A Population Based Analysis of Subclinical Psychosis and Help-Seeking Behavior

Clinically defined psychosis is recognizable and distinguishable from nonclinical or subclinical psychosis by virtue of its clinical relevance (ie, its associated distress and its need for care and/or treatment). According to the continuum hypothesis, subclinical psychosis is merely quantitatively different from more extreme phenotypic expressions and as such should also be indicative of distress and help-seeking behavior but to a lesser extent. Using data from the Adult Psychiatric Morbidity Survey, the current study focused on self-reported psychosis and help-seeking experiences in a general population sample free from clinically defined psychosis (N = 7266). After statistically controlling for the effects of a series of potential help-seeking correlates the findings showed that subclinical psychosis symptom experience was significantly associated with various forms of help-seeking behavior. Individuals who reported subclinical experiences of thought control, paranoia, and strange experiences were on average 2 times more likely to attend their general practitioner for emotional problems compared with those individuals who reported no psychosis. Individuals who reported subclinical experiences of paranoia were 3 times more likely to be in receipt of counseling/therapy compared with those with no experience of paranoia. Multiple subclinical psychotic experiences also predicted elevated help-seeking behavior. These findings may have a positive impact on the detection of individuals who are at increased risk of psychological distress and aid in the design and implementation of more effective treatments at both clinical and subclinical levels.     

Muscle imaging analogies in a cohort of patients with different clinical phenotypes caused by LMNA gene mutations

Laminopathies are a heterogeneous group of LMNA‐gene‐mutation–related clinical disorders associated with alterations of cardiac and skeletal muscle and peripheral nerves, metabolic defects, and premature aging. Leg muscle imaging investigations were performed in a cohort of patients with LMNA gene alterations who were suffering from Emery–Dreifuss muscular dystrophy, limb‐girdle muscular dystrophy type 1B, isolated cardiac disorders or a phenotype of cardiac disorders, and lipodystrophy, including one individual with peripheral neuropathy. Leg muscle imaging revealed varying degrees of alteration in the soleus and medial head of gastrocnemius in each subject. This study demonstrates that LMNA‐gene‐mutated patients devoid of any clinically detectable skeletal muscle involvement have the same pattern of leg muscle involvement as patients with overt skeletal muscle compromise. This finding suggests the presence of a continuum of skeletal muscle involvement among phenotypes of LMNA‐gene‐mutation–related skeletalmyopathy and cardiomyopathy. Muscle Nerve, 2010     

Necrostatin decreases oxidative damage,inflammation, and injury after neonatal HI

Necrostatin-1 inhibits receptor-interacting protein (RIP)-1 kinase and programmed necrosis and is neuroprotective in adult rodent models. Owing to the prominence of necrosis and continuum cell death in neonatal hypoxia–ischemia (HI), we tested whether necrostatin was neuroprotective in the developing brain. Postnatal day (P)7 mice were exposed to HI and injected intracerebroventricularly with 0.1 μL of 80 μmol necrostatin, Nec-1, 5-(1H-Indol-3-ylmethyl)-(2-thio-3-methyl) hydantoin, or vehicle. Necrostatin significantly decreased injury in the forebrain and thalamus at P11 and P28. There was specific neuroprotection in necrostatin-treated males. Necrostatin treatment decreased necrotic cell death and increased apoptotic cell death. Hypoxia–ischemia enforced RIP1–RIP3 complex formation and inhibited RIP3–FADD (Fas-associated protein with death domain) interaction, and these effects were blocked by necrostatin. Necrostatin also decreased HI-induced oxidative damage to proteins and attenuated markers of inflammation coincidental with decreased nuclear factor-κB and caspase 1 activation, and FLIP ((Fas-associated death-domain-like IL-1β-converting enzyme)-inhibitory protein) gene and protein expression. In this model of severe neonatal brain injury, we find that cellular necrosis can be managed therapeutically by a single dose of necrostatin, administered after HI, possibly by interrupting RIP1–RIP3-driven oxidative injury and inflammation. The effects of necrostatin treatment after HI reflect the importance of necrosis in the delayed phases of neonatal brain injury and represent a new direction for therapy of neonatal HI.     

肌内效贴在脑卒中后康复中的应用现状及展望

正肌内效贴(kinesio Tape,KT)又称肌内效贴布,来源于贴扎,具有弹性、力学特性、低致敏性等特点,将其贴于体表以发挥作用的超薄透气胶带,由日本加濑建造博士于1973年所发明,最初用于运动损伤。经过40余年的发展,目前广泛适用于康复医学、运动训练及医疗美容等领域,特别是在康复医学中的应用,近年来发展格外迅速,现就其在脑卒中后康复中的应用现状做一总结并予以展望。1肩关节半脱位     

Continuum beliefs and stigmatizing attitudes towards persons with schizophrenia,depression and alcohol dependence

Separation is a central step in the process of stigmatizing persons with mental disorders. We examine whether belief in a continuum of symptoms from mental health to mental illness is associated with less stigmatizing attitudes. In a representative population survey in Germany (n=3642), using case-vignettes of persons suffering from schizophrenia, depression or alcohol dependence, we measured belief in a continuity of symptoms, emotional reactions and desire for social distance related to the person described in the vignette. While 42% of respondents agreed in symptom continuity for depression, this percentage was 26% for schizophrenia and 27% for alcohol dependence. Continuum beliefs were associated in general with more positive emotional reactions and less desire for social distance. This relationship was strongest for schizophrenia, followed by alcohol dependence. Continuum beliefs thus seem to be associated with less stigmatizing attitudes, particularly regarding schizophrenia and alcohol dependence. Educational information on the continuous nature of most psychopathological phenomena could usefully be integrated in anti-stigma messages.     

Dopaminergic Function in the Psychosis Spectrum: An [18F]-DOPA Imaging Study in Healthy Individuals With Auditory Hallucinations

Background: The psychosis phenotype appears to exist in the population as a continuum, but it is not clear if subclinical psychotic symptoms and psychotic disorders share the same neurobiology. We investigated whether the dopaminergic dysfunction seen in psychotic disorders is also present in healthy, well-functioning people with hallucinations. Methods: We compared dopamine synthesis capacity (using 6-[¹⁸F]fluoro-L-DOPA [[¹⁸F]-DOPA] positron emission tomography imaging) in 16 healthy individuals with frequent persistent auditory verbal hallucinations (hallucinating group) with that in 16 matched controls. Results: There was no significant difference in dopamine synthesis capacity in the striatum, or its functional subdivisions, between groups and no relationship between subclinical psychotic symptom severity or schizotypal traits and dopamine synthesis capacity in the hallucinating group. Conclusions: Altered dopamine synthesis capacity is unlikely to underlie subclinical hallucinations, suggesting that although there may be a phenomenological psychosis continuum, there are distinctions at the neurobiological level.     

如何上好循证医学绪论课——循证医学绪论课的设计及授后总结

2005年12月3日，哈尔滨医科大学为2001级七年制临床医学专业开设了循证医学（evidence-based medicine．EBM）课程，本人是担任这次循证医学课的主讲老师，这次授课是哈尔滨医科大学有史以来的第一次为七年制学生系统开设循证医学课。万事开头难，绪论课如何讲，本人进行了精心的设计及准备，现总结如下，愿与同道共勉。     

A general protocol for creating high-throughput screening assays for reaction yield and enantiomeric excess applied to hydrobenzoin

A general approach to high-throughput screening of enantiomeric excess (ee) and concentration was developed by using indicator displacement assays (IDAs), and the protocol was then applied to the vicinal diol hydrobenzoin. The method involves the sequential utilization of what we define herein as screening, training, and analysis plates. Several enantioselective boronic acid-based receptors were screened by using 96-well plates, both for their ability to discriminate the enantiomers of hydrobenzoin and to find their optimal pairing with indicators resulting in the largest optical responses. The best receptor/indicator combination was then used to train an artificial neural network to determine concentration and ee. To prove the practicality of the developed protocol, analysis plates were created containing true unknown samples of hydrobenzoin generated by established Sharpless asymmetric dihydroxylation reactions, and the best ligand was correctly identified.     

A preliminary investigation into the experience of symptoms of psychosis in mental health professionals: implications for the psychiatric classification model of schizophrenia

The psychiatric classification system regarding the discrete category of schizophrenia remains controversial. Key concerns regarding the legitimacy of the classification system for this presentation focus on issues of study design, the relevance and inter-relationship between symptom clusters and the lack of a coherent model of aetiology. A defining summary feature of the psychiatric model is the distinctiveness of psychotic symptoms in those with a diagnosis of schizophrenia compared with non-clinical samples. The current study sought to challenge the prevailing psychiatric system by exploring the occurrence and experience of psychotic symptoms in mental health practitioners who routinely engage in therapeutic work with clients with a primary diagnosis of schizophrenia. A total of 16% ( n  = 19) of the sample indicated that they experienced voice hearing while 21% ( n  = 26) indicated they experienced delusions as assessed by validated assessment tools. The findings are indicative of a continuum model of psychotic symptom experience and run counter to the contemporary model of psychiatric classification of this disorder. The direction of future research is indicated.     

学者的学术影响力评价方法

以学者的文献信息为基础介绍了主观评价法、文献计量法、社会网络分析法和综合评价法等4种学者学术影响力评价方法,通过对上述评价方法特点和应用现状的研究分析,探讨了学者学术影响力评价方法的发展趋势。