女性晚发性精神分裂症50例临床分析

为分析女性晚发性精神分裂症的临床特征,对45岁以后首次发病的女性患,符合CCMD-2-R精神分裂症诊断标准50例,对其临床资料进行回顾性分析。结果女性晚发性精神分裂症绝大多数化程度较低,以急性或亚急性起病较多,偏执型多见,躯体症状明显,多伴焦虑抑郁、自杀意念,小剂量单一用药为主,近期疗效好。     

晚发性精神分裂症73例临床分析

分析晚发性精神分裂症的临床特征。对４０岁以后首交发病,符合ＣＣＭＤ－２－Ｒ精神分裂症诊断标准的７３例患者的临床资料进行回顾性分析。结果发现晚发性精神分裂症女性多于男性多数文化程度偏你芭急性或亚急性起病为多,执型多见,多伴焦虑抑郁、自杀意念,小剂量单一用药为主,近期疗效好。     

晚发性精神分裂症

本文对晚发性精神分裂症的概念由来、临床特征、流行学、危险因素、脑成像、神经心理学缺损,治疗等进行了讨论。     

晚发性精神分裂症患者预后相关因素分析

对晚发性精神分裂症患者的预后相关因素进行分析,报告如下。1对象和方法系2002年1月至2005年1月期间住院的晚发性精神分裂症患者,符合中国精神障碍诊断标准第3版诊断标准;发病年龄≥60岁,为首次发病;排除严重器质性疾病者。共83例,男48例,女35例;平均年龄(69·2±4·5)岁;病程3     

304例早发与晚发性精神分裂症临床对照分析

目的探讨早发与晚发性精神分裂症的临床不同点。方法对150例早发性精神分裂症和154例晚发性精神分裂症患者的临床资料进行回顾性对照分析。结果两组比较,在部分精神症状如易激惹、妄想、自笑、懒散、脱衣露体、怪异动作、伤人、毁物、出走等,以及性别、病程、文化程度、分型等项上存在显著性差异(P<0.01~0.001)。结论早发性精神分裂症精神症状显著多于晚发性精神分裂症;而晚发性精神分裂症则具有女性多见、文化程度较低、病程较长、妄想多见、偏执型居多等特点。     

晚发与非晚发精神分裂症对照研究

对４个医疗单位精神科住院病人中的晚发性精神分裂症２４７例进行观察，以非晚发性精神分裂症病人２６４例为对照。结果发现，晚发组女性显著较多，病前性格内向者显著较少，家族精神病遗传史显著较少。发病诱因以晚发组显著较多，起病急或亚急者亦然。两组文化程度相仿，近期疗效以晚发组显著较好。作者认为，不仅有年龄的不同，晚发组病例在其他方面也有不少特点，精神分裂症应有晚发型为独立的亚型。     

影响晚发性精神分裂症患者预后的相关因素分析

作者对影响晚发性精神分裂症患者预后的相关因素进行了分析。现报道于后。1　对象和方法1 1　对象　本文对象为 1995年 3月～ 2 0 0 1年 3月住院的晚发精神分裂症患者 ,均符合ＣＣＭＤ - 2 -Ｒ中精神分裂症诊断标准 ,并为首次发病者 ,其发病年龄≥ 6 5岁。本文共 2 8例 ,其中男性 18例 ,女性 10例 ;平均年龄 (6 9± 4 )岁 ;病程 35天～ 3年 ;平均住院(43± 6 )天 ;诊断为精神分裂症偏执型 2 0例 ,未定型7例 ,紧张型 1例 ;病前性格为内倾型 18例 ,外倾型 6例 ,中间型 4例 ;经奋乃静 ,氟哌啶醇 ,利培酮等治疗。1 2　方法　采用ＢＰＲＳ ,Ｔ…     

晚发与非晚发精神分裂症临床对照分析

对４年精神病院较近期入院，初次发病年龄在４５岁以上的晚发性精神分裂症患者共２２８例进行观察，以同期住院的４５岁以下，初次发病的精神分裂患者３０９例为对照，结果发现，晚发组文化程度较低，发病前有精神或射体因素为诱因者较多见，以急性或亚急性起病较多，早期症状以神经症样症状较多见，而人格改变较少见，临床类型以偏执型为多，近期疗效较好。临床症状中有不少项目两组患者也有显著差别，除发病年龄两组间又存在这些显     

早发和晚发性精神分裂症的临床对照分析

本文对１００例早发和晚发性精神分裂症进行临床比较，发现晚发组女性多，起病急，有精神因素，被害妄想、抑郁和类神经症症状较早发组多见；早发组病初表现性格改变，以逻辑障碍、情感淡漠、意志减退多见。在家族史、病前性格及幻听、思维散漫、Ｓｃｈｎｅｉｄｅｒ一级症状等方面二组无显著性差异，治疗近期疗效相似。     

晚发性和早发性精神分裂症的遗传差异

目的：了解晚发性和早发性精神分裂症在遗传效应上的差异。方法：调查精神分裂症晚发组和早发组患者亲属中精神病的患病情况。结果：早发组有精神病家族史多,一级亲属中精神分裂症的发病风险率高,一级亲属的遗传率高,与晚发组比较,有明显的差异性。结论：晚发性和早发性精神分裂症间有遗传效应上的差异。     

阿立哌唑治疗晚发性精神分裂症的疗效对照分析

目的探讨阿立哌唑治疗晚发性精神分裂症患者的疗效与安全性。方法将62例符合CCDM-3晚发性精神分裂症诊断标准的患者随机分为阿立哌唑组（30例）和利培酮组（32例）。治疗8周。使用PANSS和CGISI量表评定疗效以及TESS量表评定不良反应。结果两组PANSS量表总分,阳性、阴性症状分、一般精神病理分以及CGISI量表评分,在第2周末均有极明显改善（P均〈0．01）,在第2、4及8周末两组比较无显著性差异。阿立哌唑组有效率为70％,利培酮组有效率为68．75％。阿立哌唑常见不良反应为失眠、焦虑、静坐不能、便秘及食欲下降等。结论阿立哌唑对晚发性精神分裂症的阳、阴性症状有效,其不良反应较轻微。     

晚发性精神分裂症的研究进展

精神分裂症是一种常见的病因尚未完全阐明的精神病,常有特殊的思维、知觉、情感和行为等多方面的障碍和精神活动与环境的不协调。多起病于青壮年,而临床上起病年龄为40岁以上的精神分裂症患者并不少见。Bleuler于1943年首次提出“晚发性精神分裂症”（Late—onset Schizophrenia）,指出发病年龄在40岁以后的为晚发性精神分裂症。     

What do we really know about late-onset schizophrenia?

Actual knowledge on classical late-onset schizophrenia, i.e. the schizophrenic disorders with onset after age 40 years, is reviewed regarding incidence, symptomatology and course. As is shown, sound empirical knowledge is scarce. Reasons for this are, on the one hand, the conceptual and terminological confusion which has occurred internationally regarding this illness group, and, on the other hand, the methodological limitations of the empirical studies conducted on this clinical picture thus far. If we only draw onclassical late-onset schizophrenia, as originally defined by Bleuler, and primarily on methodologically sound studies, as well as on own studies, we can nevertheless conclude that the term “late-onset schizophrenia” could be omitted. Late-onset schizophrenia does not seem to be a distinct entity, but instead seems to belong to the same illness group as classical schizophrenia with earlier onset. Slight differences in symptomatology and course are probably due to unspecific influences of age. The markedly higher proportion of women among late-onset cases, as well as our finding that symptomatology and course of late-onset women are comparably poor, could possibly be explained by an effect of the female sex hormone oestradiol.     

Comparative study of neuropsychological correlates in schizophrenia with onset in childhood, adolescence and adulthood

Childhood onset schizophrenia (COS) patients have marked neuropsychological deficits in areas of attention, working memory and executive functions. Similar deficits have been found in studies on Adolescent onset (AdOS) and Adult onset schizophrenia (AOS). In this study we compared the neuropsychological profile of COS with AdOS and AOS to test the hypothesis that earlier the onset greater is the severity of illness and greater are the neuropsychological deficits. A sample of 15 patients of COS was compared with 20 patients each of AdOS and AOS group. Assessment of neuropsychological profile was done using standard neuropsychological battery for Indian population. Nahor Benson Test and Bender Visual Motor Gestalt Test were used to assess perceptuomotor functioning. COS patients showed significantly greater deficits on scales of IQ, memory and perceptuomotor skills as compared to AdOS that in turn had greater deficits than AOS. The persistence of differences across the three groups inspite of controlling for education and age suggest that these deficits may have been present even before the onset of illness and was not the result of poor academic achievements. These findings also point towards a brain damage in schizophrenia that occurs on a continuum of severity with COS being the most virulent, AOS being the least and AdOS falling in between these two extremes.     

Comparative study of neurological soft signs in schizophrenia with onset in childhood, adolescence and adulthood

OBJECTIVE: To compare neurological soft signs (NSS) in patients of schizophrenia with onset in childhood (COS), adolescence (AdOS) and adulthood (AOS). METHOD: Assessment of NSS in 15 patients of COS and 20 patients each of AdOS and AOS was made using condensed neuropsychiatric examination for NSS. RESULTS: NSS were significantly more frequent in COS (100%) and AdOS (90%) when compared with AOS (55%) patients. COS patients showed significantly higher scores on temporal and frontal lobe NSS, of which differences between the three groups in temporal lobe NSS disappeared on ancova. Parietal lobe dependent NSS were seen in a few COS patients. The NSS were more in those with lesser IQ, lower education and higher Positive and Negative Syndrome Scale scores. CONCLUSION: Findings indicate that earlier onset types may be more strongly associated with a generalized disruption of brain function. Non-suppression of primitive reflexes with cortical maturation in COS point towards disordered neurodevelopment. Preponderance of fronto-temporal and a relative lack of parietal lobe NSS point towards differential lobar involvement. Neurodevelopmental abnormalities leading to NSS also lead to lower IQ and lower educational level.     

产后精神分裂症患者临床特征分析

背景 分娩可能使女性产生强烈的应激反应,并在一定程度上诱发精神心理问题,甚至导致女性精神分裂症患者疾病复发。目前国内关于产后精神分裂症临床特征及治疗的研究有限。目的 探讨产后精神分裂症患者的临床特征,为其临床治疗提供参考。方法 纳入2012年—2020年在广州医科大学附属脑科医院成人精神科女病区住院治疗的、符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)精神分裂症诊断标准的24例产后精神分裂症患者(产后组),同期纳入住院治疗的48例非产后女性精神分裂症患者(对照组)。收集两组患者基本资料、阳性和阴性症状量表(PANSS)评定结果及出院带药情况。结果 产后组首次发病及精神疾病家族史阳性的比例均高于对照组,差异均有统计学意义(χ²=9.321、5.240,P<0.05或0.01)。与对照组相比,产后组PANSS兴奋因子评分更高(t=-2.220,P<0.05),阴性症状因子评分更低(t=3.377,P<0.01)。出院带药方面,产后组抗精神病药物剂量高于对照组(t=-2.095,P<0.05),联合苯二氮?类药物和抗抑郁药物的比例均高...     

思瑞康治疗女性首发精神分裂症患者的疗效及安全性观察

目的 探讨思瑞康对女性首发精神分裂症患者的疗效及安全性.方法 对48例女性首发精神分裂症患者进行为期16周的思瑞康开放性治疗试验.治疗前及治疗后第4、8及16周末采用阳性和阴性症状量表（PANSS）及临床疗效总评疾病严重度量表（CGI-SI）评价疾病的严重程度;不良反应量表（TESS）评估药物不良反应;Sampson氏锥体外系不良反应量表（SAS）评价不良反应症状;利用自编的月经调查问卷每4周调查1次月经情况;治疗前、治疗结束时分别测定体重及血清催乳素（（PRL）水平.结果 ①治疗16周后PANSS总分值较治疗前明显下降,差异有极显著性（P＜0.001）,阳性和阴性症状量表分值较治疗前均明显下降（P＜0.05）;②各治疗时段PANSS总分、阳性因子分、阴性因子分均较前一次明显下降（P＜0.05）;③疗后CGI-SI分值与疗前相比明显下降,差异有极显著性（P＜0.001）;④36例患者PANSS减分率≥75%;⑤SAS评分疗前、疗后无显著性差异;⑥治疗后体重中度增加,与治疗前相比差异有显著性（P＜0.01）;⑦患者疗前、疗后血清PRL水平差异无显著性（P=0.307）;⑧月经周期、月经量及行经时间与用药前比较均无明显改变;⑨整个治疗期间未发生严重的不良反应.结论 思瑞康剂量达500～800mg/d时,能有效控制精神症状,对阳性、阴性症状均有效;发生锥体外系不良反应的危险性较小;对月经影响不明显,是较为理想的新型抗精神病药物.     

Effects of thymectomy on late-onset myasthenia gravis without thymoma

OBJECTIVES: This study aims to investigate whether thymectomy is beneficial for late-onset (>50 years) myasthenia gravis patients with no thymoma, particularly for those with mild generalized weakness. PATIENTS AND METHODS: A total of 34 patients were included in the study. The clinical course and long-term outcomes over 2 years were reviewed in 20 patients who underwent thymectomy and in 14 without thymectomy. RESULTS: Of the 34 patients, 20 (59%) underwent thymectomy. Thymectomized patients had more severe disability at entry than non-thymectomized patients, but outcome measures did not significantly differ between the two patient groups. Moreover, subgroup analyses including 22 patients with mild generalized weakness at entry showed that the thymectomized group (n=10) showed a greater percentage of clinical remission (no symptoms; 50% versus 17%; p=0.11) and a lower frequency of the presence of generalized symptoms (30% versus 75%; p<0.05) than the non-thymectomized group (n=12) at the end of follow-up (means 9.6 years after onset). CONCLUSIONS: Thymectomy is a potentially effective treatment for late onset, non-thymomatous patients with mild generalized myasthenia gravis.     

高泌乳素血症对女性精神分裂症患者的影响

目的:探讨高泌乳素血症对女性精神分裂症患者疗效及生活质量的影响。方法:将女性精神分裂症患者82例,分为研究组42例(伴有高泌乳素血症)及对照组40例(不伴高泌乳素血症)。以阳性与阴性症状量表(PANSS)、副反应量表(TESS)、生活质量综合评定问卷(GQOLI)评定的疗效、不良反应及生活质量。观察6个月。结果:第6个月末,研究组PANSS减分低于对照组(P<0.05)。GQOLI总分、躯体健康维度、心理健康维度、社会功能维度较入组时分值亦下降(P均<0.01);与对照组比较分值显著下降(P<0.01)。结论:伴有高泌乳素血症的女性精神分裂症患者的疗效差,生活质量下降。