氯丙咪嗪合并利培酮治疗强迫症的对照研究

目的探讨利培酮对于氯丙咪嗪治疗强迫症的增效作用。方法将70例强迫症随机分为2组,氯丙咪嗪同时合并利培酮和单独使用氯丙咪嗪治疗,治疗8周。采用强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评定疗效。结果合并利培酮组有31例完成试验,氯丙咪嗪组有32例完成试验。治疗8周后,两组Y-BOCS平均总分有明显下降,合并利培酮组优于氯丙咪嗪组,两组无显著性差异(P<0.05);HAMA、HAMD的评分均显著下降,两组无显著性差异(P>0.05)。结论合并利培酮对于氯丙咪嗪治疗强迫症有增效作用。     

米氮平治疗抑郁症的临床疗效

目的　评价米氮平治疗抑郁症的临床疗效和安全性。方法　对符合CCMD 3抑郁症诊断标准的 5 3例抑郁症患者进行米氮平和丙咪嗪的对照研究 ,其中米氮平组 30例 (15～ 4 5mg/d) ,丙咪嗪组 2 3例 (10 0～ 2 0 0mg/d) ,共治疗 6周。采用汉密顿抑郁量表HAMD ,汉密顿焦虑量表HAMA ,临床总体评定量表CGI评定临床疗效 ,副反应量表TESS评定不良反应。结果　经 6w治疗后 ,米氮平组治疗总有效率为 87% ,显效率为 6 9% ,丙咪嗪组分别为 86 %和 6 7% ,两组相比较 ,差异无显著性 (P >0 0 5 )。米氮平组治疗第 1周就起效。两组的HAMD ,AHMA评分治疗前后相比较差异有高度显著性(P <0 0 1) ;两组之间比较差异无显著性 (P >0 0 5 )。米氮平组的不良反应相对于丙咪嗪组少而轻 ,常见的有头昏、口干、胃肠不适等。结论　米氮平治疗抑郁症疗效好 ,起效快 ,不良反应少而轻 ,适合临床应用。     

舍曲林与氯丙咪嗪治疗少年强迫症的对照研究

目的 探讨舍曲林与氯丙咪嗪治疗少年强迫症的临床疗效及不良反应.方法 将64例少年强迫症患者随机分为舍曲林组和氯丙咪嗪组,疗程均为8周.分别于治疗前和治疗后2、4、6、8周采用Yale-Brown强迫量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效,采用副反应量表(TESS)评定不良反应.结果 舍曲林组和氯丙咪嗪组治疗后,Y-BOCS、HAMD、HAMA分值均显著下降,差异无统计学意义.舍曲林不良反应发生率明显少于氯丙咪嗪.结论 舍曲林治疗少年强迫症与氯丙咪嗪疗效相当,不良反应较轻.     

舍曲林与氯丙咪嗪治疗强迫症的对照研究

目的比较舍曲林与氯丙咪嗪治疗强迫症的疗效和不良反应。方法应用舍曲林和氯丙咪嗪治疗强迫症各30例，应用Yale-Brown强迫量表、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)及临床4级标准评定疗效。结果舍曲林与氯丙咪嗪治疗后Yale-Brown强迫量表分值、HAMD、HAMA分值均显著下降，两组间减分比较，差异无显著性，舍曲林不良反应发生率明显少于氯丙咪嗪。结论舍曲林治疗强迫症疗效与氯丙咪嗪相当，不良反应较轻，值得推广。     

米氮平与氯丙咪嗪治疗强迫症的对照研究

目的　探讨米氮平与氯丙咪嗪治疗强迫症疗效及副作用比较。方法　选择符合诊断标准的强迫症60例,随机分为米氮平与氯丙咪嗪两组　米氮平组平均(53.6±5.1)mg/d;氯丙咪嗪组平均(215.6±37.6)mg/d。观察8周。结果　两组疗效比较无显著差异,米氮平组第1 周末起效,氯丙咪嗪组第4 周末起效,起效时间两组比较差异显著(P<0.05);副反应两组比较米氮平显著较低(P<0.01)。结论　米氮平是一种安全有效的抗强迫症药物。     

国产吗氯贝胺治疗抑郁症的双盲对照研究

目的　对照研究吗氯贝胺治疗抑郁症的疗效及其安全性。方法　用丙咪嗪作对照药物 ,采用双盲对照的方法 ,用HAMD、HAMA、SDS、SAS评定病情的变化 ,用TESS评定不良反应。结果　 2 0例 ( 10对 )病例完成了 4周的临床研究 ,吗氯贝胺组和丙咪嗪组的HAMD、HAMA评分均有显著性下降 (P <0 0 1) ,而两组之间疗效无显著性差异 (P >0 0 5 )。结论　吗氯贝胺是一种有效而又较安全的抗抑郁药     

米氮平治疗强迫症的疗效对照观察

目的 探讨米氮平治疗强迫症的疗效及不良反应.方法 将58例强迫症患者随机分为两组,分别以米氮平和氯丙咪嗪治疗8周.用Yale-Brown强迫症量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)、不良反应量表(TESS)评定疗效和不良反应.结果 米氮平与氯丙咪嗪治疗强迫症疗效相似,但前者起效更快,不良反应少.结论 米氯平是一种安全有效的抗强迫症药.     

帕罗西汀与氯丙咪嗪治疗强迫症对照研究

目的探讨帕罗西汀治疗强迫症的疗效和不良反应。方法应用帕罗西汀和氯丙咪嗪治疗强迫症各30例,应用Yale-Brown强迫量表(Y-BOCS)、汉密顿抑郁量表(HAMD),汉密顿焦虑量表(HAMA)及临床4级标准评定疗效,用副反应量表(TESS)评定副反应。结果帕罗西汀与氯丙咪嗪疗效相似,两组显效率及有效率差异无显著性,帕罗西汀不良反应发生率明显少于氯丙咪嗪。结论帕罗西汀治疗强迫症疗效与氯丙咪嗪相当,不良反应较轻,值得推广。     

吗氯贝胺治疗抑郁症的双盲对照研究

目的　评估吗氯贝胺和丙咪嗪治疗抑郁症的疗效和副反应。　　方法　采用随机双盲对照的研究方法 ,以吗氯贝胺及丙咪嗪治疗 60例郁抑症 6周 ,比较两组HAMD、HAMA和TESS评分。　　结果　吗氯贝胺与丙咪嗪疗效相似 (有效率分别为 96.6%与 85.2 % ) ,但吗氯贝胺的副作用少于丙咪嗪。　　结论　吗氯贝胺是一种有效而安全的抗抑郁剂。     

丁螺环酮对抑郁症的辅助治疗

目的：探讨加用丁螺环酮对丙咪嗪治疗无效的抑郁症的疗效。方法：随机对38例丙咪嗪治疗无效的抑郁症患者分成A、B两组。A组加用丁螺环酮,B组继续原治疗不变。采用Hamilton抑郁量表（HAMD）、Asberg抗抑郁副作用量表（ASBS）进行评定。结果：第6周末,A组HAMD总分减分率为41．6％,好转率为52．3％（10／19）;B组分别为17．7％及10．5％（2／19）。两组差异显著。结论：加用丁螺环酮对部分丙咪嗪治疗无效的抑郁症有一定疗效,且不增加副反应。     

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.