吸烟与氟西汀疗效和副作用关系的初步研究

目的：探讨吸烟对氟西汀治疗剂量，疗效和副作用的影响。方法：对98例符合CCMS－2－R和DSM－Ⅲ诊断标准的抑郁症患者，用HAMD和HAMA减分率评价临床有效性，用TESS分值评价安全性。对每日吸10支以上烟，每日吸10支以下烟和不吸烟组进行氟西汀治疗剂量，疗效和副作用的比较。结果：在氟西汀平均日剂量相同的情况下，吸10支以上烟组疗效极显著差于吸10支以下烟和不吸烟组（P＜0．01），副作 显著轻于吸10支以下烟和不吸烟组（P＜0．01），每日吸10支以下烟组疗效显著差于不吸烟组（P＜0．05），副作用两组无显著性差异（P＞0．05），结论：抑郁症患者在氟西汀治疗期间不吸烟可以减少氟西汀治疗剂量和提高疗效。临床医生在评价氟西汀疗效和副作用时，应注意到吸烟这一因素的影响。     

吸烟与氯丙嗪治疗剂量、疗效、副反应的关系

对153例符合中国精神疾病分类与诊断标准第2版(CCMD-2)的精神分裂症患者进行吸烟与氯丙嗪治疗剂量、疗效及副反应关系的病例对照研究。结果表明，要使吸烟者达到与不吸烟者同样的治疗效果，吸烟者所需的氯丙嗪治疗剂量明显高于不吸烟者，吸烟可使氯丙嗪的疗效和副反应明显降低。     

SSRI与TCA联用的相互作用和治疗应用

本介绍了ＳＳＲＩ与ＴＣＡ联用的一些相互作用及其机制，并对其治疗应用作了评价。     

SSRI与TCA联合应用的评价

SSRI和TCA联合用于难治性抑郁症，强迫症已引起广泛兴趣。本位综述其治疗作用，TCA的血药浓度变化，相互影响机理，及主要不良反应。     

SSRI联用TCA的疗效及副反应

ＳＳＲＩ联用ＴＣＡ的疗效及副反应钱敏才陈加美ＳＳＲＩ和ＴＣＡ联合用于难治性抑郁症、强迫症已引起广泛兴趣。本文综述其治疗作用，ＴＣＡ的血药浓度变化，相互影响机理，及主要不良反应。一、治疗作用Ｂａｒｏｎ等给老鼠应用高剂量的氟西汀（１０ｍｇ／ｋｇ／日）和去...     

吸烟、饮茶、饮酒与阿尔茨海默病的关系

目的 探讨吸烟、饮茶、饮酒与阿尔茨海默病(AD)是否存在病因联系。方法 以人群为基础，将402例AD患者纳入病例组，384名健康老年人纳入对照组，以年龄、性别、受教育程度为匹配条仲，进行m：n配对的病例对照研究，条件Logistic模型进行单因素和多因素分析。吸烟和血管事件之间进行交互分析。结果 经多因素分析发现，50岁以上每月饮茶1～3次者在AD组中的比例低于其在正常对照组中的比例[OR(Odds Ratio)=0．757，P=0.0001]，随着饮茶频率的增加，OR值减少。几乎每人饮茶者OR值为0.4338。50岁以上吸烟量为0．1～9．9包-年在AD组中的比例低于其在健康对照组中的比例(OR=0．769，P=0．0602)，吸烟量≥10包-年者的OR值为0．5914。吸烟和血管事件之间存在反向交互作用。未发现饮酒与AD有关联。结论 饮茶可能是AD的保护因素，吸烟本身可能对AD具有保护作用，另外可能通过血管事件增加患AD的危险。饮茶、吸烟对AD的保护作用存在剂量一效应关系。本研究为在人群中预防和治疗AD提供了有益的线索。     

抑郁症患者吸烟对马普替林治疗作用的影响

目的探讨抑郁症患者吸烟对马普替林治疗剂量、疗效和不良反应的影响。方法对120例符合CCMD-3诊断标准的抑郁症患者,采用HAMD量表减分率评价其临床疗效,用TESS评定其安全性。对吸烟和不吸烟的抑郁症患者进行马普林治疗剂量、疗效和不良反应的比较。结果吸烟的抑郁症患者所服马普替林日平均剂量显著高于不吸烟的患者、疗效显著差于不吸烟患者,不良反应显著轻于不吸烟患者。结论抑郁症患者在马普替林治疗期间少吸烟或不吸烟,可以减少马普替林的用量和提高疗效。     

吸烟与精神分裂症临床特点的关系

目的探讨吸烟与精神分裂症患者临床特点之间的关系.方法采用临床资料表及PANSS量表对279例男性住院精神分裂症患者进行检查与评定,将吸烟者与非吸烟者之间若干临床指标进行f检验及x2检验,并对吸烟量与若干量表分数进行相关分析.结果279例男性患者中有吸烟者112例,其每日平均吸烟量为16.9士11.8支,81.3%的吸烟者在精神分裂症发病后开始吸烟.与非吸烟患者相比,病程多倾向于发作性,以往复发的次数较多.结论吸烟与患者的临床特征相关,在制定治疗康复计划时应予以考虑.     

Smoking, quitting, and psychiatric disease: a review

Tobacco smoking among patients with psychiatric disease is more common than in the general population, due to complex neurobiological, psychological, and pharmacotherapeutic mechanisms. Nicotine dependence exposes smokers with co-occurring mental illness to increased risks of smoking-related morbidity, mortality, and to detrimental impacts on their quality of life. The neurobiological and psychosocial links to smoking appear stronger in certain comorbidities, notably depression and schizophrenia. Through its action on the cholinergic system, nicotine may have certain beneficial effects across a range of mental health domains in these patients, including improved concentration and cognition, relief of stress and depressive affect, and feeling pleasurable sensations. Despite the availability of effective smoking cessation pharmacotherapies and psychosocial interventions, as well as increasing evidence that individuals with psychiatric disorders are motivated to quit, nicotine dependence remains an undertreated and under-recognized problem within this patient population. Evidence suggests that provision of flexible and individualized treatment programs may be successful. Furthermore, the complicated relationship observed between nicotine dependence, nicotine withdrawal symptoms, and mental illness necessitates integration of close monitoring in any successful smoking cessation program.     

脑卒中后抑郁与部位的相关性研究

目的：探讨急性期脑卒中患者影像学改变在脑卒中后抑郁（PSD）患者中的相关性和临床意义,期望早期发现PSD患者并为及时干预提供帮助。方法：对329例急性脑卒中后1个月内患者采用系统的神经心理评估和MRI检查。所有患者均常规行汉密尔顿抑郁量表（HAMD）评分,根据头颅MRJ结果分析病变部位。结果：PSD的发病率以左侧半球脑卒中患者明显高于双侧和右侧半球脑卒中患者,且左侧额叶和基底节尤为突出。不同病灶数目组间比较,PSD的发生率以多灶患者明显高于单灶患者（P〈0．01）。结论：急性脑卒中后PSD与病变部位在左侧半球尤其是左侧额叶、颞叶和基底节区具有显著相关性。完全前循环梗死也是易患PSD的危险因素。     

Atypical Epidemiologic Finding in Association between Depression and Alcohol Use or Smoking in Korean Male: Korean Longitudinal Study of Aging

Objective

The purpose of this study is to examine the relationship between substance use and depressive symptoms in a cohort of Koreans aged 45 years and older from a large, population-based study. Using the 2006 Korean Longitudinal Study of Aging, we estimated the prevalence of depressive symptoms and its association with smoking and alcohol use.

Methods

Depressive symptoms were measured using the CES-D 10-item scale. Age, marital status, educational attainment, employment and any disability were the control variables. Because there were gender differences in smoking and alcohol use, we also performed a separate analysis by gender.

Results

In the multivariable logistic regression, ex-drinkers were more likely to be depressed than non-drinkers (OR, 1.37; 95% CI, 1.08-1.74 for males; OR, 1.78; 95% CI, 1.23-2.57 for females). Compared to non-drinkers, males with moderate drinking habits (OR, 0.75; 95% CI, 0.63-0.90) were less likely to be depressed, whereas heavy male drinkers were more likely to be depressed (OR, 1.43; 95% CI, 1.07-1.91). Female smokers were more likely to be depressed than female non-smokers (OR, 2.07; 95% CI, 1.51-2.83).

Conclusion

This study showed atypical pattern of relationship between smoking and depression and U-shaped relationship between depressive symptoms and alcohol consumption in male population. Both of these findings could be inferred from that these regional characteristics might be cross-sectional finding of chronologic transition result from a rapid rise of late life depression in Korea.     

轻度认知障碍与卒中后抑郁关系的研究进展

轻度认知障碍（mild cognitive impairment,MCI）是认知正常和痴呆之间的过渡状态,MCI与 卒中后抑郁（post-stroke depression,PSD）关系密切。MCI常伴发抑郁,而PSD亦被认为是MCI向痴呆进展 的重要危险因素。本文就MCI与PSD关系的研究进展进行综述,着重介绍MCI和PSD关系的新进展,包 括流行病学、相关机制及治疗。     

吸烟与青年脑大动脉粥样硬化性狭窄的相关性分析

目的探讨吸烟与青年缺血性卒中患者脑大动脉粥样硬化性狭窄的相关性。方法2002～2004年于我院神经内科行血管造影检查的青年(18～49岁)脑卒中(包括短暂性脑缺血发作及脑梗死)患者93例,其中73例患者可能存在颅内或颅外大动脉粥样硬化性狭窄作为狭窄组,20例患者无大动脉狭窄作为无狭窄组,对两组患者的吸烟及其他危险因子进行调查。研究变量包括:人口学因子(如年龄、性别)、既往病史(包括高血压、糖尿病、长期吸烟及饮酒史)、实验室检测因子(血浆三酰甘油、高密度脂蛋白、低密度脂蛋白、同型半胱氨酸及血纤维蛋白原)。结果单变量分析发现,两组患者的长期吸烟率、高密度脂蛋白降低率、同型半胱氨酸及三酰甘油的升高率、高密度脂蛋白、纤维蛋白原水平间差别均无显著性意义(P＞0．05)。多变量Logistic回归分析发现,长期吸烟(OR=4．367, 95% CI 1．028-18．554,P=0．046)及血三酰甘油水平升高(OR=3．274,95% CI 1．083-9．900,P=0．036)与青年卒中患者脑大动脉粥样硬化性狭窄的发生有关。结论长期吸烟及血三酰甘油水平升高可能是青年卒中患者脑大动脉粥样硬化性狭窄的独立危险因子,应进行大样本的队列研究加以证实。     

The Effects of Maternal Depression on the Efficacy of a Literacy Intervention Program

The purpose of the present study was: (1) to determine whether depression was related to mother-child interactions in a group of low-income mothers participating in a literacy intervention; (2) to examine whether depression was related to retention; (3) to determine whether there were differential changes in depressed and non-depressed mothers in the intervention group. Participants included 488 ethnically diverse families. Depressed mothers engaged in fewer literacy enhancing behaviors with their children than non-depressed mothers and were more likely to drop out of the study. Depressed mothers were as likely to participate actively in the intervention, and benefited as much from the intervention as non-depressed mothers.     

Thyroid Function Therapeutic Efficacy of Thyroxine in Depression

Abstract: The authors administered 50–100 pg of thyroxine (T,) alone for 2 weeks to 20 patients with primary major depressive disorders, evaluated clinical changes, compared the thyroid functions before after the trial.
The results showed a significant decrease in the Hamilton Rating Scale scores, the efficacy of thyroid hormone alone was demonstrated against depression. It was also shown that this antidepressive effect varied widely from marked improvement to mild aggravation.
The degree of clinical improvement had no significant relationship with sex, age, subtype of depression, severity of symptoms before treatment. But it had significant positive correlations with the pre-trial T₃₉ T₄₉ T₃ uptake, free T, index BMR. That is, patients with a higher pre-trial thyroid function showed a greater improvement. Thus, it was suggested that the antidepressive effects is closely associated with the mechanism which suppresses endogenous thyroid hormones.     

Depression, Locus of Control, and the Effects of Epilepsy Surgery

The purposes of this investigation were (a) to determine the relationship between interictal depression and a potential psychosocial risk factor (locus of control), (b) to examine changes in self-reported depression after anterior temporal lobectomy (ATL), and (c) relate postoperative changes in depression to alterations in surgical outcome and locus of control. Thirty-seven patients with intractable seizures of temporal lobe origin were administered measures of depression and locus of control both preoperatively and 6 months postoperatively. Results revealed a significant preoperative relationship between depression and an external locus of control, but this relationship no longer existed postoperatively. Postoperative declines in depression were independent of any alterations in locus of control. Further analyses revealed that depression declined significantly only in patients rendered completely seizure-free by ATL, whereas patients who were significantly improved (greater than or equal to 75% reduction in seizure frequency) but continued to experience some seizure activity showed no changes in self-reported depression. Finally, a wide variety of neurologic and seizure-related variables were shown to be unrelated to depression. The clinical and theoretical significance of these findings is discussed.