An integrative psychophysiological approach to brain hemisphere functions in schizophrenia

The present paper proposes a new psychophysiological approach to the genesis of positive and negative schizophrenic symptoms. According to this approach, the initial factor in schizophrenic disorders is a functional insufficiency of the right hemisphere which can be determined by early emotional experience in combination with subtle brain damage. This functional insufficiency causes (a) the inability to grasp and select information before its realization; and (b) the inability to produce a polysemantic context which is crucial for creativity, psychological defense, and the restoration of search activity, all of which determine psychophysiological adaptation to the environment. Right hemisphere insufficiency causes left hemisphere hyperactivity as an ineffective attempt to compensate for this functional deficiency. As a result, normal search activity is replaced by artificial search activity which is represented by “positive” symptoms, and which uses the predisposition of the left hemisphere's catecholamine system for its increased activity. The suggestion is made that cognitive impairment in schizophrenia (the inability to use appropriate previous information in relation to current perceptual input) is related to the competition between information processing which requires left hemisphere activity, and the formation of positive symptoms, also based on left hemisphere activity.     

4409名学生心理健康状况及家庭环境与吸烟行为分析

目的:探讨中学生心理行为特征和心理健康状况及家庭心理环境与中学生吸烟行为的关系.方法:以苏州市4409名初中、高中、职业中学的学生为对象,采用SCL-90、家庭环境量表和自编问题进行问卷调查.结果:反叛性、冒险性强,倾向早熟、毅力差、顺从敏感性高是吸烟的危险因素,而情感调节性和认同敏感性与吸烟无关;吸烟组与对照组SCL-90在总分、阳性项目数、躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性方面的评分均高于对照组,且有统计学意义(P＜0.01);吸烟组在FES-CV中的亲密度、情感表达、知识性、道德宗教观、组织性平均分明显低于对照组(P＜0.01),而在FES-CV的矛盾性的平均分则明显高于对照组(P＜0.01).结论:中学生行为的反叛性、冒险性、早熟性、毅力性和不良心理健康水平是中学生吸烟的危险因素;同时不良家庭关系也是中学生吸烟的危险因素,一个亲密、融洽的家庭环境可能会减少中学生吸烟,而一个矛盾的家庭则可能会增加中学生吸烟.     

Disinhibition of somatosensory evoked potential recovery in alcoholics

The pathogenesis of cognitive impairment in alcoholics remains unclear. Previous studies suggested that diffuse white matter atrophy is associated with cognitive impairment in alcoholics. To elucidate this issue, the present study evaluated alcoholics with cognitive impairment using the somatosensory evoked potential (SEP) recovery method, which is suitable for detecting subtle dysfunction at the cortical level. Subjects comprised 12 alcoholics with mild cognitive impairment [Mild group: Mini Mental State Examination Score (MMSE), ≥24; mean, 27.9 ± 1.6], 12 alcoholics with moderate to severe cognitive impairment (Moderate group: MMSE score, < 24; mean, 21.0 ± 2.5) and 12 normal subjects (Control group). SEP was recorded from the hand sensory area contralateral to the median nerve stimulated at the wrist. Single-pulse or paired-pulse stimuli at various interstimulus intervals (10–300 ms) were administered. Recovery functions of N9 (a peripheral nerve component), N20, N20-P25 and P25-N33 (cortical components) were studied. N20 recovery curves of both alcoholic groups were less suppressive than those of Controls, and P25-N33 recovery curves of the Moderate group were more excitatory than those of the Mild or Control groups. A disinhibited recovery pattern of N20 indicates subcortical dysfunction, and a disinhibited pattern of P25-N33 would be induced by cortical dysfunction. Therefore, subcortical dysfunction indicated by an abnormal N20 recovery pattern may contribute to the early cognitive impairment of alcoholics, whilst the cortical dysfunction indicated by an abnormal P25-N33 recovery pattern may contribute to the later cognitive impairment of alcoholics.     

Psychological well‐being and psychosocial work environment characteristics among emergency medical and nursing staff

The aim of this study was to determine if the effect of psychosocial work environment on psychological well‐being was different for doctors and nurses who work in emergency departments in Spain. A cross‐sectional survey was carried out among 945 emergency doctors and nurses staff from Spain. The outcome variable was the psychological well‐being measured by two dimensions of SF‐36 Health Survey (SF‐36) (mental health, vitality) and one dimension of Maslach's Burnout Inventory (emotional exhaustion). The explanatory variable was the psychosocial work environment evaluated according to Karasek and Johnson's demand‐control model that includes the dimensions of psychological demands, job control, supervisor social support and co‐workers' social support. The adjusted odds ratios and their 95 per cent confidence intervals were calculated by logistic regression. The prevalence of low vitality, bad mental health and high emotional exhaustion was higher among doctors than nurses. Exposure to high psychological demands increased the probability of low vitality, bad mental health and high emotional exhaustion among doctors and nurses. Low job control and low co‐workers' social support at work were associated with poor psychological well‐being only among doctors. Low job supervisors' social support increased the risk of bad mental health among doctors and of high emotional exhaustion among nurses. There is a different effect of psychosocial work environment on psychological well‐being between doctors and nurses. Copyright © 2007 John Wiley & Sons, Ltd.     

When stress is mental illness: A study of anxiety and depression in employees who use occupational stress counselling schemes

A previous study found that 86 per cent of employees (n = 111) who experience stress in the workplace and sought help from their workplace counselling schemes (Employee Assistance Programmes) had serious mental health problems, but the low participation rate (24 per cent) restricted generalizability and the measure used [General Health Questionnaire (GHQ‐12)] did not allow diagnosis. The present study (n = 58) improved the participation rate to 35 per cent and used a different version of the original measure (GHQ‐28) that allowed diagnostic differentiation as well as validation of the original findings. This new study found almost exactly the same high levels of mental health problems existed (86 per cent) in employees who remained at their work and that participants had higher rates of anxiety than depression. This finding is at variance with the usual co‐morbid presentation of anxiety and depression found in community based mental health services and suggests that depression may be an important differentiating factor between those who can remain at work and use counselling and those who cannot. There are implications for those who provide mental health services. The results of this study further reinforce the suggestion that workplace stress may be yet another name for common mental health problems that require professional help and treatment. Copyright © 2005 John Wiley & Sons, Ltd.     

图片学习测验在识别老年人轻微认知功能损害中的作用

目的　分析图片学习测验在识别老年人轻微认知功能损害 (MCI)中的作用。方法　选择符合MCI诊断标准的老年人 4 8例与正常对照组 5 6名完成图片学习测验、简易智能状态检查、听觉词语学习测验及多种非记忆测验。结果　图片学习测验的 3个记忆指标 (图片短时记忆、延迟记忆和学习记忆 )在MCI与正常对照组之间有非常显著的差异。已经给出这三个图片记忆指标区分MCI与正常老年人的划界分、敏感性和特异性。结论　图片记忆操作简便、信度和效度好 ,可以作为临床医师筛选MCI的有效工具     

The accommodative response,refractive error and mental effort: 1. The sympathetic nervous system

The accommodative response of 12 emmetropic subjects was measured for an array of numbers located at -1,-3 and -5 dioptres using an objective infra-red optometer. Responses were compared for passive (reading numbers) and active (adding numbers) conditions. The imposition of mental effort induced a significant increase in mean response for the -1 D stimulus, a response equivalent to the passive condition at -3 D and a reduction in response at -5 D. Mental effort induced similar responses for the -1 D and -3 D locations when sympathetic innervation to the ciliary muscle was blocked with the beta-receptor antagonist timolol maleate. Responses for the -5 D location were, however, significantly increased. It is proposed that sympathetic inhibition can modify the effect of mental effort on near accommodative responses.     

Neuropsychological changes during steady-state drug use,withdrawal and abstinence in primary benzodiazepine-dependent patients

Impairment on neuropsychological tests during steady-state drug use and withdrawal, and after discontinuation of benzodiazepines, was studied in primary benzodiazepine-dependent patients. One group of patients was tested before and the other group after the initiation of a gradual tapering-off of the drug, and both groups were tested approximately 1 year later. At the initial assessment, both groups of patients showed impairment on most of the tests of general intelligence and on several of the tests in the Halstead-Reitan battery, as well as on a test of nonverbal memory, in comparison with healthy controls. At follow-up the patient groups had reached the level of the control group. This study confirmed earlier observations of neuropsychological deficits in long-term benzodiazepine-using patients and demonstrated that these changes are at least partly reversible by discontinuing drug intake.