以奎硫平与氟哌啶醇治疗4周.采用简明精神病评定量表(BPRS)评定疗效,简明智能状况检查表(MMSE)评定认知状况,治疗中出现的症状量表(TESS)评定不良反应. 结果:治疗结束时两组BPRS评分较入组时显著减低(P＜0.01);奎硫平组有效率86.7％,氟哌啶醇有效率80.0％,两组疗效差异无统计学意义(P＞0.05),奎硫平组MMSE减分率显著低于氟哌啶醇组,奎硫平组无明显锥外系反应. 结论:奎硫平治疗脑血管病所致精神障碍患者疗效与氟哌啶醇相似,但奎硫平不良反应较氟哌啶醇轻而少.     

奥氮平与利培酮口服液治疗精神分裂症兴奋激越的临床观察

目的观察奥氮平与利培酮口服液治疗精神分裂症急性期兴奋激越的临床疗效及不良反应。方法将170例精神分裂症急性中度兴奋患者,随机分入奥氮平组56例,利培酮口服液组54例,氟哌啶醇组60例,共治疗7天;治疗前及治疗1周末评估阳性与阴性症状量表兴奋因子（PANSS-EC）,采用TESS评定不良反应。结果奥氮平组、利培酮口服液组与氟哌啶醇组比较,均获得明显改善,差异均无显著性（P均〉0.05）,氟哌啶醇组锥体外系反应发生率高于奥氮平组与利培酮口服液组（P〈0.01）,且奥氮平组几乎无锥体外系反应发生。结论奥氮平与利培酮口服液治疗精神分裂症急性中度兴奋患者与氟哌啶醇的疗效相当,且不良反应较小,安全性良好。     

奥氮平治疗脑血管病伴发精神行为症状的对照研究

目的探讨奥氮平治疗脑血管病伴发精神行为症状的临床疗效及其对患者生活质量的影响。方法将66例符合入组标准的脑血管病伴发精神行为症状患者随机分为两组,分别给予奥氮平、奋乃静治疗8周。用简明精神病评定量表（BPRS）评定疗效,生活质量综合评定问卷（GQOLI）评定生活质量,副反应量表（TESS）评定副作用。结果2周后奥氮平组BPRS总分显著下降（P〈0.05）,4周后奋乃静组开始下降,8周后两组间BPRS总分下降无显著性差异（P〉0.05）。8周后奥氮平组生活质量除生活条件维度外,在躯体健康、心理健康、社会功能维度均高于奋乃静组,且有显著性差异（P〈0.05）。奥氮平组不良反应少于奋乃静组。结论奥氮平对脑血管病伴发精神行为症状的疗效好,起效快,不良反应少,生活质量改善优于奋乃静治疗组。     

奥氮平合用氯硝西泮治疗精神分裂症急性精神运动性兴奋的研究

目的：观察奥氮平合并氯硝西泮治疗精神分裂症急性精神运动性兴奋的疗效与不良反应。方法：65例精神分裂症急性期兴奋患者,随机分为口服奥氮平合并肌内注射氯硝西泮组（奥氮平组）34例和肌内注射氟哌啶醇组（氟哌啶醇组）31例治疗,疗程7 d。以阳性与阴性症状量表兴奋激越项目（PANSS-EC）和治疗中出现的症状量表（TESS）评定疗效和不良反应。结果：奥氮平组与氟哌啶醇组疗效相当,差异无显著性（P〉0.05）。两组急性兴奋症状均获明显改善,氟哌啶醇组不良反应发生率高于奥氮平组（P〈0.05）。结论：奥氮平合并氯硝西泮可有效治疗精神分裂症患者急性期精神运动性兴奋,疗效与氟哌啶醇相当,不良反应明显少于氟哌啶醇。     

奥氮平与氟哌啶醇治疗精神分裂症兴奋激越症状的对照研究

目的比较奥氮平与氟哌啶醇治疗精神分裂症伴兴奋激越症状的疗效和不良反应。方法将符合CCMD-3诊断标准的精神分裂症患者,随机分入奥氮平组54例,氟哌啶醇组62例,共治疗21天;以PANSS评定疗效,TESS评定不良反应。结果奥氮平治疗精神分裂症总体疗效优于氟哌啶醇;治疗第14、21天PANSS总分及兴奋性激越因子减分两组有显著性差异（P〈0．05）;奥氮平组的药物不良反应小。结论奥氮平治疗精神分裂症兴奋症状的疗效优于氟哌啶醇,且起效较快,不良反应较小,安全性良好。     

奥氮平与氟哌啶醇治疗女性精神分裂症患者的对照研究

目的比较奥氮平与氟哌啶醇治疗女性精神分裂症患者的疗效及安全性。方法将符合条件的100例住院女性精神分裂症患者随机分为奥氮平组和氟哌啶醇组,共治疗3个月,采用PANSS、TESS、健康状况问卷（SF-36）进行疗效、不良反应和生活质量评估,同时检测血清泌乳素水平。结果两组治疗前后PANSS评分均有显著性差异（P〈0．01）,治疗结束后阴性症状评分奥氮平组明显低于氟哌啶醇组,有显著差异（P〈0．01）;奥氮平组在生理机能、生理职能、生命活力、社会功能、情感职能5个因子分及生活质量总评分均明显高于氟哌啶醇组（P〈0．05）;治疗结束后奥氮平组泌乳素水平显著低于氟哌啶醇组（P〈0．01）。结论奥氮平治疗女性精神分裂症疗效好,安全性高,生活质量优于氟哌啶醇。     

奥氮平治疗酒精所致精神障碍对照研究

目的:探讨奥氮平对酒精所致精神障碍的临床疗效. 方法:66例患者随机分入两组,分别服用奥氮平或氟哌啶醇6周,用阳性与阴性症状量表(PANSS)和副反应量表(TESS)评定疗效和不良反应. 结果:奥氮平组有效率69.7%,显著较氟哌啶醇组42.4%为高. 结论:奥氮平对酒精所致精神障碍的临床疗效优于氟哌啶醇,且不良反应较少.     

氟伏沙明联合奥氮平治疗伴精神病性症状抑郁症对照研究

目的：探讨氟伏沙明合并奥氮平对有精神病性症状抑郁症的临床疗效及安全性。方法：将115例患者随机分为氟伏沙明联合奥氮平组、氟伏沙明联合舒必利组,疗程8周。采用汉密尔顿抑郁量表（HAMD）、简明精神病评定量表（BPRS）观察疗效,用治疗中出现的症状量表（TESS）评定不良反应。结果：治疗8周两组BPRS、HAMD总分及各因子分均较治疗前显著降低（P均〈0.01）;氟伏沙明联合奥氮平组起效较快,疗效亦较好。两组不良反应接近。结论：氟伏沙明联合奥氮平治疗有精神病性症状的抑郁症疗效肯定,安全性高。     

奥氮平与氟哌啶醇治疗精神分裂症急性期的临床研究

目的 比较奥氮平与氟哌啶醇治疗精神分裂症急性期的疗效及安全性.方法 奥氮平组30例,剂量范围10～20mg/d;氟哌啶醇组30例,剂量范围5～20mg/d,两组均以PANSS、CGI量表及TESS、RSESE量表评定观察2周.结果 奥氮平组治疗精神分裂症急性期症状与氟哌啶醇组相比总体疗效相当.奥氮平组PANSS兴奋激越因子减分在第1周末（t=3.16,P＜0.05）及2周末（t=3.59,P＜0.05）优于氟哌啶醇组.奥氮平组的药物不良反应小.结论 奥氮平治疗精神分裂症伴兴奋激越症状患者疗效较肯定,起效较快,副反应较小,安全性良好.     

奥氮平治疗老年期精神障碍100例临床分析

目的 评价奥氮平治疗老年期精神障碍的疗效和安全性。方法 用奥氮平治疗老年期精神障碍100例，其中，老年期分裂症40例，阿尔采默病28例，脑血管病所致精神障碍26例，脑外伤所致精神障碍6例，疗程8周；采用简明精神病量表（BPRS）、阳性和阴性症状量表（PANSS）评价临床疗效，副反应量表（TESS）评价不良反应。结果 BPRS总分、PANSS总分、阳性症状量表评分治疗后1、2、4、8周末，阴性症状量表评分治疗后1、2、4、8周末与治疗前比较差异有显著性（P〈0．05～0．01）；奥氮平疗效显著，治愈率为72％，显效率为83％；常见的不良反应是体重增加。结论 奥氮平对老年期精神障碍起效快，不良反应少，安全有效，服用方便，适合于住院及门诊老年期精神障碍者的治疗。     

躯体形式障碍患者的人格障碍倾向调查

目的:探讨躯体形式障碍(SD)患者的人格障碍倾向。方法:对64例SD患者(SD组)和52名正常对照者(NC组)进行人格诊断问卷(PDQ-4)评估和比较。结果:SD组中,人格障碍筛查阳性为37例(57.81%),介于阳性与阴性间10例(15.6%);以C组人格障碍类型中的强迫型最常见。NC组中,人格障碍筛查阳性4例(7.7%),介于阳性与阴性间4例(7.7%)。SD组人格障碍筛查阳性率显著高于NC组(χ2=31.54,P0.001)。结论:SD患者人格障碍筛查阳性率较高,提示人格特质异常可能与SD的发病机制密切相关。     

Incidence of DIS/DSM-IV social phobia in adults.

OBJECTIVE: The aim of the study was to estimate the incidence of social phobia in the general population. METHOD: The Baltimore cohort of 3481 subjects, sampled during the 1981 Epidemiologic Catchment Area study, was traced. A total of 1920 subjects were re-interviewed from 1993 to 1996 using the Diagnostic Interview Schedule (DIS). A subsample of 349 subjects was interviewed by psychiatrists using the Schedules for Clinical Assessment in Neuropsychiatry. RESULTS: The estimated incidence of DIS/DSM-IV social phobia is 4-5/1000/year. New cases were found in all age groups, with the highest rates in subjects with baseline depressive and panic disorders. Psychiatric evaluations showed broad diagnostic concordance with DIS diagnoses in incident cases. However, validity indices were highly dependent on diagnostic thresholds. None of the psychiatrist-ascertained social phobics had received treatment for the disorder, although the majority were considered likely to benefit from treatment. CONCLUSION: New cases of social phobia occur in adults of all age groups, and are often secondary to other psychiatric conditions.     

Prevalence,demographic and clinical characteristics of body dysmorphic disorder among psychiatric outpatients with mood,anxiety or somatoform disorders

Aims: To describe the prevalence, demographic and clinical characteristics of body dysmorphic disorder (BDD) compared with other psychiatric outpatients with a mood, anxiety or somatoform disorder. Method: Outpatients referred for treatment of a mood, anxiety or somatoform disorder were routinely assessed at intake. A structured interview (MINI-Plus), observer-based and self-rating instruments were administered by an independent assessor. Results: Among our sample of 3798 referred patients, 2947 patients were diagnosed with at least one DSM-IV mood, anxiety or somatoform disorder. Of these patients 1.8% (n = 54) met the diagnostic criteria for BDD. In comparison with other outpatients, patients with BDD were on average younger, less often married and were more often living alone. Highly prevalent comorbid diagnoses were major depression (in 46.3% of cases), social anxiety disorder (in 35.2% of cases) and obsessive–compulsive disorder (OCD) (in 16.7% of cases). Furthermore, patients with BDD had higher scores on the Clinical Global Impression of Severity (CGI-S) as well as lower scores on the Short Form 36 social role functioning. Conclusion: BDD is frequently associated with depression, social phobia and OCD. Patients with BDD have more distress and more impaired interpersonal functioning.     

Cross-cultural influences on psychogenic movement disorders - a comparative review with a Brazilian series of 83 cases

Objective

To describe the profile and presentation of a Brazilian series of psychogenic movement disorders (PMD) patients and to perform a comparative analysis with the previous series published worldwide.

Methods

A total of 83 patients with a clinical diagnosis of PMD were included. All patients were assessed and followed at the Movement Disorders Outpatient clinic from 2000 to 2008. Demographic, clinical, paraclinical, and treatment outcome data were collected using a standardized protocol. The Gupta & Lang criteria were used for the diagnosis of PMD.

Results

Seventy-three patients were females (87.95%), with mean age of onset of 39 ± 5.1 years. Tremor was the most frequent PMD, occurring in 42 (50.6%) patients followed by dystonia, in 27 (32.5%) patients. Cerebellar-like ataxia was seen in 3 patients (4.16%). Psychiatric co-morbidities were diagnosed in 67 (80.7%) of the patients. Thirty-five of the 58 patients (60.3%) who were managed and followed up for six months had some degree of improvement, including 22 patients (37.9%) with complete or almost complete remission.

Conclusion

In this series of patients with PMD, tremor and dystonia were most frequent PMD. Our results overlap those of the literature regarding most demographic and clinical findings, demonstrating the trans-cultural aspect of PMD.