奥卡西平治疗复发性躁狂疗效分析

目的观察奥卡西平治疗复发性躁狂的临床疗效和副反应。方法随机对96例复发性躁狂发作的患者分别以奥卡西平及碳酸锂治疗,使用Bech-Rafaelson躁狂量表（BRMS）评定临床疗效,并对治疗期间出现的药物副反应进行比较。结果两组治疗后BRMS分值均大幅度下降,差异有显著性（P〈0.01）,但组间比较差异无显著性（P〉0.05）,奥卡西平副反应发生率较低。结论奥卡西平用于治疗复发性躁狂,疗效肯定,与碳酸锂疗效相近,且副反应较轻,安全性好。     

Desire for information about drugs: a survey of the need for information in psychiatric in-patients

Background Promoting therapy adherence requires understanding various psychosocial parameters, including patients need for information. Drug information adapted to patients needs may empower them and increase their confidence in drug therapy. Objectives: To explore psychiatric in-patients information preferences and to test the reliability of a Dutch version of the Intrinsic Desire for Information (IDI) scale in psychiatric institutions in Flanders.Methods Standardised interviews were conducted with psychiatric patients in 11 hospitals. The interview consisted of the IDI-scale and five open questions. Patient demographics collected were sex, age, number of medicines taken, diagnosis, number of admissions during the past year, marital status, education level and occupation.Results 279 patient interviews were completed. A factor analysis on the original 12-item scale yielded 3 factors. An abbreviated scale was derived from the first factor (F1). This 6-item scale measured extent of information desired: (EID) and consisted of six items (Cronbachs = 0,73). A second factor (F2) measured information provider preference (IPP) ( = 0,56) and a third factor (F3) measured inhibited information desire (IID) ( = 0,69). EID was associated with number of medicines taken, duration of hospitalisation and marital status.Conclusion The internal reliability of the EID-factor appears to be reproducible in the specific setting of psychiatric hospitals. It may be useful to help healthcare professionals develop pharmaceutical care towards psychiatric patients. Validation of the scale remains to be completed. Information need in psychiatric in-patients measured by the EID-score was comparable to the need measured in general hospitals during earlier research in England. Targeted information services seem to be desirable to enhance therapy adherence and quality of life in psychiatric patients.     

Improving quality of psychiatric care in Latvia by measuring patient experiences

In Latvia, as in many former Soviet Union countries, there used to be little priority given to systematic assessments of the quality of psychiatric care. Furthermore, using the experiences of patients as a measure of quality was unthinkable because psychiatric patients were seen as incapable of assessing quality of psychiatric services. Over the past few years, and facilitated by Latvia's progress along the route of Western democracy and participation in international organizations (EU, OECD), as well as funding support from the EU, several policy documents have been developed with the aim of improving healthcare quality. Simultaneously, several small-scale initiatives have emerged aiming at the promotion of quality of care, such as the quality award, and the quality comparison of psychiatric hospitals. Furthermore, the Psychiatric Inpatient Patient Experience Questionnaire for on-site measurement (PIPEQ-OS) has recently been adapted for use in Latvia. The first application of PIPEQ-OS in a psychiatric hospital in Riga reveals high patient responsiveness, interest and surprise about being asked to participate in the decision-making process regarding treatment and pharmaceutical choices. More widespread use of the PIPEQ-OS has considerable potential for (1) improving information about treatment shortcomings from the patients' perspective and (2) improving the treatment process by opening doors of cooperation with patients and changing deep-rooted paradigms.     

Developing a Brief Neuropsychological Battery for Early Diagnosis of Cognitive Impairment

ObjectivesEarly diagnosis of cognitive impairment is increasingly emphasized in the literature to facilitate timely preventive interventions. Although bedside cognitive tests such as the Montreal Cognitive Assessment (MoCA) are widely used for such early diagnostic purposes, they may not have comparable performance to a full neuropsychological battery (FNB) in diagnosing early cognitive impairment. This study investigated whether a small subset of neuropsychological tests can be added on to MoCA to match its performance to that of the FNB in discriminating mild cognitive impairment and dementia (MCI/dementia) from normal cognition.DesignCross-sectional diagnostic study.SettingAlzheimer's Disease Centers across the United States.ParticipantsOlder participants (≥50 years) who completed MoCA and the FNB (N = 9187).MeasuresThe study sample was split into two: the derivation sample (n = 1837) was used to develop a brief neuropsychological battery that best discriminated MCI/dementia (using the best-subset approach with 10-fold cross-validation); while the validation sample (n = 7350) verified its actual performance in discriminating MCI/dementia.ResultsA 3-item neuropsychological battery was identified, comprising MoCA, Benson Complex Figure Recall, and Craft Story 21 Delayed Recall. It had excellent performance in discriminating MCI/dementia from normal cognition (area under the receiver operating characteristic curve [AUROC] 90.0%, 95% confidence interval [CI] 89.2%-90.7%), which was comparable to that of the FNB (AUROC 88.4%, 95% CI 87.6%-89.2%). By contrast, MoCA alone had significantly worse AUROC (86.9%, 95% CI 86.0%-87.7%) than that of the FNB.Conclusions/ImplicationsUsing rigorous methods, this study developed a brief neuropsychological battery that maintained the brevity of a bedside cognitive test, while rivaling the diagnostic performance of an FNB in early cognitive impairment. This brief battery offers a viable alternative when the FNB is needed but cannot be feasibly administered in nonspecialty clinics. It can have a wider health systems effect of improving patients’ access to accurate diagnosis in early cognitive impairment and facilitating timely interventions to delay the progression of cognitive impairment.     

Diagnosis of schizophrenia by computer and clinicians: A pilot study

Investigations show significant disagreement among mental health professionals in diagnosing schizophrenia.^1–11 Recently, computer-based systems have been used in attempts to improve diagnostic consistency. Spitzer and Endicott, among others, have devised a computer program using the Mental Status Examination Report (MSER) as input data.^12–19 The MSER is a systematic, relatively objective inventory of observed behaviors used to obtain a mental status. The MSER was used at the Hillside Division during 1973 and 1974. It was filled out 1 week after admission by therapists who were specially trained for this task. It was noted that a nonschizophrenic computer diagnosis was given to a number of patients diagnosed schizophrenic by clinicians, but the reverse rarely occurred. Was this due to the computer program, the MSER, clinicians, or other factors? These questions have heightened relevance in light of the imminence of Professional Standards Review Organization (PSRO).²⁰ Hospitals may be required to establish definitive operational diagnostic criteria and correlated treatments in order to maintain accreditation and be reimbursed by third-party payers. This study investigated these diagnostic discrepancies in order to ascertain what specific criteria could be used in making a schizophrenic diagnosis in hospitalized patients. Secondarily, the study sought to shed further light on whether such a computer system could be useful as an adjunctive diagnostic modality to pinpoint difficult cases.     

What is the purpose of launching the World Journal of Psychiatry?

The first issue of World Journal of Psychiatry (WJP), whose preparatory work was initiated on May 18, 2011, will be published on December 31, 2011. The WJP Editorial Board has now been established and consists of 103 distinguished experts from 32 countries. Our purpose of launching WJP is to publish peer-reviewed, high-quality articles via an open-access online publishing model, thereby acting as a platform for communication between peers and the wider public, and maximizing the benefits to editorial board members, authors and readers.     

Radicalisation et « image de soi »

Europe and France are traversed by new forms of mobilization, individual or collective initiatives that find their expression in an exacerbated radicalism, forged and fed by the rejection of the republican pact. With economic crisis, young people are looking for an ideal. This phenomenon of radicalization feeds in particular societal and social changes of recent decades, such as the break-up of the family structure with the devaluation of parental authority. Also, radical Islamism offers them a “kit ready to think”. We report the role of “self-image” as a product of bodily sensations and emotions in the genesis of this phenomenon. Radical Islam can provide them a kind of “identity prosthesis” that will support the gap between self-representation and self-idealism.     

反思功能在精神病学中的研究进展

反思功能(Reflective Function,RF)为心智化的测量与实证研究提供了途径和框架.本文对RF的概念、测量工具做出了简要介绍,陈列并讨论了目前RF在不同精神病理学背景下的实证研究.RF作为一个新兴概念,相关研究主要在国外开展,各项研究已初步证明RF在精神病理学中所扮演的重要角色,随着RF测量工具的飞速进展,大样本量的实证研究将得到更多的开展.     

酒精所致精神障碍患者的嫉妒妄想分析

目的了解酒精所致精神障碍患者嫉妒妄想的发生频率及妄想的特征,所致的攻击行为。方法对64例住院的酒精所致精神障碍患者进行了分析并对是否伴有嫉妒妄想的患者进行组间比较。结果有嫉妒妄想占60.9%,嫉妒妄想组在伴有被害妄想、幻听、幻视及对配偶攻击行为方面显著高于无嫉妒妄想组。结论伴有嫉妒妄想的酒精所致精神障碍患者具有更大的对配偶攻击危险性及更多的其他精神病性症状,应及时加强治疗与监管。