上海市精神疾病临床医学中心的建设成效和体会

1上海市精神疾病临床医学中心建设概况上海市精神疾病临床医学中心为上海市卫生局“十五”规划重点建设项目之一(上海市现建有33个临床医学中心)。建设周期共五年:2002．2-2006．12;建设经费2000万元人民币(上海市财政市卫生局共投资建设经费1000万,上海市精神卫生中心共匹配经费1000万)。     

上海杨浦区肇事肇祸精神疾病患者的临床特征及相关因素

精神疾病患者在精神病性症状的支配和影响下容易产生毁物、伤人、自杀、放火、无故上访等肇事肇祸行为,因此越来越引起政府和精神卫生专业人员的重视.国内对肇事肇祸精神疾病患者的系统研究较少,本研究对上海市杨浦区肇事肇祸精神疾病患者的临床特征及相关因素进行深入调查,以期为今后更有效地治疗和干预提供线索.     

2009国家级中日森田疗法和内观疗法讲习班纪要

具有国家级继续教育特色的2009年度中日森田疗法和内观疗法讲习班于7月13—17日在上海市精神卫生中心内举办。     

2009第二届中国精神分析大会征文通知

第二届中国精神分析大会将于2009年9月18日至20日在上海光大会展中心召开。本次会议由中国心理卫生协会心理咨询和心理治疗专业委员会精神分析学组主办，上海市精神卫生中心承办，上海市心理卫生协会协办。     

中国解决精神卫生老问题的新举措

由于疾病本身的影响,精神障碍患者主动寻求或接受治疗的意愿和能力受到损害。许多国家都在致力于提高此类患者的治疗率。其中,以下两个问题颇受争论。     

中国首届森田疗法临床技能高级培训班通知

中国心理卫生协会森田疗法应用专业委员会定于2007年6月6日至12日再次在山东？甾博举办全国森田疗法实践技能培训班，邀请国内森田疗法领域著名专家崔玉华、李振涛、路英智、施旺红等教授主讲。结合中国传统文化的特点，通过理论讲授、小组演练、案例督导等方式进行系统的培训。实践基地为淄博市精神卫生中心森田疗法病区。     

我国精神卫生工作的挑战及主要立法对策探讨

精神卫生服务的发展历史以及疾病的特殊性已反复证明,精神疾病患者这一弱势群体的公民权益极易受到侵害,要真正改善患者的处境,必须通过法律手段对其被广泛剥夺或忽视的权益加以保护。当今全球精神卫生立法还逐渐呈现这样一个趋势,即努力在患者个人自由和保护其他人不受患者病态行为影响之间取得适当的平衡,在患者的自尊与大众保持对精神健康的关注之间取得适当的平衡。     

全球化和中国的精神卫生及其政策

中国的全球化进程是从 1978年底开始的,即在提出改革开放以后,中国进入了全球化的行列,且速度非常快.全球化会对各行各业带来诸多影响,精神卫生也不例外.现简就全球化对我国精神卫生及精神卫生政策的影响,谈点个人看法.抛砖引玉,欢迎指正.     

47例酒精所致精神障碍的临床资料分析

为了进一步探讨酒精所致精神障碍的临床特点,作者对47例住院酒精所致精神障碍患者临床资料进行回顾性分析,并报道如下:1对象和方法系上海市精神卫生中心2000年1月～2005年6月住院患者,符合CCMD-2-R酒精所致精神障碍诊断标准。采用自编调查表收集临床资料及杨德森等[1]编制的生活事件量表评定患者入院前生活事件。将有关数据输入电脑,采用SPSS10.0进行统计。2结果2.1一般资料47例均为男性,年龄27～73岁,平均为(47.55±9.12)岁,已婚29例、未婚7例、离婚11例,工人26例、下岗10例、农民5例、其他6例,小学文化6例、初中30例、高中(含中专)10…     

精神活性物质所致精神障碍

1病史摘要患者,男,35岁,因“反复使用冰毒4年,易激惹2个月,猜疑,耳闻入语伴失眠10d”第二次入住上海市精神卫生中心戒毒科。患者于2006年在朋友影响下,因好奇开始吸食冰毒（甲基苯丙胺）,当时人很兴奋,不停地说话。最初1～2个月才使用一次。2007年使用频率增加,有时隔几天一次,后来几乎每天使用,每次1～6条,剂量不等。     

Homelessness in schizophrenia

The impact of mental illness, comorbid substance abuse, and medication nonadherence, coupled with disjointed psychiatric and social services, conspires to a disproportionately high rate of psychiatric disorders among people who are homeless in the United States. This article reviews the prevalence of homeless among the mentally ill as well as the prevalence of mental illness among the homeless and details barriers in access to care and the solutions that have been attempted. The need and solutions to introduce a new generation of physicians and allied health care workers to the unique health care needs of the homeless population are highlighted.     

Homelessness in the state and federal prison population

AIMS: This study sought to investigate the rates and correlates of homelessness (i.e. living on the street or in a homeless shelter), including mental illness, among US adult state and federal prison inmates (ASFPIs). METHOD: Data from a national survey of ASFPIs based on a random sampling survey (N = 17,565) were used to compare the homelessness rate among AFSPIs with that in the general population. Logistic regression was then used to examine the association of homelessness among ASFPIs with factors including symptoms, treatment of mental illness, previous criminal justice involvement, specific crimes, and demographic characteristics. RESULTS: Nine percent of ASFPIs reported an episode of homelessness in the year prior to arrest, 4-6 times the estimated rate in the general US adult population after allowing for age, race/ethnicity, and gender. In comparison to other inmates, these homeless inmates were more likely to be currently incarcerated for a property crime, but also to have had previous criminal justice system involvement for both property and violent crimes, to suffer from mental health and/or substance abuse problems, and to be more likely to have been unemployed and with a low income. CONCLUSIONS: Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals.     

Homelessness among patients with schizophrenia in rural China: a 10-year cohort study

OBJECTIVE: To explore the frequency and risk factors of homelessness among a previously identified cohort of patients with schizophrenia in rural China. METHOD: A 10-year follow-up investigation among a 1994 cohort (n = 510) of patients with schizophrenia was conducted in Xinjin County, Chengdu, China. RESULTS: Thirty-nine patients (7.8%) experienced homelessness during the follow-up period. The rate of homelessness was 0.9 per 100 person-years during the 10-year follow-up period. Four significant predictors of homelessness remained in the final logistic regression model: living in shabby or unstable house or shelter, positive family history of mental disorders, without income of the patient, and unmarried, divorced, or separated. Risk of homelessness increased substantially with exposure to multiple risk factors. CONCLUSION: Substantial numbers of homeless patients with schizophrenia are challenges for mental health care and public health. Appropriate community-based services, especially housing services, should be crucial for prevention of homelessness in patients with schizophrenia.     

The Trauma of Homelessness

This study explored the predictive value of disease insight for violent behavior for a group of Taiwanese schizophrenic outpatients over a one-year period. The Schedule of Assessment of Insight in Psychosis and its expanded version were used to provide a baseline insight score for sixty-three schizophrenic outpatients considered to be in remission or to have minimal psychopathology. A psychiatrist reassessed subjects at the end of the period to determine the predictive value of initial insight rating on the presence of violent behaviors. The binary logistic regression model was built first, which could explain 65.2 percent of the variance of patients' violent behavior tendency. Then, a support vector machine (SVM) was developed. After the training with cross validation, no misclassifications were found in the training data, and the average percentage of misclassification for the testing data was 23.8 percent, resulting in a 76.2 percent predictive power. These findings showed that SVM is more robust than a binary logistic regression model due to the good learning capability of an SVM for the nonlinear dependency between the input and output (also called outcome) variables. This SVM might help to build an early-warning and advisory system guiding the medical care of schizophrenic patients living in the community.     

Homelessness and drug abuse in New Haven.

The prevalence of drug abuse among homeless people in New Haven, Connecticut, was examined using questionnaire data collected from 80 percent of all homeless persons (N = 181) residing in the city's five emergency shelters during a four-week study period in 1990. Fifty-four percent of the sample had used drugs during the 30 days before the interview, and almost two-thirds during the previous year. Cocaine was reported to be the most frequently used drug. Almost one-fourth of the sample identified drug use as the primary reason for their homelessness. Drug use was most prevalent among people who had been homeless for six months to three years and less prevalent among newly homeless people and people who had been homeless four years or more.     

Mental Health Correlates of Past Homelessness in Latinos and Asians

Mental illness and addiction are strongly associated with homelessness, yet few studies have shown how these relationships vary across ethnic categories that are underrepresented in the homeless population. This study draws from the National Latino and Asian American Survey to examine mental health and substance abuse correlates of homelessness amongst Latinos and Asians living in the United States. Clinical and institutional factors associated with homelessness varied by ethnicity. Among Latinos, alcohol abuse or dependence, conduct disorder and intermittent explosive disorder were risk factors for homelessness, while attending a religious service more than once a week was a protective factor. Among Asians, mood disorder was a risk factor as were health problems and receiving welfare in the past. Understanding ethnicity-specific correlates of homelessness may guide culturally nuanced mental health prevention and intervention efforts.