麻果所致精神障碍12例临床分析

目的:了解麻果所致精神障碍的临床表现及转归。方法:对滥用麻果符合CCMD-3精神活性物质所致精神障碍诊断标准的12例患者作临床分析。结果:麻果所致精神障碍以意志行为障碍、知觉障碍、思维障碍、情感障碍为主。给予小剂量抗精神病药、情绪稳定剂、镇静安眠药、对症支持及脱毒等治疗,可消除患者的精神症状。结论:滥用麻果可损害人的神经系统,及时治疗,精神症状可缓解。     

"K粉"、麻谷所致精神障碍24例临床分析

目的:了解"K粉"、麻谷所致精神障碍的临床表现及转归.方法:对滥用K粉、麻谷符合CCMD-3精神活性物质所致精神障碍的24例患者作临床分析.结果:"K粉"、麻谷所致精神障碍以知觉障碍、思维障碍、情感障碍、意志行为障碍为主.给予小剂量抗精神病药、情绪稳定剂、镇静安眠药、对症支持及脱毒等治疗,可消除患者的精神症状.结论:滥用"K粉"、麻谷可损害人的精神系统,及时治疗,精神症状可缓解.     

苯丙胺类兴奋剂所致精神障碍临床特征及治疗分析

目的：总结苯丙胺类兴奋剂所致精神障碍的临床特征及治疗。方法：对120例符合CCMD-3诊断标准的苯丙胺类兴奋剂所致精神障碍患者进行临床特征及治疗的总结和分析。结果：滥用苯丙胺者以青少年居多,男女性别差异不大,文化素质普遍偏低,职业以无业和个体为主。常见临床表现为心慌烦躁、兴奋、发热、血压升高、抑制、消瘦、性欲亢进、食欲下降、抑郁、激越和精神病症状,部分病人有口腔和鼻粘膜溃疡、震颤、行走不稳和肌张力增高等类帕金森氏病样症状等。治疗以对症治疗为主,但类帕金森氏病样症状治疗效果不佳。结论：苯丙胺类兴奋剂是一类对生理和心理有显著伤害的中枢兴奋剂,治疗以对症治疗为主,并辅以心理治疗,总体疗效尚佳。     

吸食笑气所致精神病性障碍一例报告并文献复习

目的:总结滥用笑气所致精神病性障碍患者的临床表现、实验室检查的特点。方法:回顾性分析一例22岁男性滥用笑气所致精神病性障碍患者的临床资料,并结合文献进行复习讨论。结果:患者吸食笑气1年半,导致精神萎靡、肢体麻木、思维迟缓,并出现被害妄想等精神病性症状。心电图示窦性心动过缓,窦性心律不齐。头颅磁共振检查发现双侧额叶白质脱髓鞘改变。结论:长期滥用笑气可以导致躯体不适及精神障碍,有成瘾倾向,需引起临床及监管部门重视。     

氯胺酮所致精神障碍的临床特点分析

目的:探讨氯胺酮所致精神障碍的临床特点。方法:对41例氯胺酮所致精神障碍患者的临床资料进行分析。结果:患者多为男性未婚青年。氯胺酮滥用时间为21.8±s17.8月,滥用剂量为0.4 g·次-1±s0.2 g·次-1,吸食频度为9.5次·月-1±s8.5次·月-1,滥用方式全部为鼻吸。患者均有多物质滥用的经历。临床诊断主要依据确切的氯胺酮滥用史和临床表现,临床类型以精神病性障碍多见,占85.4%(35/41)。依赖者的耐受性增加不明显,戒断症状出现较迟且较轻,心理依赖呈中等程度;精神病性障碍者的主要表现为:幻听、被害妄想、易激惹、兴奋和行为异常等。患者的治疗效果较好。结论:氯胺酮所致精神障碍以精神病性障碍多见,应加以重视。     

中西医结合治疗冰毒所致精神病性症状疗效观察

<正>近年来,我国苯丙胺类药物滥用呈上升趋势,我省苯丙胺类药物滥用也呈上升和分布广泛之势,由苯丙胺类药物滥用所致的急性中毒、慢性中毒、戒断症状、精神障碍等临床表现也呈上升趋势,尤其是吸食冰毒所致的精神障碍危害严重。本研究采用中西医结合的治疗方法,使得抗精神病药物的不良反应明显降低,控制患者精神病性症状迅速、有效,报告如下。1资料和方法1.1临床资料:90例观察对象均为2010年11月至2014年     

28例“冰毒”所致精神障碍患者临床资料分析

目的：总结＂冰毒＂所致精神障碍患者的临床特征,为治疗提供帮助。方法：采用回顾性个案调查对28例＂冰毒＂所致精神障碍患者进行临床特征的总结和资料分析。结果：滥用＂冰毒＂者以青壮年为主,男性多于女性,文化素质偏低,职业以无业和个体为主。常见临床表现为幻听、被害妄想、嫉妒妄想、焦虑和兴奋冲动等。治疗以支持治疗和抗精神病药物治疗为主,辅以心里治疗。结论：＂冰毒＂所致精神障碍患者精神病性症状明显,治疗以支持治疗和抗精神病药物治疗为主,总体疗效尚佳。     

165例酒精中毒所致精神障碍住院病人的流行病学分析

目的:探讨酒依赖及酒精中毒伴发精神障碍的流行病学、临床表现特点、躯体损害及转归。方法:对1995年、2005年北京市三家三级以上精神病专科医院诊断为酒精所致精神障碍/酒相关障碍的病历档案进行回顾性抽样调查分析。结果:三家医院共收集1995年和2005年的酒精所致精神障碍患者165例,男女比例为38∶1。发病年龄为44.5 a±s9.4 a,以依赖综合症和戒断症状出现最多,躯体疾病以肝损害及心血管系统疾病出现最多。两年病例的职业分布有显著不同;入院前平均日饮酒(白酒)量越大,发病率越高(χ2=6.597,P<0.05)。经住院治疗67.3%的病例好转,26.7%的病例痊愈。结论:酒中毒及导致的精神障碍已是一个日趋严重的社会问题,酒的过度滥用极易对人的心身健康造成严重损害,及早干预并制定有关防治措施和法规势在必行。     

脑外伤所致精神障碍63例临床特征分析

目的分析脑外伤所致精神障碍的临床特征,为临床诊治提供参考。方法对63例住院病人资料进行分析。结果脑外伤所致精神障碍均有不同程度的意识障碍,同时伴有神经症样综合征、精神病性症状等。结论应重视脑外伤所致精神障碍的诊断和治疗。     

药物依赖的诊断标准

药物依赖在精神疾病分类中被列入精神活性物质所致精神障碍。常见的精神活性物质有酒类、阿片类、大麻、催眠剂、镇静剂、抗焦虑剂、麻醉剂、兴奋剂、致幻剂和烟草等,反复多次使用这些物质可形成依赖。中国精神疾病分类方案与诊断标准第２版修订版中,精神活性物质所致精神障碍的诊断标准为［１］:①有使用精神活性物质的证据,其用量和使用时间足以引起精神障碍;②使用精神活性物质后,出现心理和生理症状、行为改变,如中毒、依赖综合征、戒断综合征、精神病性症状和情感障碍、智能障碍、遗忘综合征和人格改变等,且有理由推断精神障碍由精神活…     

Drug-induced neurological disorders

When a patient presents with a neurological or neuromuscular disorder, it is essential to consider drugs as a possible cause. Drugs can affect virtually any part of the neuraxis and the resulting disorders can usually be classified in terms of the anatomical site affected and the clinical presentation. In general, the signs and symptoms of drug-induced neurological disorders are virtually indistinguishable from those seen in naturally occurring disease but are usually reversible if diagnosed early enough. Cortical depression may produce coma, particularly in overdose cases, but a large number of drugs can also initiate seizures in susceptible individuals. The effects of drugs in the pathogenesis of headaches are certainly underestimated, and the eye, hearing and balance mechanisms can be severely damaged by certain drugs before symptoms prompt investigation. The long term effects of antipsychotic drugs on basal ganglia demand that these drugs are used only when absolutely essential and for as short a period as possible. Finally, there is increasing awareness of the role of drugs in the development of neuromuscular disorders such as peripheral neuropathies, myasthenic syndromes and myopathies.     

Evaluation of factors influencing medication compliance in inpatient treatment of psychotic disorders

Rationale Short- and long-term compliance to prescribed antipsychotic drugs is of particular concern in regard to medication choice and treatment outcome in the care of psychotic disorders.Objective We evaluated patient-related and treatment-related factors associated with medication compliance in inpatients with a diagnosis of schizophrenia, schizoaffective disorder, or other psychotic disorder.Methods Within a naturalistic study in seven psychiatric hospitals, individuals with a psychotic disorder were assessed weekly on mental state, social functioning, side effects, and medication compliance. Logistic regression analyses were computed to assess patient and clinical predictors of medication compliance.Results We found a significant association between medication compliance and substance abuse (OR 0.52, CI 0.32–0.85), involuntary admission (OR 0.60, CI 0.41–0.89), history of aggressive behavior (OR 0.57, CI 0.38–0.85), and no school graduation (OR 0.59, CI 0.41–0.86). Individuals with pronounced paranoid or negative symptoms were also less compliant in taking their prescribed medication. There was no association between the initial inpatient antipsychotic medication regime and patients’ compliance. Individuals who switched from a typical to an atypical antipsychotic drug were more compliant than those with their typical antipsychotic drug maintained. Those with higher medication compliance showed significantly greater improvement of their psychiatric symptoms during the inpatient stay.Conclusion Patient-related in addition to disease-related factors may strongly influence medication compliance. Besides more compliance with atypicals supposed by the literature, there may be a higher propensity for atypical drugs to be prescribed to those assumed to be more compliant.     

Drug-induced psoriasis: an evidence-based overview and the introduction of psoriatic drug eruption probability score

Psoriasis is a common skin disorder that needs a long-term management, not only because, of its prevalence but also because of the profound impact it can have on patients quality of life. Drugs may result in exacerbation of a preexisting psoriasis, in induction of psoriatic lesions on clinically uninvolved skin in patients with psoriasis, or in precipitation of the disease in persons without family history of psoriasis or in predisposed individuals. The knowledge of the drugs that may induce, trigger, or exacerbate the disease is of primary importance in clinical practice. By reviewing the literature, there are many reports on drug-induced psoriasis, but the data are not univocal. We propose, when possible, the use of a probability score from the authors to obtain a better classification and further understanding of drug-induced psoriasis.     

Drug-Induced Neuromuscular Blockade and Myasthenia Gravis

Myasthenia gravis is an uncommon disorder of the neuromuscular junction resulting in weakness of all striated voluntary muscles. Therapeutic advances have increased patients' age and survival. Older patients with myasthenia gravis may have additional medication needs. Numerous drugs have experimental and clinical evidence of neuromuscular blockade. A MEDLINE search of the English literature from 1966 to the present pertinent to drug-induced myasthenia gravis was performed. Additional literature was obtained from reference citations of relevant articles. Drugs with several reports of neuromuscular blockade were assessed for causality by a recognized probability scale. Prednisone was most commonly implicated as aggravating myasthenia gravis, and D-penicillamine was most commonly associated with myasthenic syndrome. The greatest frequency of drug-induced neuromuscular blockade was seen with aminoglycoside-induced postoperative respiratory depression. However, drugs most likely to impact myasthenic patients negatively are those used in the treatment of the disease. These include overuse of anticholinesterase drugs, high-dose prednisone, and anesthesia and neuromuscular blockers for thymectomy.     

69例药物性肝炎的临床分析

目的:探讨药物性肝炎的临床特点.方法:回顾分析了2006～2011年收治的69例确诊为药物性肝炎患者的临床资料.结果:引起药物性肝炎的常见药物是中草药、抗结核药、抗生素、抗肿瘤药等.结论:引起药物性肝炎的药物种类多,许多临床常见的药物可引起肝脏损害,应加强临床用药指导及药物性肝炎的防治.     

People Who Inject Drugs and Have Mood Disorders—A Brief Assessment of Health Risk Behaviors

Background: People who inject drugs have a greater risk of infectious disease and mortality than other substance abusers and nondrug users. Variation in risk behavior among people who inject drugs is likely associated with comorbid mental health disorders. Objectives: Examine the association between a history of mood disorder and recent risk behavior among people who inject drugs. Methods: With baseline data from a behavioral HIV prevention clinical trial in a population of people who inject drugs, we used logistic regression models to compare the risk behaviors of people who report a past diagnosis of bipolar disorder (n = 113) or depression (n = 237) to a comparison group with no history of diagnosed mental illness (n = 446). We also assessed differences between groups before and after adjusting for demographic characteristics and current depressive symptoms. Results: While there were no differences between groups in frequency of drug use, people who inject drugs who report a history of mood disorders reported more injection risk behaviors, drug overdoses, sex exchanges, and multiple partners than those with no history of mental illness. Adjusting the comparison for demographic characteristics and current depressive symptoms had little impact on these findings. Variation in risk between depression and bipolar disorder groups was minimal. Conclusions/Importance: People who inject drugs and have mood disorders have unique and significant social, clinical, and risk reduction needs. Despite the limited validity of self-reported mental health history, simply asking about a history of mood disorder may be effective for identifying a particularly vulnerable population of people who inject drugs.     

临床药师参与1例怀疑药物引起精神异常ICU患者的治疗分析

本院药师参与1例怀疑药物引起精神异常患者的治疗,分析患者入住ICU后引起精神异常的环境因素、心理因素和药物因素（包括药物之间的相互作用和不良反应）,发现最有可能引起精神异常的药物为伏立康唑、美罗培南和硝普钠,停用这3种药物并使用镇静、抗焦虑药物后,患者出院时未出现精神异常症状。本文就临床药师参与治疗的过程进行总结分析。     

206例药物性眼部损害文献分析

目的:探讨药物性眼部损害的特点。方法:对1998年1月～2005年12月国内医药学术期刊报道的206例有关药物性眼部损害进行统计、分析。结果:诱发眼部损害的药物以抗感染类、激素类、中枢神经系统类药物所占比例较大;眼部损害临床主要表现为青光眼、角膜炎、巩膜炎、视网膜病变、前房出血、干眼症、角膜上皮损害以及视力障碍等。结论:药物性眼部损害轻者视力下降,重者可致失明,应引起医务人员重视。     

70例吸食新型毒品致精神和行为障碍临床分析

目的：经过对吸食新型毒品所致精神和行为障碍的临床症状研究,了解其临床特点,对其制定相应的治疗方案和心理疏导措施。方法：对2009年3月-2010年3月我所收治吸食新型毒品所致精神和行为障碍的70例患者进行临床分析。结果：新型毒品冰毒、K粉（氯胺酮）、麻果（混合冰毒）都可引起精神和行为障碍。临床表现为兴奋、易激惹、失眠、焦虑、幻觉、被害幻想、恐惧、烦躁不安为主。大多数在2—4周明显缓解,但也有少数病例延至一年以上。结论：我所收治的70例新型毒品的患者,所表现的精神和行为障碍符合ICD-10-F10-19使用精神活性物质所致的精神和行为障碍。