卒中后抑郁状态患者的血浆、脑脊液单胺类神经递质测定

目的　探讨卒中后抑郁状态与血浆、脑脊液单胺类递质水平的关系。方法　采用高压液相色谱仪 ,测定 32例卒中后抑郁状态患者、30例卒中后无抑郁状态患者及 2 8名正常人的血浆、脑脊液单胺类递质水平 ,进行对照分析。结果　卒中后抑郁状态患者血浆、脑脊液中单胺类递质水平[多巴胺 (DA) =(2 6± 0 4) μmol L ,(2 0± 0 3) μmol L ;去甲肾上腺素 (NE) =(0 19± 0 0 6 ) μmol L ,(0 14± 0 0 6 ) μmol L ;5 羟色胺 (5 HT) =(1 0 9± 0 30 ) μmol L ,(0 6 0± 0 12 ) μmol L]低于卒中后无抑郁组 [DA =(3 2± 0 5 ) μmol L ,(2 6± 0 4) μmol L ;NE =(0 31± 0 12 ) μmol L ,(0 2 8± 0 0 8) μmol L ;5 HT=(1 31± 0 40 ) μmol L ,(1 11± 0 40 ) μmol L]及正常对照组 [DA =(2 9± 0 5 ) μmol L ,(2 2± 0 6 )μmol L ;NE =(0 2 7± 0 70 ) μmol L ,(0 2 3± 0 0 8) μmol L ;5 HT =(1 19± 0 30 ) μmol L ,(0 88± 0 0 7)μmol L],而大脑左侧及前部卒中患者的血浆、脑脊液中单胺类递质水平低于其它卒中部位患者 (P <0 0 5 ) ,脑脊液单胺类递质水平与抑郁程度呈负相关 (P <0 0 5 )。结论　卒中后抑郁状态的发生与血浆、脑脊液中单胺类神经递质的降低有关     

立体定向毁损大鼠杏仁核及隔核对脑内单胺类递质含量的影响

目的 :探讨杏仁核及隔核毁损后AMP模型大鼠脑内单胺类递质含量的变化。方法 :经腹腔注射苯丙胺 (amphetamine ,AMP)制作精神分裂症动物模型 ,用立体定向技术电极毁损大鼠杏仁核及隔核 ,采用荧光分光光度法和放射免疫法测定大鼠前额叶、间脑和脑干多巴胺 (DA)、5 羟色胺 ( 5 HT)和去甲肾上腺素 (NE)的含量。结果 :杏仁核及隔核毁损组前额叶DA低于模型组 (P <0 0 1) ,5 HT、NE均高于模型组 (P <0 0 1) ;杏仁核及隔核毁损组间脑DA、NE均低于模型组 (P <0 0 1) ,5 HT高于模型组 (P <0 0 1) ;脑干DA、NE均低于模型组 (P <0 0 1) ,5 HT高于模型组 (P <0 0 1)。结论 :AMP模型大鼠前额叶和脑干DA含量增高、5 HT和NE含量下降 ,间脑DA、NE含量增高、5 HT含量下降 ,立体定向毁损杏仁核及隔核能够改变脑内单胺类递质的水平。     

强迫症、抑郁症及焦虑症患者血小板5-羟色胺浓度的对照研究

目的　研究 5 羟色胺 ( 5 HT)在强迫症发病中的作用及强迫思维与强迫动作亚组、抑郁症及焦虑症患者间血小板 5 HT含量的差异。方法　采用高效液相色谱法 ,分别测定 2 9例强迫症患者 [(强迫症组 ,根据Y BOCS强迫量表因子得分将其分为强迫思维 ( 16例 )、强迫动作 ( 7例 )和混合性( 6例 ) 3组 ]、2 0例抑郁障碍患者 (抑郁症组 )、17例焦虑障碍患者 (焦虑症组 )和 2 8名正常人 (正常人组 )的血小板 5 HT含量。结果　强迫症组血小板 5 HT水平 [( 139± 172 ) μg/L]低于正常人组 [( 2 4 8±2 15 ) μg/L]及焦虑症组 [( 397± 4 0 1) μg/L],差异具有显著性 (P =0 0 39;P =0 0 2 0 ) ;与抑郁症组 [( 2 0 2± 16 2 ) μg/L]的差异无显著性 ( P >0 0 5 ) ;强迫思维 [( 85± 6 6 ) μg/L]与强迫动作组 [( 16 9± 10 0 ) μg/L]间血小板 5 HT含量的差异有显著性 (P =0 0 2 5 )。结论　强迫症患者 5 HT浓度变化与抑郁障碍患者趋同 ,与焦虑障碍患者的差异有显著性 ;单纯强迫思维者的 5 HT浓度与单纯强迫动作患者的差异有显著性     

精神分裂症患者脑脊液单胺类神经递质含量与疗效

目的:探讨精神分裂症患者脑脊液(CSF)内多巴胺(DA)、高香草酸(HVA)含量的变化及其临床意义。　方法:86例首发精神分裂症,用利培酮治疗6个月,于治疗前及治疗6个月后采用高效液相色谱电化学(HPLC -ECD)法检测CSF中的DA及HVA含量,并与32名健康人进行对照。患者组同时用阳性与阴性症状量表(PANSS)评定临床疗效。　结果:患者组在治疗前CSF中DA和HVA含量分别为(3.2 3±0 .36 ) μmol/L和(1.99±0 .4 9) μmol/L ,显著高于对照组(2 .4 4±0 .32 ) μmol/L和(1. 4 1±0 . 37)μmol/L ;患者组治疗6个月后分别为(2 .4 9±0 .35 ) μmol/L和(1.4 2±0 .2 8) μmol/L。其治疗后降低值与PANSS总分的减分差值呈显著正相关。　结论:精神分裂症患者CSF内DA和HVA含量显著增高,利培酮对精神分裂症的疗效与DA和HVA含量的变化密切相关。同时进一步验证了精神分裂症患者中枢神经系统DA功能亢进的假说。     

帕金森病患者立体定向手术前后脑脊液单胺类递质含量的改变

目的　研究帕金森病 (PD)患者脑立体定向手术前后脑脊液 (CSF)中单胺类递质含量的变化。方法测定 2 6例原发性PD患者 (PD组 )脑立体定向术前、后CSF中多巴胺 (DA)、5 羟色胺 (5 HT)、去甲肾上腺素 (NE)及其代谢产物高香草酸 (HVA)、5 羟吲哚乙酸 (5 HIAA)、3 甲氧基 4羟基苯乙二醇 (MHPG)的含量 ,另外测定 2 5例外科疾病腰麻手术患者 (对照组 )CSF中HVA、5 HIAA、MHPG含量。结果　PD组CSF中HVA、5 HIAA、MHPG含量明显低于对照组 (P <0 0 0 1、P <0 0 5、P <0 0 0 1) ;手术后组的CSF中DA、HVA ,、5 HT、5 HIAA、NE、MHPG含量明显高于手术前组 (其中DA、HVA、5 HT、5 HIAA和NE均P <0 0 0 1;MHPGP <0 0 5 )。结论　PD患者CSF单胺类神经递质代谢产物含量明显降低 ,脑立体定向术可提高PD患者脑部单胺类神经递质及其代谢产物的含量 ,其发生机制可能与DA能神经元的保护作用有关     

应激对大鼠海马谷氨酸、天冬氨酸和γ-氨基丁酸含量的影响

目的　探讨应激对大鼠海马谷氨酸、天冬氨酸和γ 氨基丁酸 (GABA)含量的动态影响。方法　将 72只健康雄性大鼠随机分为 5个应激暴露不同时间组和对照组 ,每组 12只。利用高效液相色谱仪 紫外检测法 ,分别于应激第 1,3,7,14和 2 8天观察应激对大鼠海马谷氨酸、天冬氨酸及GABA含量的影响。结果　应激第 1天组大鼠海马谷氨酸和天冬氨酸含量与对照组相比 ,差异无显著性 ;但GABA含量 [(2 74 7± 0 339) μmol/g]低于对照组 [(3 719± 0 5 2 8) μmol/g;P <0 0 5 ]。应激第 3,7,14和 2 8天组谷氨酸含量 [分别为 (7 818± 0 799) μmol/g ,(9 0 0 7± 0 5 2 0 ) μmol/g,(8 0 4 9± 0 733) μmol/g和 (8 12 9± 1 5 5 6 ) μmol/g]高于对照组 [(6 4 11± 0 6 38) μmol/g];天冬氨酸含量 [分别为 (2 717± 0 2 5 8)μmol/g,(2 6 96± 0 317) μmol/g,(2 82 8± 0 4 6 8) μmol/g和 (4 6 4 9± 0 6 37) μmol/g]也高于对照组 [(2 0 0 3± 0 2 71) μmol/g];均P <0 0 1。应激第 14天组和 2 8天组GABA含量 [分别为 (4 4 6 2± 0 883) μmol/g和(4 4 97± 0 85 7) μmol/g]高于对照组 (P <0 0 5～0 .0 0 1) ,应激第 3天组和 7天组的GABA含量与对照组间的差异无显著性。结论　应激第 3天开始     

氯氮平治疗对以阳性或阴性症状为主的精神分裂症患者血清一氧化氮含量的影响

目的　探讨以阳性症状为主 (以下简称阳性 )或阴性症状为主 (以下简称阴性 )的精神分裂症患者用氯氮平治疗前后血清一氧化氮 (NO)含量变化及其与疗效的关系。方法　对 32例阳性患者、30例阴性患者均用氯氮平 (30 0mg/d)治疗 8周。用阳性症状评定量表 (SAPS)和阴性症状评定量表 (SANS)评定其疗效。治疗前及治疗第 8周末分别检测血清NO含量 ,并与 2 8名健康志愿者 (对照组)比较。结果　治疗前阳性组、阴性组及对照组血清NO含量分别为 :(5 9± 16 ) μmol/L、(2 6± 7) μmol/L和 (38± 11) μmol/L ,三组间的差异有非常显著性 (P <0 0 1)。治疗前阳性组血清NO含量与SAPS总分呈显著正相关 (r =0 6 92 ,P <0 0 1) ;阴性组血清NO含量与SANS总分呈显著负相关(r=- 0 916 ,P <0 0 1)。治疗第 8周末阳性组血清NO含量降低至 (39± 8) μmol/L ,其NO降低值与SAPS减分率之间呈显著正相关 (r=0 86 8,P <0 0 1) ;阴性组血清NO含量升高至 (32± 8) μmol/L ,显著高于治疗前 (P <0 0 5 ) ,但仍低于对照组 (P <0 0 1)。NO升高值与SANS减分率呈负相关(r=- 0 916 ,P <0 0 1)。结论　以阳性症状为主与以阴性症状为主的精神分裂症患者血清NO含量的差异有显著性 ;患者血清NO含量变化与疗效之间高度相关。氯氮平可能     

急性脑卒中后焦虑抑郁共病状态血清单胺类递质的变化研究

目的探讨急性脑卒中后焦虑抑郁共病患者血清单胺类递质水平的关系。方法采用荧光分光光度计法测定33例急性卒中后焦虑抑郁共病患者、22例急性卒中后抑郁患者、49例卒中后非焦虑抑郁患者及37例正常人血清单胺类递质的水平。结果急性脑卒中后焦虑抑郁共病组和PSD组血清中，NE、5-HT、DA含量低于非焦虑抑郁组和对照组，共病组NE、5-HT高于抑郁组，其中5-HT差异有显著意义，而非焦虑抑郁组血清中，单胺类递质的含量亦低于对照组。而大脑左侧及前部卒中患者的血清中单胺类递质水平低于其它卒中部位患者（P〈0．05）。结论急性脑卒中后焦虑抑郁共病组和单纯PSD的发生与血清中单胺类神经递质的降低有关。     

癫痫患儿血清一氧化氮和一氧化氮合酶含量的变化及意义

目的　探讨癫疒间 患儿血清一氧化氮 (NO)、一氧化氮合酶 (NOS)的变化及意义。方法　利用ELISA方法 ,测定 5 8例癫疒间 患儿 (癫疒间 组 )和 2 3名健康儿童 (对照组 )血清中NO、NOS的含量 ,并分组比较不同条件下其含量的变化。结果　癫疒间 组血清NO、NOS的含量分别为 (5 .86± 1.2 1) μmol/ml和 (2 8.2 6± 8.4 9)U/ml,较对照组的 (3.78± 0 .74 ) μmol/ml及 (17.86± 4 .5 8)U/ml明显升高 (P <0 0 1) ;发作近期为 (7.31± 1.2 7)μmol/ml和 (31.2 5± 11.35 )U/ml,明显高于发作间期 (4 .2 7± 0 .6 6 ) μmol/ml和 (2 4 .15± 7.85 )U/ml(P <0 0 1) ;癫疒间 组EEG异常者为 (7.18± 1.35 ) μmol/ml和 (34.4 8± 8.5 6 )U/ml,明显高于EEG正常者 (4 .0 4± 0 .75 ) μmol/ml和 (2 2 .85± 7.4 5 )U/ml(P <0 0 1) ;但与发作类型、病程及是否接受治疗无关 (P >0 0 5 )。结论　癫疒间 发作近期血中NO、NOS生成增加 ,NO作为内源性调质参与癫疒间 发作病理生理过程     

动脉粥样硬化性血栓性脑梗死患者血清总胆红素水平变化的研究

目的　探讨动脉粥样硬化性血栓性脑梗死 (ATCI)患者血清总胆红素水平的变化及其临床意义。方法　测定 6 8例ATCI患者急性期和恢复期 (4 8例 )的血清总胆红素浓度及血浆氧化修饰低密度脂蛋白 (ox LDL)含量。比较轻中重型患者的血清总胆红素浓度。结果　ATCI患者急性期血清总胆红素浓度为 (12 4 1±4 76 ) μmol/L ,显著低于健康对照者的 (16 15± 5 82 ) μmol/L(P <0 0 1) ;重型者为 (10 2 4± 1 6 8) μmol/L ,显著低于轻型者的 (13 6 5± 3 4 9) μmol/L(P <0 0 1) ;而血清总胆红素浓度与病程及病变部位无关 ;血清总胆红素浓度变化与血浆ox LDL水平变化呈显著直线负相关 (r=- 0 4 2 7,P <0 0 1)。结论　血清总胆红素浓度降低可能在ATCI的发病中起一定的作用     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.