癫痫的流行病学及其危险因素的研究现况

通过了解癫痫流行病学及危险因素特点,为临床治疗及预防提供证据。本文收集并分析了近年来癫痫的流行病学资料,同时查阅有关癫痫危险因累的文献。根据国际抗癫痫联盟的标准（ILAE）,各国癫痫患病率为0.91‰-12.3‰,发病率0～76/10万/年,总标化死亡比:3.6,危险因素包括遗传、高热惊厥、脑外伤、肿疤、脑血管病等。癫痫是一种多发病,对其危险因素的控制有助于降低癫痫的患病率和发病率。     

人格障碍诊断问卷(SCID-Ⅱ)第2版的信度和效度

目的评价人格障碍诊断问卷SCID-Ⅱ(第2版)中文译本的信度和效度。方法对125 例精神障碍患者及45名正常人进行量表评定,并进行重测和评定者间一致性检验,及与临床诊断一致性检验。结果SCID-Ⅱ(第2版)各分量表内部一致性系数中位数为0．70;重测一致性Kappa值中位数为0．70,评定者间一致性Kappa值中位数为0．86;与临床诊断的一致率达90．7％。结论SCID-Ⅱ (第2版)各分量表内部一致性尚好,重测和评定者间的一致性良好,与临床诊断的一致率较好,可以推广使用,但仍需进一步大样本的研究分析。     

反社会型人格障碍共病边缘型人格障碍特质的影响因素

目的:探讨反社会型人格障碍(ASPD)共病边缘型人格障碍(BPD)的人口学及心理环境影响因素.方法:对1804名服刑人员使用人格障碍诊断问卷(PDQ-4)进行评估,筛选出反社会型、边缘型及共病人群,采用自编一般资料问卷、患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)、儿童期虐待量表(CTQ-SF)、冲...     

军校大学生精神疾病发病危险因素的研究

应用病例配对对照研究方法，对５３例首次发病住院的军校大学生精神疾病与５３例正常学员进行了发病危险因素的对照研究，结果提示：精神病家族史，个性内向和情绪不稳定。生活事件和人际关系等多种因素的共同作用与大学生精神疾病的发病显著相关，就大学生精神疾病的危险因素和预防性措施进行了讨论。     

脑卒中高危人群中颈动脉粥样硬化的现况调查及危险因素分析

目的了解脑卒中高危人群颈动脉粥样硬化(Carotid atherosclerosis,CAS)的发病情况及相关的危险因素。方法对海口市美兰区40岁以上的居民筛查,筛选出脑卒中高危人群进一步颈部血管超声检查、实验室检查。分CAS组和非CAS组,统计分析CAS的发病率及相关危险因素。结果 CAS检出率44.7%。性别、年龄、吸烟、肥胖、高血压、高血脂、糖尿病、既往脑卒中史,高Hcy和FBS在2组比较差异有统计学意义(P<0.05)。结论年龄、男性、吸烟、超重、高血压、高血脂、糖尿病、既往脑卒中史,高Hcy和FBS均为海口市美兰区脑卒中高危患者CAS的独立危险因素。     

脑卒中及其危险因素分析

目的 调查脑卒中危险因素分布情况.方法 回顾性分析2128例脑卒中患者不同危险因素的发生率,以及年龄、性别、血压、血糖、心脏病、吸烟、血清甘油三酯(TG)浓度、总胆固醇(TC)浓度、高密度脂蛋白胆固醇(HDL-C)浓度、低密度脂蛋白胆固醇(LDL-C)浓度对脑梗死和脑出血影响的差异.结果 脑卒中危险因素的发生率从高到低依次为高血压病、高血脂症、吸烟、糖尿病、心脏病;且年龄＞60岁、高血压病、糖尿病、心脏病、吸烟、TG＞3.36 mmol/L、HDL-C＜1.04 mmol/L导致脑梗死的风险分别为脑出血的2.02、0.67、3.05、5.16、1.34、1.29、1.61倍.结论 相对于脑出血,与脑梗死显著相关的因素依次有心脏病、糖尿病、年龄＞60岁、低HDL-C、吸烟、高TG;相对于脑梗死,与脑出血显著相关的是高血压病.     

脑卒中的流行病学及其危险因素

卒中是由于脑局部血液循环障碍,主要是供应脑或脊髓的血管出现闭塞(脑血栓形成)或破裂(脑内出血或蛛网膜下腔出血)而引起的局灶性神经功能缺损。按病因学可将其分为缺血性卒中、脑出血和蛛网膜下腔出血(SAH)3组,在卒中类型中,它们分别占75%～85%、15%～20%和6%。我国90年     

泸州市在校大学生饮酒现状及危险因素

目的调查泸州市在校大学生饮酒现状,探讨大学生危险和有害饮酒的危险因素,为有效防治大学生危险和有害饮酒提供依据。方法采用分层整群随机抽样,于2015年3月10日-20日抽取四川省泸州市四所高校共1381名大学生,采用自编一般情况调查问卷、自编饮酒情况调查问卷和酒精使用障碍筛查量表(AUDIT)对其进行现场匿名调查。结果曾饮酒率为73.3%,目前饮酒率51.1%,过量饮酒率41.0%,醉酒率为24.0%,危险和有害饮酒检出率为20.8%。男生曾饮酒率(83.4%vs.60.8%)、危险和有害饮酒率(30.9%vs.8.3%)均与女生比较差异均有统计学意义(χ~2=88.39、57.39,P均0.01)。性别、初次饮酒年龄、自评饮酒依赖状况、自评饮酒量、过去一年的饮酒天数、醉酒天数、饮酒导致的不良结果、最近一年豪饮的频数8个变量是饮酒者发生危险和有害饮酒行为的危险因素(OR=0.248~1.647)。结论泸州市在校大学生男生曾饮酒率及危险和有害饮酒发生率均高于女生。男生、初次饮酒年龄越小、自我感觉酒依赖状况越重、饮酒量越高、近一年饮酒和醉酒以及豪饮的天数越多、饮酒导致了不良后果的容易成为危险和有害饮酒者。     

瑞典大学人格量表在强迫症患者中的应用

目的采用瑞典大学人格量表（SSP）探讨强迫症患者的人格特质及其与不同临床特征的关系。方法收集33例符合DSM-IV诊断标准的强迫症患者及31例健康对照,采用瑞典大学人格量表（SSP）评估两组样本的人格特质,采用Yale-Brown强迫量表（Y-BOCS）、汉密尔顿焦虑量表（HA-MA）和汉密尔顿抑郁量表（HAMD）评估强迫症患者临床特征。结果强迫症组躯体性焦虑、精神性焦虑、应激敏感性、怨恨、兴奋性和不信任分量表分别为57.70±11.64、63.19±10.41、66.77±10.31、61.14±7.56、54.09±9.13、57.15±11.57,健康对照组分别为46.18±8.30、52.08±8.42、55.79±7.69、56.37±7.92、48.03±7.69、51.59±9.97,强迫症组高于对照组,差异有统计学意义。其余分量表的差异无统计学意义。强迫症患者SSP社交愿望分与Y-BOCS总分呈正相关（r=0.349,P〈0.05）;躯体性焦虑、精神性焦虑和应激敏感性分与HAMA、HAMD总分呈正相关;社交愿望分与HAMA呈正相关;怨恨分与HAMD呈正相关。结论强迫症患者具有神经质和攻击性人格特质;强迫症患者的人格特质与强迫、焦虑和抑郁症状之间可能存在一定的相关性。     

A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder

No longitudinal study has examined risk factors for future suicide attempts in major depressive disorder in a nationally representative sample. The objective of this study was to investigate baseline sociodemographic characteristics, comorbid mental disorders, specific depressive symptoms, and previous suicidal behavior as potential risk factors for suicide attempts at 3 years follow-up. Data came from the national epidemiologic survey on alcohol and related conditions (NESARC), a large nationally representative longitudinal survey of mental illness in adults [Wave 1 (2001-2002); Wave 2 (2004-2005) n = 34,653]. Logistic regression examined associations between risk factors present at Wave 1 and suicide attempts at Wave 2 (n = 169) among individuals with major depressive disorder at baseline assessment (n = 6004). Risk factors for incident suicide attempts at Wave 2 (n = 63) were identified among those with major depressive disorder at Wave 1 and no lifetime history of suicide attempts (n = 5170). Results revealed specific comorbid anxiety, personality, and substance use disorders to be associated with incident suicide attempts at Wave 2. Comorbid borderline personality disorder was strongly associated with suicide attempts in all models. Several comorbid disorders were strongly associated with suicide attempts at Wave 2 even after adjusting for previous suicidal behavior, notably posttraumatic stress disorder (adjusted odds ratio (AOR) = 2.20; 95% confidence interval (95% CI) 1.27-3.83) and dependent personality disorder (AOR = 4.43; 95% CI 1.93-10.18). These findings suggest that mental illness comorbidity confers an increased risk of future suicide attempts in major depressive disorder that is not solely accounted for by past suicidal behavior.     

Dissocial personality disorder in the elderly: A case history

A case of dissocial personality disorder in a 71-year-old woman presented with dangerous and apparently suicidal behaviour. Such cases are rare and potentially difficult to distinguish from treatment-resistant depression or organic cerebral conditions. In view of this, investment in prolonged inpatient assessment and an adequate trial of treatment for depression is justified. The prognosis for beneficial change is not good and eventual management may involve little more than providing an environment in which behaviours can be safely contained.     

A community-based study of risk factors for probable rapid eye movement sleep behavior disorder

ObjectivesTo cross-sectionally explore the potential risk factors for rapid eye movement (REM) sleep behavior disorder (RBD) in a community cohort in Shanghai.MethodsBased on the validated RBD screening questionnaire (RBDSQ), we identified individuals with probable RBD (pRBD) in 3635 community-dwelling residents (≥50 years old) from an urban community of Shanghai. Potential risk factors of pRBD, including age, sex, smoking, socioeconomic status, obesity, consumption of tea (surrogate for caffeine intake) and alcohol, medications and chronic disease status, were assessed via questionnaire. We used logistic regression to investigate the associations between these studied factors and pRBD after adjusting for age, sex and other studied factors.ResultsBased on the RBDSQ score ≥5, 2.70% (3.28% in men and 2.41% in women) participants were considered as pRBD. We found that lower education, presence of head injury, atrial fibrillation, hyperlipidemia, constipation, olfactory disturbance, and imbalance, use of alcoholic beverage, selective serotonin reuptake inhibitor, and benzodiazepine were associated with higher likelihood of having pRBD (P < 0.05 for all). In contrast, male sex, use of coffee or tea, smoking and other factors were not significantly association with altered risk of having pRBD. We did not find significant interaction between sex, age and these factors, in relation to pRBD risk.ConclusionsIn this community-based study of older adults, we identified several potential risk factors for concurrent pRBD, including environmental factors and vascular risk factors.     

Hypomanic, cyclothymic and hostile personality traits in bipolar spectrum illness: a family-based study

OBJECTIVES: To examine hypomanic, cyclothymic and hostile personality traits in a large, euthymic, family-based group of individuals with bipolar disorder (BPD) and their affectively ill and healthy relatives. To test whether these traits follow a distribution with the most "pathological" scores in the bipolar disorder I (BPD I) group and the least "pathological" scores in the unaffected relatives. METHODS: Two-hundred and ninety-six individuals from 47 bipolar disorder families were administered a battery of personality questionnaires (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; Temperament and Character Inventory; Affective Neuroscience Personality Scale; Hypomanic Personality Scale; Borderline Traits Questionnaire) as well as a self-rating depression (Beck Depression Inventory) and mania (Altman Self-Rating Mania) scale. Out of the 296 participants, 57 were diagnosed with BPD I, 24 with bipolar disorder II (BPD II), 58 with recurrent major depression (MDE-R), 45 had one previous depressive episode (MDE-S), and 86 were unaffected. Twenty six individuals had another DSM-IV diagnosis. RESULTS: The BPD I group displayed elevated hypomanic, cyclothymic and hostile traits. These traits were also characteristic of the BPD II group but were less salient in the MDE-R group. The MDE-S group did not differ significantly from unaffected relatives. Hypomanic personality characteristics were clearly elevated in both BPD groups and differentiated BPD from major depressive disorder (MDD) individuals. CONCLUSIONS: Our results provide preliminary support for the hypothesis that temperament is a genetically quantitative trait.     

性犯罪相关因素的综合性研究

目的探讨性犯罪的相关因素及预防措施。方法采用Olsen家庭问卷、艾森克人格问卷、WAIS-RC智力测验等测查工具,对78名性犯罪者和78名正常人对照,就家庭、个性、智力、社会环境等有关因素进行综合性分析。结果母孕期营养差、少年严重疾病、智能偏低、少年学习成绩差、少年品行障碍(如反复逃学、说谎、偷窃、打架斗殴、逃离家庭)、具有精神质(P)和神经质(N)等个体因素,研究组明显高于对照组。在家庭和社会环境方面:单亲家庭、父母文化水平低、家庭中有违法犯罪成员、对孩子管教方式不良、缺乏监督、不良结伴、追求享受、赌博、酗酒、坏人教唆等明显高于对照组,差异有显著性。结论预防性犯罪应采取综合措施,需要全社会的共同努力。     

高职生个性心理特征和家庭教养方式对网瘾行为的影响分析

目的探讨网络成瘾症（简称IAD）的高职学生的内部个性特征和外部家庭教养方式等两大类因素对网络成瘾行为的贡献率。方法采用明尼苏达多项人格测验量表（MMPI）,共10个临床分量表和7个附加量表;家庭教养方式量表（EMBU）,父亲教养方式6个分量表和母亲教养方式5个分量表,构成28个分量表。采用主因素分析法与主分量分析软件来分析青少年的内部个性特征和外部家庭教养方式等两大类因素对网络成瘾行为的贡献率。结果父母教养方式作为独立影响因素对网瘾行为影响的独立贡献率为55.49%,父母教养方式对IAD起主要影响作用的是来自父亲母亲的过度保护、严厉和拒绝;个性行为特征的独立贡献率为35.03%。个性特征对IAD起主要影响作用的是精神衰弱、依赖和支配性,并与责任感负相关。结论父母教养方式对IAD学生网瘾成瘾行为的影响显著大于学生本身个性特征的影响。后者可能在网络成瘾行为的形成过程中起到了次要和配合性作用。     

Abnormalities of auditory event-related potentials in students with schizotypal personality disorder

Biological, phenomenological and cognitive similarities are known to exist between schizophrenia and schizotypal personality disorder (SPD). This study examined whether, and to what extent, abnormalities in event-related potentials (ERPs) already extensively reported in schizophrenia can also be observed in persons psychometrically identified with SPD. Event-related potentials were examined in nine SPD subjects and nine controls recruited from among 1693 college students, using the Schizotypal Personality Questionnaire (SPQ) and the Structured Clinical Interview for DSM-III-R (SCID I and II). Event-related potentials were recorded during an auditory oddball task. Smaller P300 amplitude and prolonged P300 latency were found in SPD subjects as compared with controls. Our findings indicate that such individuals do have deficits in information processing similar to that found in schizophrenia. We can conclude that P300 abnormalities may not be specific for SPD but that abnormalities shown in SPD are possibly a vulnerability marker for developing schizophrenia.     

Cluster A personality pathology in social anxiety disorder: A comparison with panic disorder

Abstract

Background: Social anxiety disorder (SAD) has been associated with cluster A personality disorder (PD) traits, mainly paranoid and schizoid traits. Aim: The aim of the study was to further investigate cluster A personality pathology in patients with SAD. Methods: Self-reported PD traits were investigated in a clinical sample of 161 participants with SAD and in a clinical comparison group of 145 participants with panic disorder with or without agoraphobia (PAD). Results: A diagnosis of SAD was associated with more paranoid and schizotypal PD traits, and an association between depression and personality pathology could indicate a state-effect of depression on PD traits. Conclusions: Patients with SAD had more cluster A personality pathology than patients with PAD, with the most solid indication for paranoid personality pathology.