双相情感性精神障碍患者迟发性运动障碍初探

调查３３例双相情感性精神障碍患者迟发性运动障碍（ＴＤ）有关的因素，并评估其认知功能。用迟发性运动障碍量表（Ｓｉｍｐｓｏｎ量表）、认知功能问卷调查，并收集临床资料。结果发现，有ＴＤ的比无ＴＤ的患者住院总次数多，因躁狂发作住院的次数多，抗精神病药治疗时间长，平均日剂量高，合并抗胆碱能药时间长。表明长期、高剂量抗精神病药治疗可能是双相情感性精神障碍病人ＴＤ产生的高危因素，且长期并用抗胆碱能药增加ＴＤ产生的危险。有无ＴＤ的病人认知功能并无差异。     

情感性精神障碍患者的药源性锥体外系症状

对情感性精神障碍患者出现药源性锥体外系症状（ＥＰＳ）研究较少，ＥＰＳ与锂盐的关系尚不清楚。有研究发现，接受抗精神病药治疗的情感性精神障碍患者比精神分裂症患者对ＥＰＳ（包括迟发性运动障碍，ＴＤ）有较高的易感性［１］。有关锂盐与ＥＰＳ间的关系，动物实验［...     

迟发性运动障碍与急性锥外系反应

目的：探讨抗精神病药所致的迟发性运动障碍（ＴＤ）的相关因素。方法：用不自主运动量表（ＡＩＭＳ），锥体外系副反应量表（ＲＳＥＳＥ）评定确认ＴＤ、急性锥体外系副反应（ＥＰＳ）存在，建立对照组。对所得临床资料进行统计学分析。结果：ＴＤ组年轻男性多，总服药时间长，服药剂量高，高效价药使用多，既往ＥＰＳ次数多，情感性精神障碍患者服药剂量比精神分裂症患者明显低。ＴＤ严重程度与各临床变量无显著相关性，ＡＩＭＳ≤     

长期抗精神病药治疗撤药时的运动障碍

目的：调查撤药出现的运动障碍（ＷＥ－Ｄ）是否为迟发性运动障碍（ＴＤ）的早期征象。方法：７１例精神分裂症病人停药２周,于停药前及停药后第２周末评定迟发性运动障碍量表（Ｓｉｍｐ－ｓｏｎ量表）及阴性症状量表,收集临床资料,并随访半年。结果：无ＴＤ组病人年龄、病程显著低于ＷＥ－Ｄ组及ＴＤ组病人;ＷＥ－Ｄ组与ＴＤ组病人间年龄、病程、抗精神病药治疗持续时间、平均剂量及阴性症状间无显著差异。结论：ＷＥ－Ｄ可能是ＴＤ的一个早期表现或为一隐匿性运动障碍     

丁螺环酮治疗迟发性运动障碍

丁螺环酮治疗迟发性运动障碍【英】／ＭｏｓｓＬＥ…／／Ｊ　ＣｌｉｎＰｓｙｃｈｏｐｈａｒｍａｃｏｌ－１９９３，１３（３）：－２０４～２０９有人报告抗精神病药治疗的病人有近２０％存在迟发性运动障碍（ＴＤ）。以往曾用胆碱能药、胺类合成阻滞剂、胺类耗竭剂、γ－...     

纳洛酮治疗迟发性运动障碍3例

纳洛酮治疗迟发性运动障碍３例郑俊忠郑璇庄伟端我们用纳洛酮治疗抗精神病药引起的迟发性运动障碍（Ｔａｒｄｉｖｅｄｙｓｋｉｎｅｓｉａ，ＴＤ），有一定疗效。举典型３例报道如下：例１男３４岁，１９８３年患精神分裂症，曾在本市精神病院住院。常年服奋乃静１２～２０...     

迟发性运动障碍出现率及其危险因素的调查分析

目的本文调查了住院５年至１０年之间病人的迟发性运动障碍（ＴＤ）的出现率及其危险因素。方法采用“Ｓｉｍｐｓｏｎ迟发性运动障碍评分表”为工具，共调查了１０７例住院病人。确定有ＴＤ的标准是面部、唇部、颌部、舌部、颈部和躯干、上肢和下肢中至少有两个部位具轻度或轻度以上的异常运动。结果ＴＤ总的出现率为３７４％。ＴＤ组首次发病年龄显著高于无ＴＤ组（ｔ＝２．０９，Ｐ＝０．０３９）；服用抗精神病药物的剂量也显著低于无ＴＤ组（ｔ＝－２．００，Ｐ＜０．０４８）。服用抗精神病药的同时联用安坦者，ＴＤ出现率显著低于未联用者（χ２＝７．１，Ｐ＜０．０１）。结论在我国长期住院病人ＴＤ的出现率并不低于西方的报道。发病年龄晚者在服用抗精神病药以后更容易出现ＴＤ；抗精神病药与安坦联用者，ＴＤ出现率显著低于未联用者     

迟发性锥体外系综合征的危险因子分析

抗精神病药物导致的迟发性锥体外系综合征（ＴＥＳ）由迟发性运动障碍（ＴＤ）发展而来。ＴＥＳ分ＴＤ、迟发性肌张力障碍（ＴＤＴ）等多个亚型，以ＴＤ最多见。ＴＥＳ的治疗无特效方法，因此预防尤为重要。本研究对上海地区七个精神病医疗单位进行普查，诊断ＴＥＳ１１３例，并采用病例－对照研究设计，对２３个相关因素进行Ｌｏｇｉｓｔｉｃ回归分析，推测ＴＥＳ的危险因子。结果发现，年龄、性别、抗胆碱能药物、用药总时间和目前用药量等五个因素在０．０５或０．０１水平上对ＴＥＳ的存在有显著意义上的作用。氯氮平、急性锥体外系统综合征还不能肯定为危险因子。     

迟发性运动障碍与吸烟的关系

迟发性运动障碍与吸烟的关系黄雄，许美庭，黄杏梅，高广斌迟发性运动障碍（Ｔ８ｒｄｉｖｅＤｖｓｋｉｎｅｓｉａＴＤ）是饮用抗精神病药物过程中出现的一种严重副反应，劫团结今未明，近年来许多研究表明，它与许多因素有为但吸烟对ＴＤ产生是否有影响，国内外报道甚少．...     

长期服抗精神病药病人的隐性运动障碍

目的：评估抗精神病药对迟发性运动障碍（ＴＤ）的掩盖,即隐性运动障碍（ｃｏｖｅｒｔ ｄｙｓｋｉｎｅ－ｓｉａ）状况。方法应用Ｓｉｍｐｓｏｎ运动障碍评分表评定ＴＤ。入组的６９例病人有２３例病人完成了减药之前、停药三周后和再服药四个月后的ＴＤ评定,６９例次检查都给于隶像,并且两个评定者按照录像独立评定ＴＤ是否存在,评定ＴＤ的一致性良好（ＩＣＣ＝０．７５）。结果完成整个调查的２３例病人中,减药前ＴＤ出现率为     

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 -