齐拉西酮与氟哌啶醇治疗脑血管病所致精神障碍对照研究

目的：探讨齐拉西酮与氟哌啶醇治疗脑血管病所致精神障碍的疗效及安全性。方法将62例脑血管病所致精神障碍患者分为两组,研究组32例,对照组30例,两组在神经内科常规治疗的基础上,研究组口服齐拉西酮治疗,对照组口服氟哌啶醇治疗,观察6周。治疗前后采用简明精神病量表评定临床疗效,副反应量表评定不良反应。结果治疗6周末研究组有效率93．7％、对照组为86．7％,研究组有效率高于对照组,但差异无显著性（χ2＝0．89,P＞0．05）。两组不良反应均较轻,研究组以头痛、嗜睡多见,对照组以肌强直、便秘、口干多见。结论齐拉西酮治疗脑血管病所致精神障碍疗效显著,与氟哌啶醇相当,安全性高,但不良反应表现形式有所不同,临床上可根据不同患者选用不同的药物治疗。     

小剂量阿立哌唑联合磁朱丸治疗精神分裂症对照研究

目的：探讨小剂量阿立哌唑联合磁朱丸治疗精神分裂症的临床疗效和安全性。方法将68例精神分裂症患者随机分为两组,均口服阿立哌唑治疗,在此基础上研究组联合磁朱丸治疗,观察2个月。采用简明精神病量表评定临床疗效,副反应量表评定不良反应。结果研究组显效率82．4％,总有效率97．1％;对照组分别为58．8％、79．4％,两组比较差异均有显著性（χ2＝4．53、5．10,P＜0．05）。研究组不良反应发生率为11．8％,对照组为41．2％,研究组显著低于对照组（χ2＝7．56,P＜0．01）。结论小剂量阿立哌唑联合磁朱丸治疗精神分裂症具有协同增效作用,疗效显著,安全性高。     

Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H-NPI) applied to Greek outpatients with Alzheimer's disease: a study of disturbing behaviors among referrals to a memory clinic

CONTEXT: No rating scales of the neuropsychiatric symptoms of patients with dementia and Alzheimer's disease (AD) have previously been developed or translated. OBJECTIVES: To develop a Hellenic translation of the Neuropsychiatric Inventory (NPI), to evaluate it's reliability and validity, and to compare NPI results in Greek patients referred to a neuropsychiatry clinic for either of two reasons: disturbing behaviors evoking embarrassment and disturbing behaviors evoking fear in the caregiver. METHODS: The Hellenic translations of the NPI, Brief Psychiatric Rating Scale (BPRS), and Emotional Distress Scale (EDS) were compared in evaluating 29 consecutive referrals of patients with AD. RESULTS: The Hellenic NPI (H-NPI) demonstrated a high degree of internal consistency reliability, and of concurrent validity when compared to the BPRS or the EDS. Patients referred for behaviors evoking embarrassment presented with higher scores on NPI ratings of apathy. However, patients referred for behaviors evoking fear presented with higher scores on NPI ratings of aggression and irritability. CONCLUSIONS: These results indicate that the H-NPI is a reliable instrument, able to detect differences in clinically referred groups of AD patients.     

A Comparative Study of Benzodiazepine Hypnotics and Zopiclone in Schizophrenia: Effects on Polysomnograms and BPRS Scores

Abstract: Sleep variables and psychiatric symptoms during benzodiazepine (BZD) hypnotic therapy and during zopiclone (ZPC) treatment were investigated in 6 male chronic schizophrenics. The amount of stage 1 was smaller and that of stage 2 was larger during treatment with ZPC than BZDs. However, no significant difference was shown in the amount of slow-wave sleep (SWS) between the treatments. Both the total and negative-symptom scores in the Brief Psychiatric Rating Scale (BPRS) were lower, and the soundness of sleep in the subjective sleep assessments was better evaluated during treatment with ZPC than BZDs. These results suggest that ZPC may be more beneficial in treating schizophrenic insomnia than BZDs.     

The relationship between haloperidol blood levels and clinical responses

Haloperidol blood levels in patients were determined to elucidate the relationship between blood levels and clinical effects. Determinations of haloperidol serum were performed by radioimmunoassay and the clinical status was estimated using BPRS. The relationship between haloperidol serum levels and BPRS total score was studied in 20 chronic schizophrenics currently receiving haloperidol treatment. The results did not show positive relationship between these two. Another 11 schizophrenic patients were treated with daily doses of average 6 mg of haloperidol. The patients were classified into improved and unchanged group according to the changes of BPRS total score. All 7 cases classified into the improved group had short duration of the illness less than one year. In this group, the levels were lower initially but gradually rised in paralled with the increase of extent of recovery on BPRS. Furthermore, improvement of psychopathology by means of decrease of BPRS total score was still found after haloperidol serum levels reached a plateau. The results did not support the view that high blood concentration of haloperidol might contribute to the clinical effects, but still suggested utility of measuring blood levels in acute or subacute patients being treated with haloperidol medications.     

奥氮平与利培酮治疗儿童青少年首发精神分裂症对照研究

目的探讨奥氮平与利培酮治疗儿童青少年首发精神分裂症的临床疗效及安全性。方法将78例儿童青少年首发精神分裂症患者按人院顺序以奇偶法分成两组,奥氮平组38例,口服奥氮平治疗,利培酮组40例,口服利培酮治疗,观察8周。于治疗前及治疗第2周、4周、6周、8周末采用简明精神病量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组简明精神病量表评分均较治疗前显著下降（P〈O．05或0．01）;奥氮平组治疗2周末较利培酮组下降更显著（P〈O．05）,其他时段评分两组比较差异均无显著性（P〉0．05）;治疗8周末,奥氮平组总有效率为89．5％,利培酮组为85．0％,两组总有效率比较差异无显著性（x^2=0．35,P〉0．05）;两组不良反应均较轻微,发生率比较差异无显著性（P〉0．05）。结论奥氮平与利培酮治疗儿童青少年首发精神分裂症患者疗效显著且相当,安全性高,但奥氮平起效更快,可以作为治疗儿童青少年精神分裂症患者的一线药物。     

High prevalence of Human Herpesvirus 8 in schizophrenic patients

Many studies have reported an association between Herpes family viruses and an increased risk of schizophrenia, but the role of Human Herpesvirus 8 (HHV8) has never been investigated. This study aimed to assess HHV8 prevalence in schizophrenic patients as well as the possible association between HHV8 infection and schizophrenia clinical features. We consecutively enrolled 108 patients meeting fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria of schizophrenia and 108 age and sex matched controls. Data about a number of demographic characteristics and potential HHV8 risk factors of infection were collected. Standardized psychopathology measures, disease severity and functioning level were obtained using Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Clinical Global Impressions (CGI) and Global Assessment of functioning (GAF). The presence of anti-HHV8 antibodies was analyzed using an indirect immunofluorescence assay. A higher prevalence of HHV8 infection in schizophrenic patients than in controls was found. Marital status, having children, sexual behavior and risk factors of blood transmission were not associated with HHV8 prevalence. However, among schizophrenic patients, HHV8 prevalence was statically associated with positive symptoms. To our knowledge, this would be the first report of a possible role of HHV8 in the pathogenesis of schizophrenia. To prove this hypothesis, further investigation of HHV8 in schizophrenia with larger samples is needed.     

流浪精神病住院患者综合治疗及护理干预效果评价

目的探讨流浪精神病住院患者综合治疗及护理干预效果,为临床治疗、康复指导及护理干预提供理论依据。方法对52例流浪精神病住院患者进行系统的综合治疗及护理干预,观察4周。于治疗前及治疗2周、4周末采用简明精神病量表评定临床疗效,住院病人观察量表评估护理干预效果。结果流浪精神病患者住院治疗后简明精神病量表评分呈持续性下降,治疗4周末与治疗前比较有极显著性差异（P〈0．01）;住院病人观察量表激惹、精神病表现、抑郁、迟缓、总消极因素、病情总估计因子分均呈持续性下降,而社会功能、社会兴趣、个人整洁、总积极因素因子分均呈持续性升高,治疗4周末与治疗前比较均有极显著性差异（P〈0．01）。结论导致流浪精神病患者的原因诸多,经住院系统治疗及护理于预后,可获得显著效果,各地政府应高度重视精神病的社区防治工作。     

精神分裂症患者攻击行为与血清甲状腺素睾酮水平的相关性

目的：探讨精神分裂症患者攻击行为与血清甲状腺素、睾酮水平的相关性。方法对120例精神分裂症患者采用简明精神病量表评定精神症状,依据既往暴力史及外显攻击行为量表评定攻击行为,将有攻击行为的70例患者设为研究组,无攻击行为的50例患者设为对照组。检测两组促甲状腺激素、血清游离三碘甲状腺原氨酸、血清游离甲状腺素、总三碘甲状腺原氨酸、总甲状腺激素及血清睾酮水平。对检测结果进行对比分析及相关分析。结果研究组血清总三碘甲状腺原氨酸、血清游离三碘甲状腺原氨酸水平显著高于对照组（P＜0．05）,促甲状腺激素水平显著低于对照组（P＜0．01）。研究组血清总三碘甲状腺原氨酸水平与外显攻击行为量表中言语攻击、财产攻击因子分呈正相关（P＜0．05）,与简明精神病量表中缺乏活力因子分呈负相关（P＜0．05）;血清游离三碘甲状腺原氨酸与外显攻击行为量表中财产攻击、自身攻击因子分呈正相关（P＜0．05）;男性血清睾酮水平与外显攻击行为量表中言语攻击、自身攻击因子分呈正相关（P＜0．05）,与简明精神病量表中缺乏活力因子分呈负相关（P＜0．05）;女性血清睾酮水平与外显攻击行为量表中自身攻击因子分呈正相关（P＜0．05）,与简明精神病量表中缺乏活力因子分呈负相关（P＜0．05）。结论精神分裂症患者攻击行为与血清总三碘甲状腺原氨酸、血清游离三碘甲状腺原氨酸水平及血清睾酮水平的变化呈正相关。临床上对伴有攻击行为的精神分裂症患者可定期监测甲状腺激素及睾酮水平进行预测性评估,为早期干预提供依据。     

氨磺必利与氯氮平对以阴性症状为主精神分裂症患者生活质量的影响

目的：探讨氨磺必利与氯氮平对以阴性症状为主的精神分裂症患者临床疗效和生活质量的影响。方法将82例以阴性症状为主的精神分裂症患者随机分为两组,分别口服氨磺必利及氯氮平治疗,观察3个月。治疗前后采用阴性症状量表、简明精神病量表评定临床疗效,副反应量表评定不良反应,生活质量综合评定问卷评定生活质量。结果治疗前两组各量表评分比较差异无显著性（P＞0．05）。治疗后两组阴性症状量表、简明精神病量表总分均较治疗前显著降低（P＜0．05）,两者比较差异无显著性（P＞0．05）;生活质量综合评定问卷的社会功能、心理健康及躯体健康因子分均较治疗前显著升高（P＜0．01）,氨磺必利组显著高于氯氮平组（P＜0．01）。氨磺必利组不良反应发生率显著低于氯氮平组（P＜0．01）。结论氨磺必利与氯氮平治疗以阴性症状为主的精神分裂症患者疗效均显著,但氨磺必利改善患者生活质量效果更佳,安全性更高。