家族性与散发性精神分裂症的病原学研究

目的：研究家族性与散发性精神分裂症相关因素。方法：采用病历记载和家属核实的方法。对501例精神分裂症患者的家族史（限于一级亲属）、性别、发病年龄进行对比分析研究。结果：FH 较FH-组发病年龄早，FH-女性组较FH 女性组及FH ，FH-男性组发病年龄晚，均有统计学意义，而FH 男性组与女性组发病年龄无差异。结论：家族性与散发性精神分裂症在发病年龄上的性别现象为：有阳性家族史者发病年龄早，家族史阴性男性较女性发病年龄早。     

家族性与散发性精神分裂症的病原学研究

目的 :研究家族性与散发性精神分裂症相关因素。方法 :采用病历记载和家属核实的方法 ,对 5 0 1例精神分裂症患者的家族史 (限于一级亲属 )、性别、发病年龄进行对比分析研究。结果 :FH +较FH -组发病年龄早 ,FH -女性组较FH +女性组及FH +、FH -男性组发病年龄晚 ,均有统计学意义 ,而FH +男性组与女性组发病年龄无差异。结论 :家族性与散发性精神分裂症在发病年龄上的性别现象为 :有阳性家族史者发病年龄早 ,家族史阴性男性较女性发病年龄早。     

精神分裂症遗传的性别差异

目的：探讨精神分裂症遗传的性别差异。方法：对1013例精神分裂症患者不同性别家族史阳性率，不同性别父系、母系、同胞、子女患病情况，不同性别先证者一、二、三级亲属患病情况进行比较。结果：男性有遗传史者11．9％，女性24．3％，男性低于女性，差异显著。女性同胞患病构成比明显高于男性，差异有显著性。男女一级亲属患病高于二级亲属，二级亲属患病高于三级亲属。结论：精神分裂症与遗传密切相关。     

氯氮平治疗家族性与散发性首发精神分裂症临床对照研究

目的 探讨氯氮平治疗家族性与散发性首发精神分裂症的临床疗效。方法 依据有无精神病家族史分组,随机取有家族史的首发精神分裂症患者53例(家族性);取同期无精神病家族史的精神分裂症患者50例(为散发性)。给予氯氮平系统治疗,分别与治疗前、治疗后1个月、2个月、3个月末进行简明精神病评定量表(BPRS)、阴性症状量表(sANS)和副反应量表(TESS)评定,并进行疗效评定。结果氯氮平对家族性和散发性精神分裂症患者的阴性、阳性精神症状均有显著疗效。而散发性患者起效更快.疗效更好。其2个月和3个月末BPRS(t=2.54和2.70 P<0.05和0.01)和SANS(t=2.03和3.15,P<0.05和<0.01)总分减分均显著优于家族性患者,其显效率显著高于家族性(x2=5.07 P<0.05)。两组主要副反应发生频数无显著差异(x2=0.16、0.12和0.30|P均大于0.05)结论 氯氮平治疗首发精神分裂症。散发性患者的疗效显著优于家族性。     

情感障碍和精神分裂症的遗传调查与分析

目的　探讨情感障碍和精神分裂症的遗传学差异。方法　收集首次住我院并符合CCMD - 3诊断标准的情感障碍及精神分裂症病例 ,以有无家族史按诊断分组对照分析。结果　同类疾病比较 ,女性情感障碍家族史阳性率高于男性情感障碍家族史阳性率 ,女性精神分裂症家族史阳性率高于男性精神分裂症家族史阳性率。同性别不同疾病比较 ,即男性精神分裂症与男性情感障碍比较 ,女性精神分裂症与女性情感障碍比较 ,仅见女性精神分裂症家族史阳性率高于女性情感障碍家族史阳性率。另外 ,还发现不论是精神分裂症还是情感障碍 ,均见Ⅰ级亲属家族史阳性率高于Ⅱ级 ,Ⅱ级高于Ⅲ级。结论　遗传因素是情感障碍和精神分裂症发病的重要因素之一 ,且患病基因可能位于X染色体上。     

家族性与散发性精神分裂症的临床特征对照研究

目的 探讨家族性与散发性精神分裂症临床特征的异同，方法 对６４例家族性精神分裂症，１５３例散发性精神分裂症的临床资料进行对比分析，结果 与散发性精神分裂症相比，家族性精神分裂症以阴性症状为主，疗效相对较差，易复发。结论家族性与散发性精神分裂症的临床特征存在明显差异，家族史的研究对分析精神分裂症的症状，采用治疗方法，判断预后及探讨精神分裂症新的分类方法具有重要价值。     

家族性与散发性精神分裂症临床对照分析

目的　探讨家族性、散发性精神分裂症临床特征的异同。方法　对６４ 例家族性精神分裂症、１５３ 例散发性精神分裂症的临床资料进行对比分析。结果　与散发性精神分裂症相比，家族性精神分裂症以阴性症状为主，疗效相对较差，易复发。结论　家族性、散发性精神分裂症的临床特征存在明显差异。家族史的研究对分析精神分裂症的症状、采用治疗方法、判断预后及探讨精神分裂症新的分类方法具有重要价值。     

精神分裂症的性别差异

目的:探讨精神分裂症患者的性别差异。方法:收集240例不同性别精神分裂症患者的首次发病年龄、病程、阳性家族史、临床症状、病前人格和诊断分型等资料,并进行分析比较。结果:首次发病年龄、病程和阳性家族史无性别差异,读心症、钟情妄想、其他妄想、思维逻辑性障碍和怪异行为等阳性症状在男性患者组和女性患者组中的分布差异有显著性,其他阳性症状及阴性症状在两组中的分布差异无显著性。结论:精神分裂症患者的阳性症状存在性别差异,女性精神分裂症患者的临床症状多表现为阳性症状。     

精神分裂症家族史性别差异调查

目的 了解不同性别精神分裂症遗传的差异及父系、母系阳性家族史的差异.方法 对长沙市城、乡在我院住院的及同时段各社区进行免费药物求助的共1938例精神分裂症患者进行精神障碍遗传的问卷调查,发现精神分裂症阳性家族史患者253例,其中男性139例,女性114例.对家族史阳性率,先证者父系、母系、同胞子女患病情况作统计分析.结果 男性阳性家族史比率较女性稍低,但无统计学意义;父系、母系、同胞子女的阳性家族史无明显性别差异;母系阳性家族史明显高于父系.结论 遗传因素对精神分裂症有很大的影响,不同性别精神分裂症的阳性家族史无明显差异.精神分裂症中母系后代比父系后代有更高的发病风险.     

家族性与散发性精神分裂症对照研究

为探讨家族性与散发性精神分裂症患者的临床特征差异，对３２例家族性和７５例散发性精神分裂症患者进行了临床对照研究。结果显示：家族性与散发性精神分裂症患者的临床特征相比，在发病年龄、出生季节，病前适应能力，病程，阴性症状及意志缺乏，以及即期疗效等方面均有显著性差异。提示家族史与精神分裂症的一些临床特征有密切的关系，家族史作为精神分裂症的一个分类原则是适合的。     

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.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -