曲唑酮治疗抑郁症的疗效观察

目的：观察曲唑酮治疗抑郁症的疗效。方法：对31例抑郁症患者给予每日50～250mg曲唑酮治疗，不合用其它精神药物，并用汉密尔顿抑郁量表(HAMD)，不良反应症状量表(TESS)进行治疗前后对照。结果：痊愈20例，显著进步6例，进步2例，无效3例，总有效率90．3％。结论：曲唑酮是一种强效而安全的抗抑郁药。     

急性脑卒中后抑郁症25例临床分析

目的 :观察分析急性脑卒中后抑郁症的病理过程及治疗效果。方法 :统计分析 2 5例脑卒中病人的临床资料 ,特别对汉密顿抑郁量表的结果进行评价。结果 :2 5例病人中 ,脑出血 10人 ,脑梗塞 15人 ,汉密顿抑郁量表平均总分 2 4分± 5分 ,其中重度 4例 ,中度 15例 ,轻度 6例。经赛乐特治疗后 ,平均总分下降至 13分± 5分 ,其治愈率为 75 % ,显效 2 5 %。结论 :急性脑卒中后抑郁症的临床表现较功能性者轻 ,早期发现与正确治疗后 ,疗效满意     

Tender points, depressive and functional symptoms: Comparison between fibromyalgia and major depression

Summary The degree of symptomatic overlap between fibromyalgia and major depression should be estimated by assessing the amount of local tenderness and the frequency and severity of depressive and functional symptoms. Tender points were assessed by palpation and symptoms by psychometric scales in 30 patients with fibromyalgia and 26 patients with major depression. The patients with fibromyalgia had markedly more tender points (16.5) than the depressive patients (1.3). In contrast, depressive and functional symptoms were present in both groups of patients, and some depressive patients (26%) also suffered from clinical pain. An increased sensitivity to pressure pain clearly distinguishes fibromyalgia from depression even if there is an overlap of other symptoms.     

学龄儿童行为问题危险因素配对研究

将２１４名经Ｒｕｔｔｅｒ儿童行为问卷调查评定为有行为问题的学龄儿童与２１４名对照儿童进行了配比分析，以探讨学龄儿童行为问题的危险因素。研究结果表明，父、母文化程度和父亲职业是影响学龄儿童行为问题的重要因素；多因素条件Ｌｏｇｉｓｔｉｃ逐步回归分析结果显示父母文化程度偏低是学龄儿童行为障碍的两项独立危险因素。文中对学龄儿童行为问题的预防和矫治进行了讨论。     

Platelet-rich plasma serotonin levels in tension-type headache and depression

We measured platelet-rich plasma (PRP) serotonin in patients suffering from tension-type headache, before and after treatment with amitriptyline, comparing them with a healthy control group and patients with untreated depression. We evaluated the severity of headache and depression in each group. PRP serotonin levels were higher in patients with headache than in controls and depressed patients. We observed a fall of PRP serotonin in patients with tension-type headache to similar levels after treatment as the depressed group. This fall was correlated with the improvement of headache but not with depression scales. Our data suggest that the rise of platelet serotonin levels in tension-type headache is related to pain and not depression.     

抑郁症的基础与认知激活脑SPECT显像

目的通过抑郁症患者基础和认知激活局部脑血流（ｒＣＢＦ）灌注显像的半定量分析，评估抑郁症患者的脑血流灌注异常。方法选择２７例未经抗抑郁治疗、ＩＣＤ１０分类为中度抑郁发作伴躯体症状的患者，１５例年龄匹配的健康人作正常对照。２７例患者中２１例、１５例健康人中１３例行双日法基础与认知激活脑ｒＣＢＦ显像；另６例患者及２例健康人仅行基础脑ＳＰＥＣＴ显像。认知激活采用Ｗｉｓｃｏｎｓｉｎ卡片分类试验。半定量分析在横断面图像７～１１帧上进行，将各ＲＯＩ的平均计数与同侧小脑的最高计数相除，得到各ＲＯＩ的ｒＣＢＦ比值。结果抑郁症左额叶和左颞叶的基础ｒＣＢＦ值均为０７２０，明显低于对照组（０７６４和０７５０，Ｐ＜００５）；左额、左颞、左顶叶的认知激活ｒＣＢＦ值分别为０７１９、０６９０及０７０１，明显低于对照组（０７８２、０７５２和０７６６，Ｐ＜００１和Ｐ＜００５）。结论①抑郁症患者存在左额叶、左颞叶的局部血流低灌注。②额叶、颞叶皮层低灌注可能是引起抑郁症认知障碍、心境低落的原因。③Ｗｉｓｃｏｎｓｉｎ卡片分类试验认知激活脑ＳＰＥＣＴ显像有助于提高抑郁症的诊断准确性     

胎儿宫内窘迫对新生儿神经行为的影响

目的：测定宫内窘迫的新生儿神经行为，以探讨宫内窘迫与新生儿神经行为表现、预后的关系。方法：用ＮＢＮＡ神经行为２０项指标进行测定。结果：宫内窘迫新生儿６０例与正常新生儿６０例比较，测定总分之间差异有显著性（Ｐ＜０．０１）。窘迫组中４１例无窒息者与正常对照差异有显著性（Ｐ＜０．０１），窘迫组中１９例有窒息者与正常对照组差异更为显著，急性窘迫３８例与慢性窘迫２２例之间也有显著差异（Ｐ＜０．００１）。结论：胎儿宫内窘迫影响新生儿的神经行为能力。     

Quantitative assessment of the microstructure of rat behavior: I.f(d), The extension of the scaling hypothesis

Previous studies demonstrated that drug effects on the movement sequences of rats in unconditioned motor activity paradigms can be quantified by scaling measures that describe the average relationship between a variable of interest and an experimental parameter. However, rats engage in a wide variety of geometrically distinct movements that can be influenced differentially by drugs. In this investigation, the extended scaling approach is presented to capture quantitatively the relative contributions of geometrically distinct movement sequences to the overall path structure. The calculation of the spectrum of local spatial scaling exponents,f(d), is based on ensemble methods used in statistical physics. Results of thef(d) analysis confirm that the amount of motor activity is not correlated with the geometrical structure of movement sequences. Changes in the average spatial scaling exponent,d, correspond to shifting the entiref(d) function, and indicate overall changes in path structure. With the extended scaling approach, straight movement sequences are assessed independently from highly circumscribed movements. Thus, thef(d) function identifies drug effects on particular ranges of movement sequences as defined by the geometrical structure of movements. More generally, thef(d) function quantifies the relationship between microscopically recorded variables, in this paradigm consecutive (x, y) locations, and the macroscopic behavioral patterns that constitute the animal's response topography.Exemplary calculations of path segments with different geometrical characteristics can be obtained from the authors. Questions regarding the computational implementation of this method should be addressed to MPP preferably via email (martin@rat.ucsd.edu) or FAX (619-543-2493)     

Advances in development of medications for alcoholism treatment

 Over the past decade, research on medications to treat alcohol problem has flourished. Naltrexone and acamprosate are tangible fruits of such endeavors and each has now earned approval in a large number of countries. Recent studies on naltrexone indicate that patient compliance is important if full benefits are to be achieved. Several laboratory studies with human subjects are beginning to elucidate the mechanisms underlying efficacy of naltrexone, as well as explaining variability of response among subpopulations of drinkers. In addition to these two agents, recent investigations have also demonstrated that the antidepressants desipramine, imipramine, and fluoxetine reduce mood-related symptoms and, to some extent, drinking itself in alcoholics who are depressed. Research to date suggests that opioid antagonists and selective serotonin reuptake inhibitors are more effective in reducing alcohol intake when used in combination. Clinical issues, methodology, and directions for future research are also reviewed in this article. In particular, issues addressed include alternative dosage regimens, necessary duration of treatment, employment of medications in combination, integration of pharmacologic agents with behavioral interventions, enhancement of patient compliance, and concurrent treatment of psychiatric comorbidity. Received: 16 December 1997 / Final version: 15 April 1998     

Comorbid disorders in hospitalized bipolar adolescents compared with unipolar depressed adolescents

This study examined comorbid psychiatric disorders in adolescents with bipolar disorder. Hospitalized bipolar adolescents (N=10) were compared to hospitalized adolescents with unipolar depression (N=33), and to adolescents with nonaffective psychiatric disorders (N=11). Results showed conduct disorder, attention-deficit hyperactivity disorder, psychosis, and having any DSM-III-R psychoactive substance use disorder were all significantly more common in the bipolar group than the unipolar depressed group. Comorbid anxiety disorder was present in 40–45% of the subjects in the unipolar and bipolar groups, but in none of the control group subjects. This study is supported in part by a grant to Dr. Borchardt from the University of Minnesota Graduate School.