Risk factors for diabetes,but not for cardiovascular disease,are associated with family history of Type 2 diabetes in subjects from central Mexico

Background: Independent of obesity, family history of type 2 diabetes mellitus (FHT2DM) is another important risk factor for developing diabetes.

Aim: To establish the association among FHT2DM, risk factors for diabetes and cardiovascular disease in subjects from central Mexico.

Subjects and methods: Clinical and biochemical studies were performed in 383 first-degree relatives of patients with type 2 diabetes and 270 subjects unrelated to patients with type 2 diabetes—all subjects were from the city of Puebla in central Mexico. Logistic regressions were used to assess the association between FHT2DM and metabolic parameters. Cardiovascular risk was classified by dyslipidemia and the Framingham Risk Score (FRS).

Results: FHT2DM was associated with risk factors for diabetes, such as increased fasting insulin levels (OR = 1.731, 95% CI = 1.041–2.877), decreased insulin sensitivity (OR = 1.951, 95% CI = 1.236–3.080) and pre-diabetes (OR = 1.63, 95% CI = 1.14–2.33). FHT2DH was not associated with risk factors for cardiovascular disease, such as dyslipidemia (OR = 1.12, 95% CI = 0.70–1.79) and FRS (OR = 0.74, 95% CI = 0.40–1.36) when adjusted for gender, age, smoking and obesity.

Conclusion: Diabetic risk factors, but not cardiovascular disease risk factors, are associated with a positive family history of diabetes in subjects from central Mexico, independent of the presence of obesity.     

2型糖尿病家系非糖尿病一级亲属胰岛β细胞功能状态的研究

目的:探讨2型糖尿病(T2DM)家系非糖尿病一级亲属在不同糖耐量时胰岛素分泌第一时相的变化,及其在2型糖尿病发生、发展中的作用。方法:收集T2DM一级亲属正常糖耐量(NGT)组30例、糖耐量异常(IGT)组32例及新诊断T2DM组38例,并以无糖尿病家族史的30例健康成人(NC)为对照组,进行25 g静脉葡萄糖耐量试验(IVGTT),计算各组第一时相胰岛素分泌功能指数(AIR3-5)及胰岛素敏感指数(ISI)并进行比较。结果:新诊断的T2DM人群中,Homaβ、FPG、AIR3-5和ISI异常最为明显;而T2DM家系非糖尿病一级亲属的AIR3-5(53.67±2.36)mU/L和正常对照人群相比(80.85±1.43)mU/L出现下降;而ISI显著低于正常组均(P<0.01),但所有指标均处在正常人群和新诊断T2DM患者之间。结论:与正常对照人群相比,T2DM一级亲属NGT人群的胰岛β细胞第一时相胰岛素分泌减低,且存在胰岛素抵抗。     

强迫症患者一级亲属的三维人格特征的研究

目的 探讨强迫症患者一级亲属的三维人格特征.方法 运用三维人格问卷(TPQ)对48例强迫症患者一级亲属和95例正常对照进行测定.结果 强迫症患者一级亲属与正常对照组相比猎奇性分量表总分及各因子分无统计学差异;躲避伤害分量表HA1及HA2因子及总分均较高(P＜0.05);奖赏依赖分量表因子得分及总分无统计学差异.两组TPQ各因子评分无性别差异(P＞0.05).结论 强迫症患者一级亲属的三维人格特征表现为躲避伤害,看事情悲观,害怕不确定性.     

Intelligence,educational attainment,and brain structure in those at familial high‐risk for schizophrenia or bipolar disorder

First‐degree relatives of patients diagnosed with schizophrenia (SZ‐FDRs) show similar patterns of brain abnormalities and cognitive alterations to patients, albeit with smaller effect sizes. First‐degree relatives of patients diagnosed with bipolar disorder (BD‐FDRs) show divergent patterns; on average, intracranial volume is larger compared to controls, and findings on cognitive alterations in BD‐FDRs are inconsistent. Here, we performed a meta‐analysis of global and regional brain measures (cortical and subcortical), current IQ, and educational attainment in 5,795 individuals (1,103 SZ‐FDRs, 867 BD‐FDRs, 2,190 controls, 942 schizophrenia patients, 693 bipolar patients) from 36 schizophrenia and/or bipolar disorder family cohorts, with standardized methods. Compared to controls, SZ‐FDRs showed a pattern of widespread thinner cortex, while BD‐FDRs had widespread larger cortical surface area. IQ was lower in SZ‐FDRs (d = −0.42, p = 3 × 10⁻⁵), with weak evidence of IQ reductions among BD‐FDRs (d = −0.23, p = .045). Both relative groups had similar educational attainment compared to controls. When adjusting for IQ or educational attainment, the group‐effects on brain measures changed, albeit modestly. Changes were in the expected direction, with less pronounced brain abnormalities in SZ‐FDRs and more pronounced effects in BD‐FDRs. To conclude, SZ‐FDRs and BD‐FDRs show a differential pattern of structural brain abnormalities. In contrast, both had lower IQ scores and similar school achievements compared to controls. Given that brain differences between SZ‐FDRs and BD‐FDRs remain after adjusting for IQ or educational attainment, we suggest that differential brain developmental processes underlying predisposition for schizophrenia or bipolar disorder are likely independent of general cognitive impairment.     

Association between familial suicidal behavior and frequency of attempts among depressed suicide attempters

Objective: Only a few studies have examined whether a family history of suicide influences the severity of suicidal acts and the results have been inconsistent. The current study aimed to examine whether a family history of suicidal acts predicts severity of suicide attempts. Method: 190 suicide attempters aged 18–75 years with a lifetime history of major depression were assessed for first‐degree family history of suicidality and severity of suicide attempts (number and lethality of prior suicide attempts and age at first attempt). Results: Regression analyses indicate that a positive family history of suicidal behaviors predicts a greater number of suicide attempts. Reasons for living predict number and lethality of prior attempts. Conclusion: It is critical to assess for family history of suicidal behavior when treating depressed suicide attempters as it may serve as an indicator of the risk of repeat suicide attempt and as a guide for treatment.     

精神分裂症患者未患病一级亲属的认知功能研究

目的 探讨精神分裂症未患病的一级亲属认知功能的特点。方法 对110例精神分裂症患者未患病一级亲属（亲属组）及50例正常对照（对照组）进行认知功能测验,包括持续注意力测试（CPT）、威斯康星卡片分类测试（WCST）、修订版韦氏记忆量表（WMS-RC）的逻辑记忆和词语流畅性测试。结果 精神分裂症患者一级亲属在WMS-RC逻辑记忆中的即刻逻辑记忆、延迟逻辑记忆,词语流畅性测试中的词语总数、词语正确数,CPT中的视觉漏报、视觉平均反映时间1和2、听觉漏报数、听觉平均反应时间1和2的成绩均差于对照组（P〈0.05）。结论 精神分裂症未患病的一级亲属存在一定程度的认知功能损害,提示认知损害可能是精神分裂症的内表型指标之一。     

心理干预对精神分裂症患者亲属心理状况的影响

目的：探讨心理干预对精神分裂症患者亲属心理状况的影响。方法：采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和自编精神分裂症健康知识调查问卷对83名精神分裂症患者的亲属进行调查,并对其进行为期4周的心理干预。结果：精神分裂症患者亲属心理干预前的SAS和SDS评分分别为（53.90±2.02）分和（61.40±1.07）分,显著高于全国常模的（41.90±2.60）分和（41.40±1.83）分（P〈0.05）;心理干预后患者亲属的SAS和SDS评分分别为（41.00±1.56）分和（41.50±1.08）分,较干预前有显著降低（P〈0.05）;干预后亲属对患者疾病相关知识的知晓度明显提高。结论：心理干预可有效改善患者亲属的心理状况。     

A comparison of euthymic bipolar patients with unaffected first-degree relatives and healthy controls in terms of neuropsychological functions

Objective. Cognitive dysfunction in bipolar disorder (BD) is well established in the literature. The neurocognitive deficits have been considered to be endophenotypic markers of BD, and studies have examined whether neurocognitive deficits exist in first-degree relatives of individuals with BD I. We hypothesized that performance in tests of neurocognitive function would be impaired in euthymic BD I patients and their unaffected first-degree relatives compared to that of healthy controls. Methods. We compared the performance of bipolar patients, their first-degree relatives, and healthy controls in a battery of neurocognitive tests to reveal possible endophenotypes of BD. A diagnostic interview and neuropsychological test battery were administered to 30 BD I patients, 55 of their unaffected first-degree relatives and 32 healthy controls. Results. The patients and their first-degree relatives were significantly impaired in executive function assessed using the Wisconsin Card Sorting Test (WCST) and Trail Making Test-B (TMT-B) relative to the controls (WCST; perseverative errors: p < 0.0005, categories completed: p = 0.002, TMT-B; p = 0.002). There were no significant differences between the groups in terms of attention, psychomotor speed, verbal memory, or learning. Conclusion. Our study suggests that the deficits in executive function may be endophenotypic markers of genetic vulnerability to BD I.     

Visiting a nursing home: Relatives' experiences of encounters with nurses

The purpose of this study was to explore and interpret the meaning of relatives' experiences of encounters with nurses when visiting residents in nursing homes. Thirteen relatives of residents in three nursing homes in Sweden were interviewed. The interviews were tape-recorded and transcribed verbatim. The method used was hermeneutical text analysis. Four themes emerged in the analysis and interpretation of the whole text: 'being paid attention to', 'being ignored', 'being involved' and 'being safe and secure'. A further interpretation of the findings shows a deeper understanding of the meaning of relatives. This meaning was revealed as being invited into an encounter with nurses and gave a sense of community but the opposite was being ignored and left outside. This study gives a deeper understanding of the meaning of encounters between relatives and nurses in nursing homes; it also illuminates how these encounters also can affect the care of the residents. This new understanding can hopefully offer support for nurses during their encounters with relatives and optimise the ability to provide a positive outcome for residents in nursing homes.     

护理干预对ICU患者亲属焦虑状态的影响

目的探讨护理干预对ICU患者亲属焦虑状态的影响。方法对干预组患者亲属进行健康教育及心理疏导,对照组采用常规宣教,在患者入住ICU后24～36h,采用状态焦虑量表对患者亲属进行调查。结果ICU患者亲属的状态焦虑问卷得分明显低于对照组,差异具有统计学意义（P〈0．01）。结论有针对性地进行健康教育和心理疏导可减轻ICU患者亲属的焦虑程度。