住院躯体疾病患者心理健康状态调查

对５００名住院躯体疾病患者应用症状自评量表（ＳＣＬ－９０）社会支持评定量表ＳＳＲＳ,汉密顿抑郁量表（ＨＡＭＤ）焦虑量表（ＨＡＭＡ）和住院躯体疾病患者心理健康状态调查统计表（自制）进行心理健康状态调查及评定,结果显示：ＳＣＬ－９０阳性项目数及各因子得分（人际关系除外）均极显著高于全国常女性病人“恐怖”,男性病人“抑郁,焦虑”内向性格病人ＳＣＬ－９０,ＨＡＭＡ,ＨＡＭＤ得分都有极显著性,年龄比较,青年     

阿尔采末氏病与多发脑梗塞性痴呆病人认知功能的比较研究

目的：探讨阿尔采末氏病（ＡＤ）和多发脑梗塞性痴呆（ＭＩＤ）病人认知功能的异同。方法：用韦氏成人智力量表和韦氏记忆量表对２１例ＡＤ和１５例ＭＩＤ病人的认知功能进行测查。结果：韦氏智力量表的分析结果表明，ＡＤ组在知识、领悟、算术、相似性、数字广度、词汇和图片排列的量表分以及言语ＩＱ和总ＩＱ显著低于ＭＩＤ组，其余指标差异不显著。ＡＤ组累加、视觉再生、定向、再认、背数的得分以及总量表分和记忆商均明显低于ＭＩＤ组。结论：ＡＤ组和ＭＩＤ组均表现出明显的智能和记忆障碍，ＡＤ组的受损更为严重，以言语理解和记忆注意受损为突出特点，ＭＩＤ组则相对受损较轻，并以操作能力受损为突出特点。     

老人日常生活活动能力的变化及与痴呆的关系

目的：了解正常老人日常生活活动能力的自然衰退情况及其影响因素，探索ＡＤＬ评定对预测痴呆的作用。方法：用１４项日常生活活动能力量表对３０１９例正常社区老人进行间隔５年的两次随访并按ＤＳＭ－Ⅲ－Ｒ标准诊断是否痴呆。结果：正常老人ＡＤＬ平均得分１４．９５，５年后增加１．４３。增幅随年龄增长而加大。痴呆组ＡＤＬ总分显著高于正常组，且离散度大，５年间平均增加１４．４９分。Ｌｏｇｉｓｔｉｃ回归分析显示，年龄大，ＰＳＭＳ得分高以及教育程度低者，发生痴呆的相对危险性大。结论：社区智力正常老人ＡＤＬ保持良好，自然衰退幅度不大，与年龄有关。如无特殊躯体原因，ＡＤＬ总分年内上升５分以上，应考虑痴呆可能。     

几种心身疾病患者的心理卫生状况与个性特征

本文以横断面对照研究方法，采用ＳＩＭＨ精神症状自评量表（ＳＣＬ－９０）、Ｈａｍｉｌｔｏｎ焦虑量表（ＨＡＭＡ）、Ｈａｍｉｌｔｏｎ抑郁量表（ＨＡＭＤ）、艾森克个性问卷（ＥＰＱ）对冠心病（ＣＨＤ）、原发性高血压（ＰＨ）、糖尿病（ＤＭ）、消化性溃疡（ＰＵ）等几种心身疾病患者及健康对照组进行测试。结果表明，心身疾病患者的心理卫生状况普遍不佳，且各组间心理障碍的主要方面有差异。ＣＨＤ组、ＤＭ组患者的个性类型多为外倾情绪不稳定型；ＰＨ组、ＰＵ组则多为内倾情绪不稳定型。神经质是ＰＵ发病的主要危险因素；精神质是ＰＨ、ＤＭ发病的主要危险因素。     

抑郁性神经症功能失调状况与临床症状的关系

目的：探讨抑郁性神经症患者的功能失调状况是属于素质性的,还是一种状态依从性的变量。方法：应用功能失调状况评定量表（ＤＳＡ）测评了９０例抑郁性精神症患者,并以９０正常人作对照。另外,将抑郁性神经症的ＤＡＳ总分和因子分与症状自评量表（ＳＣＬ－９０）的总分及因子分进行了相关分析。结果：抑郁性精神症的ＤＡＳ总分及因子分均明显高于正常人;ＤＡＳ得分与ＳＣＬ－９０评分之间的分析提示绝大部分变量间呈现密切正相关     

用认知行为疗法治疗精神分裂症的继发抑郁

目的：探讨认知行为疗法治疗精神分裂症的继发抑郁的疗效。方法：使用“旧金山预防抑郁研究”教材录制的录像带，对２３例伴有抑郁症状，且符合ＤＳＭ－Ⅳ有关精神分裂症和分裂样精神障碍诊断标准患者，通过看录像进行认知行为疗法，每周一次，８周为一疗程。治疗前后用ＨＡＭＤ、ＣＥＳ－Ｄ、ＨＡＭＡ、ＢＰＲＳ、ＧＡＳ量表评定。结果：认知行为治疗后ＨＡＭＤ、ＣＥＳ－Ｄ、ＨＡＭＡ评分均有逐渐下降趋势、ＧＡＳ评分有逐渐上升趋势（Ｐ＜０．０５），而ＢＰＲＳ评分无显著差异（Ｐ＞０．０５）；治疗６周及８周ＨＡＭＤ减分率与ＢＰＲＳ减分率、ＧＡＳ变化值之间均呈密切相关（Ｐ＜０．０１）。结论：认知行为疗法能改善精神分裂症的抑郁和焦虑症状，能提高患者临床总体情况和功能水平     

森田疗法用于口吃矫治的疗效研究

目的：探讨森田疗法对口吃病的治疗效果，为口吃治疗提供依据。方法：采用森田疗法，用焦虑自评量表（ＳＡＳ）、抑郁自评量表（ＳＤＳ）、自制的口吃程度量表于治疗前后分别测量，并与对照组或自身比较。结果：口吃患者治疗前ＳＡＳ、ＳＤＳ得分显著高于对照组（Ｐ＜０．０１），治疗后与对照组无差异（Ｐ＞０．０５）。治疗前后口吃程度构成有显著性差异（Ｐ＜０．０１），治愈率７４％。结论：森田疗法治疗口吃有效。     

躯体疾病对老年抑郁症患者认知功能的影响

目的 探讨老年人躯体疾病与抑郁症的关系。方法 就５２例观察组和４５例对照组进行对照研究,用ＨＡＭＤ、ＧＡＳ量表评价精神疾病的严重程度,用ＨＤＳ和ＭＭＳＥ量表评价认知功能。结果 对照组疗效和恢复期情况优于观察组。观察组认知功能较对照组损害明显。结论 老年抑郁症患者躯体疾病可加重精神症状,增加复发率,延长病程,影响认知功能。     

阿尔茨海默病评定量表中文译本的效度和信度

目的：评价阿尔茨海默病评定量表（Ａｌｘｈｅｉｍｅｒ’ｓ Ｄｉｓｅａｓｅ Ａｓｓｅｓｓｍｅｎｔ Ｓｃａｌｅ,ＡＤＡＳ）中文译本的效度和信度。方法：选择２０例符合ＮＩＮＣＤＳ－ＡＳＲＳＡ诊断标准的很可能ＡＤ患者为被试,两名评定者盲法评定,通过评定者间一致性评价量表信度。进行ＡＤＡＳ、ＭＭＳＥ、ＧＤＳ、ＡＤＬ和Ｂｌｅｓｓｅｄ Ｒｏｔｈ量表评分,通过相关分析考察量表效度。ＡＤＡＳ各条目评分进行相差分析,以     

PACAP对vSMC表达增生细胞核抗原影响的定量分析

目的：从定量角度分析垂体腺苷酸环化酶激活肽（ＰＡＣＡＰ）对血管平滑肌细胞（ｖＳＭＣ）增殖的影响。方法：以培养的猪肺动脉ＳＭＣ为实验对象，免疫组织化学ＬＳＡＢ法检测ＳＭＣ中增生细胞核杭原（ＰＣＮＡ），Ｔｉｇｅｒ９２０Ｇ细胞图象分析仪上测量计算各组细胞中ＰＣＮＡ阳性细胞的百分率；并检测阳性细胞的平均光密度（ＡＯＤ）和积分光密度（ＩＯＤ），计算阳性水平指数（ＰＬＩ）。结果：ＰＡＣＡＰ组ＳＭＣ的ＰＣＮＡ阳性率显著低于对照组细胞（Ｐ＜０．０１）；ＡＯＤ、ＩＯＤ及ＰＬＩ值也显著低于对照组（Ｐ＜００１）。结论：ＰＡＣＡＰ能抑制培养的ｖＳＭＣ增殖，可能具有抗动脉粥样硬化作用     

Cognitive impairment following frontal lobe damage and its relevance to human amnesia

Whether frontal lobe pathology can account for some of the cognitive impairment observed in amnesic patients with Korsakoff's syndrome was investigated. Various cognitive and memory tests were given to patients with circumscribed frontal lobe lesions, patients with Korsakoff's syndrome, non-Korsakoff amnesic patients, and control Ss. Patients with frontal lobe lesions were not amnesic. Nevertheless they exhibited 2 deficits that were also exhibited by patients with Korsakoff's syndrome but not by other amnesic patients: (a) impairment on the Wisconsin Card Sorting Test and (b) impairment on the Initiation and Preservation subscale of the Dementia Rating Scale. Thus, frontal lobe pathology can explain some of the cognitive deficits observed in patients with Korsakoff's syndrome.     

Serum magnesium levels and cognitive impairment in hospitalized hypertensive patients.

We performed this cross-sectional case control study to investigate the association between low serum magnesium levels and cognitive impairment in hypertensive hospitalized patients. The study was carried out in general medical care units at 81 hospitals participating in the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study throughout Italy, and a total of 1058 patients with diagnoses of hypertension at the discharge were studied. The occurrence of cognitive impairment at discharge was the primary outcome of our study. Cognitive impairment was ascertained using the Hodkinson Abbreviated Mental Test (HAMT). Sociodemographic variables, body mass index, laboratory parameters, comorbidity, use of antihypertensive drugs and number of drugs were considered as potential confounders. Twenty-nine percent of the selected hypertensive patients were classified as having cognitive impairment. In univariate analysis, older age, female sex, and low educational level showed a significant trend for association to cognitive impairment. Moreover the proportion of subjects with cognitive impairment decreased with increasing alcohol consumption, and the prevalence of ex smokers and smokers was significantly lower in patients with cognitive impairment. The lower tertiles for serum albumin and creatinine clearance were more frequent among patients with cognitive impairment, and the lower tertile for serum magnesium levels was significantly more frequent in these patients. Number of drugs was slightly lower in cognitively impaired patients, while number of diagnoses and length of hospital stay were higher in these subjects. In the multivariate logistic regression analysis cognitive impairment decreased with increasing education level (highest education: OR 0.11; 95 per cent CI 0.05-0.25). The lower tertile for serum albumin (< 3.5 g/dl) was significantly associated to cognitive impairment (OR 2.14; 95 per cent CI 1.31-3.49), as well as the lower tertiles for serum magnesium (0.74-0.86 mmol/L: OR 1.54; 95 per cent CI 1.06-2.22; < 0.74 mmol/L: OR 1.75; 95 per cent CI 1.13-2.72]. Our results demonstrate the existence of a significant association between magnesium imbalance and cognitive impairment. These data suggest that the assessment of magnesium status may be of some relevance in hypertensive subjects with cognitive disorders.     

ADAS-Cog中文版区分轻、中度阿尔茨海默病的能力

目的：探讨阿尔茨海默病评定量表认知部分(ADAS-Cog)中文版区分轻、中度AD的能力。方法：199例轻度和106例中度AD患者为研究被试(符合NINCDS-ADRDA很可能AD诊断标准),对所有被试进行ADAS-Cog中文版测试。结果：中度AD患者ADAS-Cog总分及各条目评分明显高于轻度AD被试,GLM分析提示ADAS-Cog评分不受被试年龄与受教育程度的影响,ADAS-Cog能有效反映轻、中度AD患者不同的认知损害模式而不依赖于被试的学历。Logistic回归分析定向力和结构性练习条目评分及ADAS-Cog总分能有效区分轻、中度AD,敏感度为78％-82％,特异度为70％-73％。结论：ADAS-Cog中文版对轻、中度AD具有较好的区分能力,推荐将该量表用于评估药物对中国AD患者认知功能的疗效。     

Neonatal ultrasound results following very preterm birth predict adolescent behavioral and cognitive outcome

This study investigated the association between different neonatal ultrasonographic classifications and adolescent cognitive, educational, and behavioral outcomes following very preterm birth. Participants included a group of 120 adolescents who were born very preterm (<33 weeks of gestation), subdivided into three groups according to their neonatal cerebral ultrasound (US) classifications: (a) normal (N = 69), (b) periventricular hemorrhage (PVH, N = 37), and (c) PVH with ventricular dilatation (PVH + DIL, N = 14), and 50 controls. The cognitive functions assessed were full-scale IQ, phonological and semantic verbal fluency, and visual-motor integration. Educational outcomes included reading and spelling; behavioral outcomes were assessed with the Rutter Parents' Scale and the Premorbid Adjustment Scale (PAS). Adolescent outcome scores were compared among the four groups. A main effect for group was observed for full-scale IQ, Rutter Parents' Scale total scores, and PAS total scores, after controlling for gestational age, socioeconomic status and gender, with the PVH + DIL group showing the most impaired scores compared to the other groups. The current results demonstrate that routine neonatal ultrasound classifications are associated with later cognitive and behavioral outcome. Neonatal ultrasounds could aid in the identification of subgroups of children who are at increased risk of neurodevelopmental problems. These at risk subgroups could then be referred to appropriate early intervention services.     

Hypnosis and Conversion Hysteria: A Unifying Model

Introduction. Interview-based scales can be used as coprimary measures to complement the assessment of cognitive impairment in schizophrenia. One major question that arises from the use of such tools is how specific they are in relation to other psychopathological domains. We analyse the specificity of the Positive and Negative Syndrome Scale (PANSS) negative subscale and the Schizophrenia Cognition Rating Scale (SCoRS).

Methods. We performed a principal component analysis (PCA) of PANSS negative subscale, rated by the interviewer, and SCoRS ratings from three different sources (patient, informant, and interviewer) in 101 patients with schizophrenia. Additionally, we correlated mean SCoRS ratings to PANSS negative subscale items to determine whether any PANSS item is particularly related to cognition.

Results. The PCA showed that the two first components, which explained approximately 40% of the total variance of the scales, represent the SCoRS ratings and the PANSS negative subscale ratings, respectively. The mean interviewer SCoRS was significantly correlated with the PANSS negative Item 5 (difficulty in abstract thinking) and with the mean PANSS negative subscale. The latter correlation was no longer significant when “difficulty in abstract thinking” was eliminated from PANSS negative subscale.

Conclusions. In general, SCoRS and PANSS negative subscale scores address different constructs; however, the PANSS negative item “difficulty in abstract thinking” seems to address a cognitive dimension.     

老年性痴呆生活质量量表修订版的信度和效度分析

目的：引入国外的老年性痴呆生活质量量表（QOL—AD）修订版．并分析其信度和效度。方法：将222例痴呆或轻微认知功能损害患者，分别评定其生活质量、认知功能、13常生活功能、心理状况、精神症状等。探讨它们之间的相关性，并对QOL—AD的内部一致性予以检验。结果：QOL—AD的内部一致性系数α=0．9243：QOL-AD得分与认知功能正相关（r=0．593，MMSE；r=0．446，FOM；r=0．599，RVR；r=0．489，BD；r=0．518，DS），与抑郁负相关（r=-0．316，HAMD-P），与13常生活功能相关（r=-0．781，ADL），与精神症状负相关（r=-0．504，BPRS）。结论：QOL—AD修订版具有良好的信度和效度，对今后的研究有一定的帮助。     

轻度认知障碍患者平衡功能与视空间感知功能的关系

目的:对轻度认知障碍(MCI)患者的平衡功能与视空间感知功能之间的关系进行初步的探讨。方法:通过Berg平衡量表(BBS)测评,将116例MCI患者分为平衡障碍组(BBS46分,29例)和平衡正常组(BBS≥46分,87例)。同时,采用线方向判断测验评估MCI患者的视空间感知功能。结果:平衡障碍组的线方向判断测验评分低于平衡正常组,差异有统计学意义(t=-3.218,P=0.002)。MCI患者的线方向判断测验评分与BBS总分(r=0.256,P=0.006)、动态平衡功能评分(r=0.284,P=0.004)正相关;而与BBS静态平衡功能评分(r=0.163,P=0.369)无显著相关性。结论:MCI患者的视空间感知功能,对患者的平衡功能、特别是动态平衡功能有影响;视空间感知功能受损,可能是MCI患者平衡障碍的一个原因。     

Determining neuropsychological impairment using estimates of premorbid intelligence: comparing methods based on level of education versus reading scores.

When inferring brain dysfunction, test scores are typically compared to normative data based on estimates of premorbid intelligence (e.g., by educational level or reading scores). However, these methods are likely to lead to differing results, with important diagnostic and forensic implications. The current study compared estimates of impairment (reported in z-scores) based on educational level versus reading scores in a population with traumatic brain injury. The study included 174 patients (M age = 27.3; M education = 12.3) evaluated as outpatients at a university hospital rehabilitation department. Wilcoxen ranked sign tests indicated that the two methods yielded estimates that were statistically different (p <.0001) for all variables. The education based method yielded greater estimates of impairment than the reading score method for WAIS-R FIQ. Grip Strength, and Finger Tapping, with a pattern of generally consistent impairment across cognitive/motor areas (z-score range = -0.59 to -.97). In contrast, the reading score based method yielded greater estimates of impairment in processing speed (Trails A) and flexibility (Trails B), with a wider range of impairment noted between cognitive and motor domains (z-score range = +0.21 to -2.95). Clinical implications are discussed.     

Factors associated with neuropsychological performance in HIV-seropositive subjects without AIDS

BACKGROUND: Previous research has suggested that several factors may influence the presence of cognitive impairment in human immunodeficiency virus (HIV) infection. The objective of this study was to assess the impact of cognitive reserve capacity and other variables on neuropsychological performance in early HIV infection. METHODS: The neuropsychological performance of 100 HIV-seropositive subjects without AIDS (71 men and 29 women) was compared with that of 63 seronegative controls (51 men and 12 women). Measures included a neuropsychological battery, a medical examination and a psychiatric assessment. Cognitive reserve scores were based on a combination of years in school, a measure of educational achievement, and an estimate of pre-morbid intelligence. RESULTS: HIV-positive subjects had longer reaction time latencies than HIV-negative subjects. Those in the HIV-positive group with low cerebral reserve scores showed the poorest performance on the neuropsychological tests. The prevalence of cognitive impairment was significantly higher in the HIV-positive group (27%) than in the controls (32%). Multiple regression analysis and logistic regression analysis were used to identify factors associated with global neuropsychological performance and cognitive impairment. Older age, lower cerebral reserve scores and not being on zidovudine treatment were associated with lower global neuropsychological scores and with the presence of cognitive impairment. CONCLUSIONS: Our results suggest that although cognitive impairment is not characteristic of early HIV infection, there is a subgroup of subjects who perform more poorly than expected. A lower reserve capacity, older age and not being on zidovudine treatment are factors that lower the threshold for neuropsychological abnormalities in cases of early HIV infection.     

听觉词语学习测验的社区老人常模

目的:编制汉语的听觉词语学习测验(AVLT)在社区老人中的常模。方法:对上海城区360名55岁至85岁、初中及以上教育程度的健康老人完成AVLT、简明精神状态量表(MMSE)、词语阅读能力、执行功能测验及自行编制的一般情况调查表。结果:正常老人有记忆减退感受的占70%;AVLT分析指标与MMSE总分有显著相关性、与记忆自评相关性较低、在躯体疾病中仅与高血压病有显著相关性。70岁和80岁是听觉词语记忆减退的2个转折点;AVLT分析指标与年龄成正相关而与教育程度的相关性较低,根据不同年龄层次制定了短时记忆、延迟回忆和AVLT总分与的划界分。结论:AVLT的社区老人常模将为老年人记忆减退检测提供参照数据。