Coexistence of folie communiquée and folie simultanée

Objective. The authors report a case during which they observed serious subtypes of induced delusional psychosis (folie communiquée and folie simultanée) without any common genetic background or premorbid psychosis in the case of the secondary patient. Method. The clinical phenomenology of the case is described. Results. Mild intellectual disability and environmental–psychological factors (social isolation and the symbiotic-like interpersonal relatedness) play an essential aetiological role in the case of the secondary recipient patient. Conclusion. The authors emphasize the importance of subclassification of induced delusional psychosis for further aetiological and clinical research.     

Cognitive Effects of Chemotherapy-Induced Menopause in Breast Cancer

This study examined whether chemotherapy-induced menopause affects cognitive functioning in women with early breast cancer. The neuropsychological performance of 121 breast cancer patients (age M?=?49.62, SD?=?8.11, range?=?25.25–67.92) treated with chemotherapy was assessed pre-chemotherapy, as well as 1, 6, and 18 months post-chemotherapy completion. Linear mixed modeling was used to evaluate the data. Type of menopause (pre, chemotherapy-induced, and post menopause) was found to significantly interact with cognitive performance on two cognitive variables. Specifically, chemotherapy-induced menopausal women did not show any significant changes in performance on an abstract reasoning task, while the pre-menopausal and post-menopausal groups significantly improved over time. A significant interaction on a test of finger dexterity and coordination was also found, although inspection of the results indicated that this was due to a significant improvement in the pre-menopausal groups at 6 months post chemotherapy. After chemotherapy most cognitive variables showed improvements over time, although two indicators of verbal memory showed significant declines immediately after chemotherapy, with improvement by 18 months post completion. The current study found little evidence to suggest that chemotherapy-induced menopause broadly affects cognitive functioning after treatment administration. However, longer follow-up assessments are warranted to assess the long-term effects of combined chemotherapy and endocrine treatment.     

The well-being of community residents in remission from major depression disorder

This study hypothesized that the well-being of community residents in remission from major depression disorder (MDD) would not be significantly different from those without MDD. Data from the Midlife in the United States Survey (MIDUS), a prospective general population survey conducted in 1995 and 2004, were analysed. A comparison of the psychological well-being scores, Big Five personality scores and life satisfaction scores of remitted and non-remitted respondents revealed generally small effect size differences. The remitted group were more likely than the non-remitted group to have had past-year panic disorder at follow-up. In general, these results suggest that the well-being of respondents in MDD remission was relatively high.     

Seizure recurrence and remission after switching antiepileptic drugs

Purpose: Studies of seizure outcome in patients undergoing serial antiepileptic drug trials have all been uncontrolled, with no account made for the spontaneous changes in disease state that could confound the elucidation of drug effects. In addition, no study has ever looked at outcome following antiepileptic drug switch in seizure‐free patients, despite the fact that this is done routinely in clinical practice. We aimed to address both of these issues using a matched case‐cohort design. Methods: We followed patients taking phenytoin or carbamazepine in monotherapy for focal epilepsy who were being crossed over to a newer agent as part of studies on the metabolic effects of anticonvulsant therapy. Many had been seizure‐free but were being switched nonetheless due to side effects or concerns about long‐term adverse consequences. Each patient was matched with two controls of the same seizure status who were taking anticonvulsant monotherapy and whose drug was not switched. Seizure freedom over the ensuing 6 months was the primary end point. Key Findings: There were 43 cases and 86 matched controls. Twenty‐three patients (cases) had been seizure‐free on their old drug; 5 (21.7%) had seizure recurrence after drug switch compared to 2 (4.3%) of 46 matched controls. Twenty patients (cases) were having seizures on their old drug; 6 (30%) entered remission after drug switch, compared to 8 of 40 matched controls (20%). The two groups differed at baseline in number of anticonvulsants previously failed, which was the most important factor for prognosis. After statistical adjustment to account for this, seizure‐free patients had 6.53 times higher odds of seizure recurrence if switched to a new drug (95% confidence interval [CI] 1.02–61.19; p = 0.06). Non–seizure‐free patients had 1.66 times higher odds of remission if they remained on the same drug compared to switching, although this was not significant (95% CI 0.36–8.42; p = 0.532). Neither dose changes, nor drug mechanism, nor duration of seizure freedom had any bearing upon the results. Significance: Although the large majority of seizure‐free patients remain so when switched to another agent, about one sixth have a recurrence attributable to the change. Conversely, our study design provides the first evidence to suggest that most improvements in drug‐resistant patients are likely due to spontaneous remissions, not new drug introductions. These findings have conflicting implications for two competing models of comparative antiepileptic drug efficacy, which will require further study to elaborate.     

CE-Chirp听觉稳态反应检测在听阈评估中的价值

目的探讨CE-Chirp听觉稳态反应(CE-Chirp ASSR)检测在听阈评估中的价值。方法2016年5月~2018年11月对100例(187耳)感音神经性耳聋患者行纯音测听、传统ASSR和CE-Chirp ASSR测试,比较传统ASSR、CE-Chirp ASSR同纯音测听的相关性。结果不同刺激声ASSR在各频率的诱发阈值均大于纯音测听。0.5、1、2、4 kHz频率下CE-Chirp ASSR诱发阈值与纯音测听阈值的绝对差值均小于传统ASSR诱发阈值与纯音测听阈值的绝对差值,差异有统计学意义(P<0.05)。将本组患者各频率下的不同刺激声ASSR诱发阈值与纯音测听阈值进行相关性分析,显示均呈现明显的直线相关趋势(P<0.05)。CE-Chirp ASSR诱发阈值与纯音听阈的相关系数在0.5、1、2、4 kHz频率下均高于传统ASSR诱发阈值和纯音听阈的相关系数。结论CEChirp ASSR检测在听阈评估中更快捷、准确。     

A review of dramatherapy research in schizophrenia: methodologies and outcomes

Abstract

This article aims to examine all the different types of research studies in the existing literature regarding the impact of dramatherapy on patients with a schizophrenic disorder to provide a springboard for future advances in the application of dramatherapy as an adjunct therapeutic approach for this client group. Quantitative research approaches in the form of randomized clinical trials have proven to be feasible in dramatherapy when they aim at providing evidence of the improvement in the condition of patients with schizophrenia or of the diminution of their symptoms. Qualitative approaches explore the therapeutic processes through which dramatherapy practice can confront more effectively the schizophrenic psychopathology. Furthermore, theater-based research brings to light the creative side of patients with schizophrenia despite their psychopathology and promotes through action the discourse between patients “in role” and their audience in relation to the social stigma attached to people with schizophrenia.

Dieser Artikel zielt darauf ab, alle unterschiedlichen Arten der Untersuchung der Effekte von Dramatherapie bei Patienten mit einer schizophrenen Störung durchzugehen, um einen Fortschritt in der Anwendung von Dramatherapie als einem Hilfsprogramm für diese Patientengruppe zu ermöglichen. Quantitative Untersuchungen in Form von randomisierten klinischen Studien haben sich für Dramatherapie als möglich erwiesen, wenn sie auf der Basis einer Verbesserung des Zustandes der Schizophreniepatienten durchgeführt werden oder auf eine Verringerung ihrer Symptome abzielen. Qualitative Vorgehensweisen erforschen die therapeutischen Prozesse, durch die die Anwendung von Dramatherapie schizophrene Psychopathologie positiv beeinflussen kann. Darüber hinaus zeigen Theater-basierte Untersuchungen die kreativen Seiten von schizophrenen Patienten auf, die sie trotz ihrer bestehenden Psychopathologie haben und fördern den handlungsbezogenen Diskurs zwischen Patienten in einer Rolle und ihre Zuhörerschaft hinsichtlich des sozialen Stigmas, das Menschen mit Schizophrenie anhaftet.

Cet article vise à examiner les différents types de recherches dans la littérature sur l'impact de la thérapie par le théâtre (dramatherapy) pour les patients avec un trouble schizophrénique dans le but de fournir un tremplin pour des avancées futures dans l'application de la thérapie par le théâtre comme approche thérapeutique complémentaire pour ce groupe de patients. Les approches quantitatives, sous la forme d’études randomisées contrôlées, ont démontré leur faisabilité pour la thérapie par le théâtre lorsque celle-ci vise à fournir la preuve de l'amélioration de la condition des patients schizophrènes ou de la diminution de leurs symptômes. Les approches qualitatives explorent les processus par lesquels la pratique de la thérapie par le théâtre peut faire face plus efficacement à la psychopathologie schizophrénique. En outre, les recherches basées sur le théâtre éclairent le côté créatif des patients avec une schizophrénie et encouragent par l'action un discours entre le patient «?dans son rôle?» et son audience en relation avec la stigmatisation sociale attachée au personnes avec une schizophrénie.

Este artículo se propone examinar los diferentes tipos de investigaciones en la literatura existente sobre el impacto de la dramaterapia en pacientes con desorden esquizofrénico, a fin de proveer un trampolín para futuros avances en la aplicación de la dramaterapia como adjunto terapéutico para este grupo de clientes. Los enfoques de investigación cuantitativa en forma de ensayos clínicos randomizados han demostrado ser factibles en dramaterapia cuando buscan evidencia de mejoría en la condición de pacientes con esquizofrenia o en la disminución de sus síntomas. Los enfoques cualitativos exploran los procesos terapéuticos a través de los cuales la práctica de la dramaterapia puede hacer frente más eficazmente a la psicopatología esquizofrénica. Más aún, la investigación basada en el teatro trae a luz el aspecto creativo de los pacientes con esquizofrenia a pesar de su psicopatología y promueve, a través de la acción, el discurso entre pacientes “en el rol” y su audiencia, en relación con el stigma social que afecta a las personas con esquizofrenia.

Este artigo procura examinar todos os diferentes tipos de estudos de investigação existentes na literatura existente relativos ao impacto da terapia de drama nos pacientes com perturbaç[otilde]es de esquizofrenia, para assim providenciar uma plataforma para futuros avanços na aplicação desta terapia como uma abordagem terapêutica adicional para este grupo de pacientes. Os estudos de abordagens quantitativas com grupos clínicos aleatoriamente seleccionados têm-se mostrado serem viáveis para a terapia de drama quando o seu objectivo era fornecer evidência para melhorias nas condiç[otilde]es dos pacientes com esquizofrenia ou para a diminuição dos seus sintomas. As abordagens qualitativas exploram os processos terapêuticos através da prática da terapia de drama podem mais eficazmente abordar a psicopatologia esquizofrénica. Para além disso, estudos baseados no teatro evidenciam o aspecto criativo do paciente com esquizofrenia, apesar da sua psicopatologia, e promovem através da acção o discurso entre pacientes “a representar” e a sua audiência em relação ao estigma social associado às pessoas com esquizofrenia.

Questo articolo ha lo scopo di esaminare tutti i differenti tipi di studi di ricerca nella letteratura esistente per quanto riguarda l'effetto della dramma-terapia sui pazienti con schizofrenia, per fornire un trampolino di lancio per progressi futuri nell'applicazione della dramma-terapia come approccio terapeutico aggiuntivo per questo gruppo di pazienti.

I metodi di ricerca quantitativi, nella forma degli esperimenti clinici randomizzati, sono risultati essere fattibili nella dramma-terapia quando mirano a provare l'evidenza del miglioramento nei pazienti con schizofrenia o della diminuzione dei loro sintomi.

I metodi qualitativi esplorano i processi terapeutici con cui la pratica della dramma-terapia può confrontare pi[ugrave] efficacemente la psicopatologia schizofrenica.

Ancora, la ricerca basata sul teatro mette in luce il lato creativo dei pazienti con schizofrenia malgrado la loro psicopatologia e promuove, attraverso l'azione, il discorso tra i pazienti “nel ruolo” e il loro uditorio rispetto allo stigma sociale, attaccato alle persone con schizofrenia.

     

支气管哮喘不同时期证候演变规律的临床调查研究?

目的探讨支气管哮喘急性发作期、慢性持续期、临床缓解期的证候演变规律。方法收集17家三级甲等中医院支气管哮喘患者资料,运用SPSS 18.0统计软件包建立以中医辨证为特征的临床调查研究数据库,并进行频率的统计描述及卡方检验。结果发放表格2 500份,收回表格2 481份,有效2 428份。急性发作期以实证为主,临床表现为外寒内饮证、痰热壅肺证、痰浊阻肺证、风痰阻肺证、血瘀证;慢性持续期以虚实兼杂为主;缓解期以虚证为主,表现为肺气虚证、肺肾气虚证、肺脾气虚证、肺肾气阴两虚证、肺肾阳虚证。结论支气管哮喘中医证候演变有一定的规律性,可为本病的防治提供依据。