513例住院精神分裂症患者临床特点的性别差异

目的 :比较男性及女性精神分裂症住院病人的起病年龄、症状特点、病程演变特点及社会功能等指标的差异。方法 :选择 5 13例住院精神分裂症患者 ,详细收集临床资料 ,并进行《阳性及阴性症状评定量表》 (PANSS)及《大体功能量表》 (GAF)的评定 ,以此为依据进行性别间的比较分析。结果 :(1)总体上看 ,男性患者的起病年龄 (2 5 6± 7 3岁 )显著早于女性患者 (2 7 5± 8 6yrs) (P <0 0 1) ,但有家族史的患者间起病年龄差异不显著 (2 6 3± 6 9岁vs 2 6 8± 8 4岁 ) ;与男性相比 ,女性患者具有如下倾向 :症状模式较多为持续阳性症状 ,多为发作性波动或轻度恶化病程 ,阳性及情感症状更明显 ,且未婚或离婚的比例(5 3 9% )显著低于男性 (67 2 % )。结论 :男性及女性精神分裂症患者在发病年龄、症状特点及病程转归等多方面均存在显著差异 ,提示在制定治疗康复方案方面 ,应有所区别     

92例恢复期女性精神分裂症患者述情障碍临床研究

目的探讨恢复期女性精神分裂症患者述情障碍及相关因素。方法应用多伦多述情障碍量表(TA S)对92例恢复期女性精神分裂症患者评定,并对不同文化程度、病程患者TA S评分进行比较。结果①恢复期女性精神分裂症患者TA S总均分及因子分均明显高于常模,差异具有显著性(t=3.04~10.56,均P<0.01);②不同文化程度患者的TA S总均分、因子Ⅰ、Ⅱ、Ⅳ分均存在显著差异性(t=1.98~8.06,P<0.05或P<0.01);③不同病程患者的TA S总均分、因子分存在显著差异(t=1.97~7.53,P<0.05或P<0.01)。结论恢复期女性精神分裂症患者存在着严重的述情障碍,文化程度低、病程长者述情障碍更严重。     

精神分裂症患者暴力行为临床特征研究

目的 探讨精神分裂症患者的暴力行为特点及相关影响因素,为制定干预措施提供依据.方法 对176例具有暴力行为的精神分裂症患者的相关文化背景、职业、、精神症状等进行回顾性研究.并提出干预对策.结果 男性暴力行为发生率高于女性(3:1);工人农民居多,占68.75%.初中以下文化程度占76.15%.结论 暴力行为多发生于男性,且与患者的文化背景、职业等特征有关,早期预测和干预有重要意义.     

88例恢复期精神分裂症患者述情障碍的临床研究和中西医对策

目的 探讨恢复期精神分裂症患者述情障碍及相关因素和中西医对策。方法 对88例恢复期精神分裂症患者采用TAS评定，并对不同病程、年龄、文化程度、性别组进行TAS评定和比较。结果 恢复期精神分裂症患者存在着明显的述情障碍．且不同病程、年龄、文化程度、性别组的总均分因子分存在明显差异。结论 恢复期精神分裂症患者存在着严重的述情降碍．中西医结合干预有一定效果。     

舒必利治疗首发精神分裂症的性别差异

目的 了解抗精神病药物对男女精神分裂症患者是否存在性别差异。方法 对71例首发精神分裂症患者以不同性别进行分组,应用舒必利治疗,以阳性症状和阴性症状量表（PANSS）、副反应量表（TESS）评定疗效及不良反应,在治疗前及治疗后第1、2、4、6、8周末各评定1次。结果 两组患者治疗后与治疗前的PANSS评分比较差异有显著性（P〈0．05或P〈0．01）,男性平均用药剂量大于女性平均用药剂量,有显著性差异（P=-0．034〈0．05）。结论 首发精神分裂症患者男女用药剂量不一样,女性患者平均用药剂量较小。     

强迫症与伴强迫症状的精神分裂症的比较研究

目的：比较强迫症与伴强迫症的精神分裂症的多项指标，为临床诊断和治疗提供参考。方法：对61例强迫症和28例伴强迫症状的精神分裂症的起病年龄、病程、住院时间、家族史、自杀倾向、EGG等指标进行比较分析。结果：两组在平均起病年龄和平均病程等无显著差异，在平均住院时间上有显著差异。结论：①OCD痛苦程度高于Sch OCD。②Sch组可能有器质性基础及家族史。③Sch OCD与OCD症状类型有差异。     

博思清与利培酮治疗首发精神分裂症的对照研究

目的 比较博思清和利培酮治疗首发精神分裂症的临床疗效与安全性。方法 60例首发住院的女性精神分裂症患者,随机分为两组,分别用博思清和利培酮进行8周治疗。采用阳性症状与阴性症状量表（PANss）评定疗效,用副反应量表（TESS）评定不良反应。结果 两种药物对首发精神分裂症的疗效相当。两组患者在嗜睡、锥体外系症状及月经功能紊乱方面的不良反应差异有显著性（P〈O．05）。结论 博思清、利培酮对精神分裂症疗效相似,不良反应有所不同,程度均较轻。     

不同性别伴抑郁症状的精神分裂症临床分析

为了解不同性别伴抑郁症状的精神分裂症的临床特征,对我院1998年伴抑郁症状的男女精神分裂症患者的临床资料进行对照研究,结果显示,女性患者病前诱因较多,躯体化障碍明显;男性无助、无望感明显。女性患者较多表现为疑病、罪恶和虚无妄想,紧张焦虑者多见;男性患者具有自杀行为的较多。治疗上女性患者加用抗抑郁剂多见。伴抑郁症状的精神分裂症病人不同性别存在某些差异。     

54例精神分裂症性格分析

有关精神分裂症的个性特征问题，长期以来一直受对精神病学家及心理学家的关注，认为病前性格与精神病的发生率有着密切的联系[1]。现将我院1992年诊断明确的54例精神分裂症患者的性格，对照分析如下：1对象与方法在我院住院治疗的精神病人，符合CCMD－2精神分裂症诊断标准，共54例患者。其中男性38例，女性16例；年龄17－54岁，男性平均30．5±9．6岁，女性33．4±8．7岁；文化程度在初中以上。对照组为附近的正常工人及店员，其中男性40人，女性14人；年龄20－56岁，男性平均31．4±10．2岁，女性32.5±11．5岁；文化程度均在初中以上。…     

不同性别焦虑症的临床对照研究

目的　探讨焦虑症的临床变量与性别间的关系。方法　对 4 3例男性和 2 5例女性焦虑症患者的临床变量进行回顾性调查并做对照比较。结果　男、女患者在病程、婚姻状况、文化程度、临床类型等变量方面存在显著性差异 (P<0 .0 5) ,且生活事件的内容也有较大差别。结论　焦虑症不同性别间确实存在着差异 ,诊断、治疗上应有所不同     

Is gender a factor in psychiatrists' evaluation and treatment of patients with major depression?

BACKGROUND: Gender differences in clinical assessment and treatment have been reported in several areas of medicine. We examine whether differences exist in the routine outpatient psychiatric management of men and women with major depression. METHODS: Psychiatrists practicing in the community completed case forms on a systematic sample of their adult outpatients with major depression. Comparisons are presented between male (n=261) and female (n=472) patients focusing on their background characteristics, clinical presentation, assessment, and treatment. Significant gender disparities in assessment and treatment are also examined with respect to the gender of the treating psychiatrist. RESULTS: Although male and female patients had generally similar clinical profiles, a significantly greater proportion of males than females had psychomotor retardation and substance use disorders. No significant gender differences were observed in the assessment of depressive symptoms, psychiatric comorbidities, and treatment with antidepressant medications or psychotherapy. However, a significantly smaller percentage of depressed women than men received assessments of sexual function and medication-related sexual side effects. Female patients were also less likely to have discussed their treatment preferences with their psychiatrists. LIMITATIONS: Only a minority (33.2%) of psychiatrists invited to participate contributed patients to this study. The results are based on structured assessments completed by practicing psychiatrists rather than patient self-assessments or independent research assessments. CONCLUSIONS: Although we find overall little evidence of gender bias in the clinical management of major depression, both male and female psychiatrists need to further explore sexual function and treatment preferences in female patients.     

不同性别躯体化障碍临床对照分析

目的了解不同性别躯体化障碍的临床特征。方法对我院2001年4月-2004年5月男女躯体化障碍的临床资料进行对照研究。结果女性患者住院次数多,住院前去其他科就诊者多,泌尿、生殖器、性症状及皮肤、软组织症状明显,紧张、焦虑突出;男性患者消极意念或行为者明显。使用抗抑郁剂方面,女性患者用SSRI类相对多见,而男性患者用TCA类较多。结论躯体化障碍男女患者在临床上存在某些差异。     

Symptomatology, psychosexual development and gender identity in 42 anorexic males

Forty-two male patients with an anorexic syndrome were assessed. Twenty-nine of them had a primary anorexia nervosa (most of them also had bulimic symptoms). They were compared with a series of 23 female anorexia nervosa patients. The males scored more highly than female patients on a number of symptoms, but generally more similarities than differences in symptomatology were apparent. Male patients with primary anorexia nervosa also showed several signs of a disturbed psychosexual and gender identity development. The data support the hypothesis that males with atypical gender role behaviour have an increased risk for developing anorexia nervosa or bulimia in adolescence.     

Absent gender differences of hippocampal atrophy in amnestic type mild cognitive impairment

Hippocampus displayed progressively gender-associated damage in Alzheimer's disease. However, gender effects have been largely neglected in studies of amnestic type mild cognitive impairment (aMCI) patients who were believed to represent an early stage of this disease. The goal of this study was to use in vivo neuroimaging techniques to determine whether there were any evidences of gender differences in hippocampal atrophy in aMCI. A region of interest-based magnetic resonance imaging approach was used to compare hippocampal volume between aMCI patients (22 male, 17 female) and normal aging controls (12 male, 11 female). Independent of group, male hippocampal volumes were larger than female volumes and right hippocampal volumes were typically smaller than left volumes. Hippocampal volumes were significantly reduced in the clinical group but no gender differences were noted in terms of degree of atrophy present. However, female patients showed more impaired cognitive function than male patients despite this apparent equivalence in atrophy. The absence of a gender difference suggested that early neuropathological progression might be independent of gender. However, the data also suggested female aMCI patients had an increased vulnerability to cognitive impairment earlier in the illness course.     

Is there evidence for a male depressive syndrome in inpatients with major depression?

BACKGROUND: The question is investigated whether atypical depressive symptoms such as irritability, anger attacks, aggressiveness or abusive behavior, which are hypothesized to indicate a hypothetical male depressive syndrome are more prevalent in male than in female inpatients with unipolar major depression. METHODS: Data were obtained from 2411 patients who had been consecutively admitted to the Department of Psychiatry of the Ludwig-Maximilians-University of Munich. Psychopathological symptoms had been assessed by a standardized documentation system (AMDP). RESULTS: Neither frequency nor mean scores of most of the symptoms describing a male depressive syndrome differed between males and females. There were no gender differences in symptoms with respect to severity of depression, first hospitalization and duration of illness. However, gender differences emerged when regarding symptom patterns by factor analysis. Limitations: Only inpatients were studied, and comorbidity was not considered. CONCLUSIONS: The hypothesis of a male depressive syndrome needs further research, focusing on the gradual development of (masked) depression by men in mainly non-clinical samples.     

Gender differences in bipolar affective disorder

We report a study of gender differences in a sample of 111 manic patients. Female manics (N = 78) exhibited fewer manic and more depressive symptoms than males (N = 33). Although male manics had a more frequent history of delayed landmarks, the two groups did not differ in cortical function as measured by EEG and neuropsychological testing. There were no significant differences between male and female relatives of male and female probands for unipolar or bipolar affective disorder, alcoholism or sociopathy. Female relatives of both groups were at greater risk for total affective disorder and male relatives were at greater risk for alcoholism. Familial illness patterns indicated that male and female manics shared the same genetic liability for affective disorder and that X-linked transmission was unlikely.     

不同性别首发精神分裂症患者听觉事件相关电位的研究

目的 研究不同性别首发精神分裂症患者听觉事件相关电位(ERP)是否存在差异,并分别探讨两组事件相关电位与临床阴性、阳性症状的关系.方法 对60例(男32例,女28例)首发神分裂症患者及30例正常人进行事件相关电位检测,并运用阳性和阴性症状量表进行精神症状评定.结果 ①两患者组的N2、P3潜伏期明显长于对照组,P3波幅明...     

Gender Difference in the Prodromal Symptoms of First-episode Schizophrenia

To investigate the gender difference of early symptoms appearing before the onset of the psychotic symptoms in patients with first-episode schizophrenia, we reviewed the medical records of 63 patients (38 males, 25 females), who were hospitalized for first-episode schizophrenia. The frequency and duration of prodromal and psychotic symptoms, Clinical Global Impression scale scores, Global Assessment of Functioning (GAF) scale scores at admission, and other clinical characteristics were recorded for all patients. Overall, the most common prodromal symptoms were attenuated positive symptoms (89%), followed by mood symptoms (86%). Negative symptoms were the most common in male patients (97.4%), whereas attenuated positive symptoms were the most common in female patients (84%). Male patients demonstrated more frequent negative, cognitive, and obsessive-compulsive symptoms than female patients did and also showed a tendency of having negative symptoms for the longer period. Correlational analysis showed a significant negative correlation between the duration of negative symptoms and GAF scores at admission in male patients. Our findings suggest that different patterns of prodromal symptoms between male and female begin before the onset of the psychosis. Further prospective studies should be needed.