以阳性或阴性症状为主的精神分裂症患者脑脊液催乳素水平测定

目的　探讨以阳性症状为主 (以下简称阳性 )和以阴性症状为主 (以下简称阴性 )的精神分裂症患者脑脊液催乳素 {PRL)水平及氯氮平治疗前后的变化。方法　对 2 6例阳性精神分裂症患者 (阳性组 )和 2 2例阴性精神分裂症患者 (阴性组 )用氯氮平治疗 6周 ,用简明精神病量表 (BPRS)、阳性症状量表 (SAPS)或阴性症状量表 (SANS)评定疗效。治疗前及治疗 6周末用放射免疫测定法测定患者脑脊液PRL水平。结果　治疗前阳性组PRL水平 [(1.0 8± 0 .39) μg/L]低于阴性组 [(1.34± 0 .4 1) μg/L],P <0 .0 5 ;治疗后阳性组PRL水平 [(1.16± 0 .35 ) μg/L]较治疗前升高 ,阴性组 [(1.2 4± 0 .4 6 ) μg/L]较治疗前降低 ,差异均无显著性 (P >0 .0 5 )。两组治疗后BPRS、SAPS或SANS总分较同组治疗前下降均有极显著性差异 (P <0 .0 1)。结论　阳性和阴性精神分裂症患者脑脊液PRL基础水平有差异 ,氯氮平对精神分裂症患者脑脊液PRL水平影响较小。     

氯氮平治疗精神分裂症阴性阳性症状的临床研究

氯氮平治疗精神分裂症阴性阳性症状的临床研究杨甫德，吉中孚，刘华清抗精神病药对精神分裂症的阳性和阴性症状的疗效尚有不同意见，一般认为对阳性症状效果较好，见效较快，对阴性症状则较差较慢；也有人认为两者变化呈正相关的关系。氯氮平对阴性阳性症状的作用，也有不...     

阳性和阴性症状精神分裂症患者的血清睾丸酮水平测定结果与比较

目的 探讨阳性、阴性症状精神分裂症患者和正常对照组三者间血清总睾丸酮（T－Tes)和游离睾丸酮（F－Tes)水平的变化。方法 采用放射免疫分析法（RIA）和酶联免疫分析法（ELISA）,对阳性症状患者（78例）、阴性症状患者（94例）和正常人对照组（100例）的血清T－Tes和F－Tes水平进行测量和比较。结果 阴性症状患者血清T－Tes和F－Tes水平明显低于阳性症状患者组和正常对照组,差异有显著性（P＜0．05,P＜0．05）;阳性症状者组血清T－Tes和F－Tes水平与正常对照组相比较,虽有差异但无显著性（P＞0．05）。结论 精神分裂症患者的血清Tes水平存在一定的改变,尤以阴性症状患者血清Tes水平处于低值状态,提示该型患者下丘脑－垂体－性腺轴系统功能低下。     

精神分裂症患者认知功能损害与阴阳性症状的关系

目的：探讨精神分裂症认知功能损害与阴性、阳性症状的关系。方法:至73例入组的患者随机给予利培酮、氯氮平治疗12周,并于治疗前、后盲法评定Wisconsin卡片分类测验（WCST）,Wechsler记忆测验（WMS）,阴状症状评定量表（SANS）与阳性症状评定量表（SAPS）。结果：治疗前精神分裂症患者的阴性症状、阳性症状均与认知功能有显著相关。主要与执行功能相关;注意障碍与记忆相关。治疗后,仅SAPS中怪异行为得分与WCST的持续反应数、持续错误数显著相关。结论：精神分裂症的认知功能损害是原发性的,并不是在阳性、阴性症状基础上产生的。     

精神分裂症症状与认知功能损害的关系

目的：探讨精神分裂症症状与认知功能损害的关系。方法：对１８例阴性精神分裂症和１５例阳性精神分裂症采用氯氮平治疗;对１１例阴性精神分裂症和１３例阳性精神分裂症采用利培酮治疗。并分别评估其治疗前和治疗８周后的阳性症状,阳性症状记忆,注意及执行功能。结果：精神分裂症的记忆损害与阴性症状和阳性症状都呈显著性相关,注意及执行功能损害与阴性症状显著相关,与阳性症状无明显相关;记忆随思维贫乏的改善而改善,注意和执行功能损害的改善与症状的改善无明显相关。结论：精神分裂症认知功能损害主要与阴性症状相关,但精神分裂症的大部分认知功能并不随阴性症状改善而改善。     

精神分裂症记忆与阳性、阴性症状的研究

目的探讨精神分裂症患者记忆特点及与阳性、阴性症状的关系。方法采用修正的加工分离记忆实验程序测试精神分裂症患者记忆变化情况,用PANSS评定精神分裂症患者阳性、阴性症状分。结果精神分裂症外显记忆与对照组比较明显受损(P0.05),其文字概念和图像概念实验类型驱动的内隐记忆成绩与对照组比较也受损(P0.05);阳性症状为主的患者外显记忆成绩均高于阴性症状为主的患者组(P0.05);阳性症状为主的患者内隐记忆成绩与以阴性症状为主的患者组之间的差异无统计学意义(P0.05);阳性症状与外显记忆无显著相关关系(P0.05),阴性症状与外显记忆呈显著负相关关系(P0.01);阳性症状、阴性症状与内隐记忆均无显著相关关系(P0.05)。结论精神分裂症外显记忆严重受损,而内隐记忆不同程度的受损;外显记忆与阳性症状无相关性,与阴性症状有显著相关;内隐记忆与阳性、阴性症状均无明显相关性。     

对阴性症状和阳性症状认识的评价（四）：四,精神分裂症症状流变学

对阴性症状和阳性症状认识的评价（四）四、精神分裂症症状流变学金卫东，王高华对精神分裂症的多巴胺假说提出疑问之后，继而转向阴性症状等诸方面的研究，充分显示了阴性症状在生物学、遗传学、神经心理学等方面与阳性症状不同，甚至截然相反，由此引起了人们对这两组症...     

阴性阳性症状与出院疗效等的关系

作者根据主要临床表现(阴性或阳性症状)、遗传史、及男女性别,分析2364例精神分裂症住院病人的出院疗效,以期了解这些因素的预后价值。方法由二位主治医师按1984年黄山会议制定的精神分裂症诊断标准,重新肯定精神分裂症计2364例。并按病情记录,参照 Andreasen 的标准分为阴性症状为主与阳性症状为主的二组。阳性症状组共2169例,占95.55%,其中有遗传史者756例(35%),无     

The simon effect in schizophrenic patients with negative symptoms

Automatic shifting of visual attention was investigated using the Simon task in schizophrenic patients with prevailing negative symptomatology. Reaction times were recorded in condition of spatial correspondence and non-correspondence between side of spatially defined responses and side of stimulus presentation. Schizophrenic patients showed asymmetries between the two hemifields attributable to a slowing down of reaction times for non-corresponding trials in the left hemifield. These results are interpreted as a deficit in the process that inhibits the automatic corresponding response, and in general as a difficulty to inhibit dependence on external stimuli, in the left hemifield/right hemisphere.     

Positive and negative symptoms of schizophrenia and linguistic performance

Selected subjects from a group of first onset schizophrenics (aged under 30 years) were taken from a previous study and placed in one of two groups depending upon whether they had exclusively positive symptoms (n = 9) or a mixture of positive and negative symptoms (n = 9). Their linguistic profiles were compared with those of a group of controls (n = 10) matched for educational attainment and parental social class. Both groups of schizophrenics had significantly lower integrity scores, suggesting that they made more syntactic and semantic errors. Those patients who presented with negative symptoms tended to have speech of lower syntactic complexity than the other two groups, although the difference just failed to reach statistical significance. It is suggested that syntactic and semantic errors are state dependent features associated with positive symptoms, whereas low syntactic complexity may be a more enduring feature associated with the presence of negative symptoms.     

有暴力行为男性精神分裂症患者执行功能研究

目的:研究有暴力行为的男性精神分裂症患者的执行功能。方法:对75例有暴力行为史的男性精神分裂症患者(暴力组)和43例无暴力行为史的男性精神分裂症患者(对照组)收集一般资料,评定阳性和阴性症状量表(PANSS),采用言语流畅性测验、连线测验(TMT)、威斯康星卡片分类测验(WCST)和Stroop色词测验评定受试者的执行功能。结果:暴力组的Stroop卡五2min内正确数成绩比对照组显著为差(t=-2.58,P=0.01),暴力组的WCST分类数成绩比对照组显著为差(t=-2.27,P=0.02)。其余认知指标(SIE正确数、SIE时间、卡四2min内正确数、卡四完成时间、卡五完成时间、WCST正确数、WCST错误数、WCST持续错误数、TMT-A时间、TMT-B时间、言语流畅正确数)两组间差异无统计学意义(P均≥0.05)。结论:有暴力行为史的男性精神分裂症患者执行功能较没有暴力行为史的损害明显。     

分裂样精神病与精神分裂症阴性、阳性症状比较

目的：探讨分裂样精神病与精神分裂症阴性和阳性症状的特点。方法：对49例分裂样精神病与70例精神分裂症患者的阴性和阳性症状作对照研究。结果：两组患者阳性和阴性症状的发生率差异无显著性（P〉0.05）;分裂样精神病组中有妄想症状者明显多于精神分裂症组;而精神分裂症组中情感平淡、思维贫乏等阴性症状者明显多于分裂样精神病（P〈0.01）。结论：分裂样精神病与精神分裂症在阴性、阳性症状方面存在差异。     

White matter alterations in schizophrenic patients with pronounced negative symptomatology and with positive family history for schizophrenia

BACKGROUND: In recent years, in vivo and post-mortem studies detected structural brain changes in schizophrenia. The aim of our analysis was to investigate potential changes of white matter in schizophrenic patients compared to controls, and the relationship to clinical characteristics. METHODS: Fifty male, right-handed schizophrenic patients who met DSM-IV criteria for schizophrenia were recruited. Fifty right-handed, age- and sex-matched subjects without a psychiatric disorder were enrolled as controls. Volumes of white matter in several brain regions were measured by 1.5 T MRI using a volumetry and segmentation software (BRAINS). Regions of interest including frontal, temporal, parietal, occipital and subcortical areas were determined using Talairach spaces. RESULTS: No significant differences in white matter volumes of total brain tissue and regions of interest were detected between patients and controls. A significant reduction of white matter in parietal cortex of right hemisphere was found in a subgroup of patients with pronounced negative symptoms. Furthermore, patients with first-grade relatives suffering from schizophrenia showed a reduction of subcortical white matter in the right hemisphere. CONCLUSIONS: Our results indicate that subgroups of schizophrenic patients show alterations of white matter in distinct brain regions, including the right parietal lobe.     

Prevalence and background factors of depression in first admitted schizophrenic patients

OBJECTIVE: The aim of this study was to investigate the prevalence and background factors of depression in first admitted schizophrenic patients. METHOD: The study is an analysis of 998 consecutively admitted schizophrenic patients with their first hospitalization. Patient's characteristics were prospectively assessed using standardized instruments at the time of first admission and discharge. RESULTS: High prevalence rates of depressive symptoms were found. Depressed schizophrenic patients were more likely to have suicidal tendencies, were older, more frequently married, less frequently single and unemployed and had more family members with psychiatric disorders other than schizophrenia than the non-depressed patients. Positive, negative and extrapyramidal symptoms do not have a substantial influence on depression in these patients. CONCLUSION: The study suggests that depression represents a distinct psychopathological dimension of the acute illness in first admitted schizophrenic patients. In particular, in light of the suicidal tendencies, recognition and treatment of depression is an important clinical task.     

Methodological issues in negative symptom trials

Individuals from academia, the pharmaceutical industry, and the US Food and Drug Administration used a workshop format to discuss important methodological issues in the design of trials of pharmacological agents for improving negative symptoms in schizophrenia. The issues addressed included the need for a coprimary functional measure for registration trials; the characteristics of individuals who should enter negative symptom trials; the optimal duration for a proof-of-concept or registration trial; the optimal design of a study of a broad-spectrum agent that treats both positive and negative symptoms or a co-medication that is added to an antipsychotic; the relative strengths and weaknesses of available instruments for measuring negative symptoms; the definition of clinically meaningful improvement for these trials; and whether drugs can be approved for a subdomain of negative symptoms.