抗精神病药物对儿童少年精神分裂症患者血浆白细胞介素-6的影响

目的探讨抗精神病药物对儿童少年精神分裂症患者白细胞介素-6(IL-6)的影响及IL-6与精神病理的关系。方法对41例儿童少年首发精神分裂症患者用酶联免疫吸附法检测抗精神病药物治疗前后IL-6血浆水平,用健康儿童少年作对照,并用阳性和阴性症状量表(PANSS)评估精神症状及其变化。结果治疗前患者组血浆IL-6水平显著高于正常对照组,治疗后4、8周末IL-6水平显著低于治疗前。治疗后4周末IL-6水平与阳性症状呈正相关,治疗后4、8周末一般病理分减分率、治疗后8周末PANSS总分减分率与IL-6减分率呈正相关。结论儿童少年精神分裂患者存在细胞免疫异常,抗精神病药物对儿童少年精神分裂症患者有免疫抑制作用,血浆IL-6与精神分裂症精神病理之间有一定的关系。     

精神分裂症患者短时和瞬时记忆因子与精神症状严重性的关系

目的:探究精神分裂症患者精神症状严重程度对其记忆测试得分的影响。方法:对80例符合DSM-Ⅳ诊断标准的精神分裂症住院患者进行阳性与阴性症状量表(PANSS)、韦氏记忆力测试(Wechsler Memory Scale,WMS)的短时和瞬时记忆(再认、图片、联想、背数4项因子)测评,比较其间是否具有相关性。结果:通过双变量相关分析,精神分裂症患者PANSS阳性症状得分与WMS短时和瞬时记忆总得分具有显著负相关(r=-0.293,P=0.008),精神分裂症患者PANSS总得分与WMS短时和瞬时记忆总得分具有显著负相关(r=-0.285,P=0.010),精神分裂症患者PANSS一般精神症状得分与WMS短时和瞬时记忆总得分具有显著负相关(r=-0.230,P=0.040)。结论:精神分裂症患者精神症状严重程度(尤其是阳性症状得分)对其WMS短时和瞬时记忆测试得分产生显著的影响。     

精神分裂症致炎性细胞因子、酪氨酸羟化酶基因表达水平与临床症状的关系

目的检测精神分裂症患者致炎性细胞因子(白介素-1β、肿瘤坏死因子-α)和酪氨酸羟化酶(TH)的基因表达水平,探讨其与临床症状的关系。方法采用送转录-聚合酶链式反应(RT-PCR)和半定量技术,分别检测39例精神分裂症患者,25例同胞对照和30例正常对照外周血单个核细胞IL-1β、TNF-α和TH的基因表达水平,同时应用PANSS量表评定精神分裂症患者临床症状。结果IL-1β在病例组、同胞对照组和正常对照组的基因表达水平分别为1.52±1.01、1.18±0.99和0.55±0.33;TNF-α在三组样本的基因表达水平分别为1.52±1.09、1.01±0.87和0.61±0.32;TH在三组样本的基因表达水平分别为0.74±0.38、0.70±0.29和0.28±0.20。其中病例组与同胞对照组IL-1β、TNF-α、TH基因表达水平无显著差异(P>0.05);病例组和同胞对照组的IL-1β、TNF-α、TH基因表达水平均显著高于正常对照组(P<0.05或P<0.01)。同时发现IL-1β(r=0.420)、TNF-α(r=0.430)基因表达水平与PANSS量表的一般病理症状分显著相关(P<0.01)。结论精神分裂症患者存在多巴胺功能亢进和致炎性细胞因子的过度表达,且可能受遗传背景影响。致炎性细胞因子可能参与精神分裂症一般病理症状的形成。     

奎硫平和利培酮治疗首发精神分裂症对比分析

目的:比较奎硫平和利培酮对首发精神分裂症病人的疗效和不良反应。方法:将68例符合中国精神疾病分类方案与诊断标准第3版(CCMD-3)的首发精神分裂症病人随机分为两组,奎硫平组和利培酮组。于治疗基线和治疗后1、2、4、8周末分别进行阳性症状和阴性症状量表(PANSS)、领悟测验、数字广度测验、填图测验评定临床疗效,治疗时出现的症状量表(TESS)评定不良反应。结果:经过8周治疗,两组疗效无显著性差异(P>0.05),不良反应发生率无显著性差异(P>0.05),奎硫平组锥体外系反应的发生率明显低于利培酮组(P<0.05),而心电图改变明显高于利培酮组(P<0.05)。结论:奎硫平和利培酮对首发精神分裂症患者的疗效相当,前者锥体外系不良反应轻,心电图改变较多。     

维思通治疗精神分裂症疗效与PANSS应用的初步研究

目的初步研究维思通治疗精神分裂症的疗效和不良反应，以及ＰＡＮＳＳ的临床适用性。方法２０例病人用维思通治疗八周，用ＰＡＮＳＳ、ＣＧＩ和ＧＡＳ评定疗效，ＥＳＲＳ和实验室检查评价不良反应。结果维思通对阳性和阴性分裂症状有效，起效较快。不良反应有轻度锥外反应和激越。ＰＡＮＳＳ的平行效度和内部一致性尚可。结论维思通对精神分裂症有效且安全性高。ＰＡＮＳＳ适合做为精神分裂症的评定工具     

Predictors of compulsory admission in schizophrenia-spectrum patients: excitement, insight, emotion perception

Purpose

We explored socio-demographic and clinical variables associated with compulsory admissions (CA) compared with voluntary admissions in schizophrenia-spectrum patients; moreover, we investigated the ability of excitement, emotion perception, and lack of insight to predict CA.

Methods

119 consecutive schizophrenia-spectrum patients admitted to the Servizio Psichiatrico di Diagnosi e Cura (SPDC = PES = psychiatric emergency service) of the Department of Neuroscience and Mental Health-San Giovanni Battista Hospital of Turin in the period between December 2007 and December 2009 were enrolled in the study. A backward stepwise logistic regression was used to test factors contributing to CA.

Results

CA rate in our sample was 28.5%. Previous CAs, drop-out, severity of illness, positive symptoms, excitement, emotion perception, and insight were significantly different in CA patients compared to voluntary ones. After backward selection of variables, three variables predicted CA in our sample: excitement, impaired emotion perception and lesser insight. Finally, the effect of excitement on CA status seemed partially mediated by emotion perception, the prediction model accounting for 53.8% of the variance of CA status. Conversely, insight seemed not to be a mediator of excitement on CA.

Implications

Understanding CA patterns in special populations represents a first step towards improving clinical decision-making and developing appropriate interventions and service-provision.     

Effect of Probiotic Adjuvant Therapy on Improvement of Clinical Symptoms & Interleukin 6 Levels in Patients With Schizophrenia

Objective This study aims to examine the effect of giving probiotic adjuvant therapy on improving clinical symptoms & IL-6 levels in patients with schizophrenia. Methods This research was a double-blind, placebo-controlled trial conducted at Dadi Psychiatric Hospital, South Sulawesi Province, Indonesia in November–December 2021. The sample of the research was patients with schizophrenia undergoing hospitalization who received therapeutic doses of risperidone with a total of 21 samples in each treatment and control group. Research subjects were measured with Positive and Negative Syndrome Scale (PANSS) at baseline, 2nd, 4th, and 6th weeks. The treatment group received one capsule/12 hours/oral of probiotics for six weeks and the control group received 1 capsule/12 hours/oral placebo for 6 weeks. In addition, two measurements of IL-6 using enzyme-linked immunosorbent assay were performed in both groups, namely at the beginning of week 0 and the end of the 6th week. Results We found the decrease in the PANSS value which described the improvement in clinical symptoms of the schizophrenic group after receiving therapeutic doses of antipsychotics and probiotic capsules or the treatment group as well as the schizophrenia group receiving therapeutic doses of antipsychotics and placebo capsules or the control group. Conclusion Improvements in clinical symptoms and decreased levels of IL-6 in the group of patients with schizophrenia who received risperidone with probiotic adjuvant therapy were better than in the group of patients with schizophrenia who received risperidone without probiotics as adjuvant therapy.     

利培酮与氯丙嗪治疗精神分裂症临床研究

目的比较利培酮与氯丙嗪治疗精神分裂症的疗效及安全性。方法随机抽取28例服用利培酮、28例服用氯丙嗪的精神分裂症患者，用阳性与阴性症状量表、副反应症状量表进行评定，两组分别进行比较。结果利培酮组的PANSS评分与临床治疗效果明显好于对照组，两组的副反应症发生情况无显著性差异。结论利培酮能更好地改善首发精神分裂症患者的认知功能，临床疗效好，安全性优，值得临床推广。     

No association of serotonin transporter polymorphism (5-HTTVNTR and 5-HTTLPR) with characteristics and treatment response to atypical antipsychotic agents in schizophrenic patients

Background

Serotonin transporter is a candidate gene for the pathogenesis of some psychiatric disorders. The aim of this study was to examine the role of the serotonin transporter gene polymorphism in the clinical aspects of schizophrenia including symptomatology and therapeutic response.

Methods

This study comprised 141 unrelated patients who strictly met the DSM-IV criteria for schizophrenia and 115 control subjects. All subjects were of Korean ethnicity. Serotonin transporter intron 2 VNTR polymorphism (5-HTTVNTR) and serotonin transporter linked polymorphic region polymorphism (5-HTTLPR) were analyzed in schizophrenia patients and control subjects. The Positive and Negative Symptom Scale (PANSS) was used at baseline and 6 weeks after atypical antipsychotic treatment to evaluate the clinical symptoms. Body mass index (BMI), the Barnes Akathisia Rating Scale (BARS), the Simpson–Angus Rating Scale (EPS) for adverse effect and the Calgary Depression rating Scale for Schizophrenia (CDSS) were measured.

Results

There were no significant differences in the frequency of genotypes between schizophrenia patients and control subjects. There were no significant differences in PANSS scores before treatment according to the serotonin transporter genotypes. Treatment response after atypical antipsychotics did not differ among the genotypes. No difference was shown among the genotypes for the scales in adverse effects and depression (BMI, BARS, EPS, CDSS).

Conclusions

Our results suggest that the serotonin transporter polymorphism does not seem to be a susceptibility factor for schizophrenia. Similarly, the serotonin transporter polymorphism might not affect the therapeutic response and adverse effect to atypical antipsychotics in Korean patients with schizophrenia. Further studies with a larger number of subjects are required to better understand the role of the serotonin transporter polymorphism in schizophrenia.     

Decreased serum BDNF levels in chronic institutionalized schizophrenia on long-term treatment with typical and atypical antipsychotics

Accumulating evidence showed that brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. Decreased BDNF levels have been found in the serum of schizophrenic patients with mixed results. In the present study, we assessed serum BDNF levels in a large group of 364 schizophrenic patients (157 on clozapine, 89 on risperidone and 118 on typical antipsychotics), compared to 323 healthy control subjects matched for age and gender. The schizophrenia symptomatology was assessed by the Positive and Negative Syndrome Scale (PANSS), and serum BDNF levels were measured by sandwich ELISA. The results showed that BDNF levels were significantly lower in chronic patients with schizophrenia than in healthy control subjects (9.9 ± 2.0 ng/ml vs.11.9 ± 2.3 ng/ml, p < 0.0001). Lower BDNF levels were observed in patients treated with risperidone (9.3 ± 2.3 ng/ml) compared to those with clozapine (10.2 ± 2.0 ng/ml, p < 0.001) and typical antipsychotics (10.0 ± 2.1 ng/ml, p < 0.01). Furthermore, a stepwise multiple regression analysis identified types of antipsychotic drugs (beta = − 0.37, t = − 3.15, p = 0.001) and BDNF levels (beta = − 0.26, t = − 2.51, p = 0.014) as the influencing factor for the positive symptom subscore of PANSS. In addition, there was a sex difference in BDNF levels in patients with schizophrenia (9.7 ± 1.9 ng/ml for males vs.10.4 ± 2.1 ng/ml for female, p < 0.005), but not in normal controls. Our findings indicated decreased BDNF serum levels in chronic patients with schizophrenia, which may be related to clinical phenotypes, including gender, antipsychotic treatment and the severity of psychotic symptoms.