目的 探讨小组治疗对酒依赖患者的生活质量、社会支持、生活方式等的干预效果,以及对患者出院后酒精复饮的影响.方法 将71例住院治疗的男性酒依赖患者随机分为研究组和对照组,采用生活质量综合评定问卷(GQOLI-74)、社会支持评定量表(SSRS)及应对方式问卷(CSQ),在研究的治疗前、24周进行量表评价,并在1年后随访复饮情况.结果 除物质生活的评分外,研究组在GQOLI-74量表中其余3个维度评分及客观状况总分较对照组升高,差异有统计学意义(P<0.01);研究组在SSRS量表的总分及3个维度的评分均高于对照组,差异有统计学意义(P<0.01);研究组在CSQ的评分中较对照组显著改善,差异具有统计学意义(P<0.01或P<0.05).研究组复饮率低于对照组,差异具有统计学意义(P<0.05).结论 小组治疗能够有效提高酒依赖患者的生活质量和应对方式,增强其社会支持状况,并且有效降低其复饮率.

Objective:To explore the efficacy and safety of Duloxetine in treating alcohol abuse patients with depression. Methods:66 alcohol abuse patients with depression were randomly divided into Duloxetine group(n = 33)and Controll group(n = 33). Duloxe-tine group was treated by Duloxetine combined with regular treatment of alcohol abuse. Controll group was treated by regular treatment of alcohol abuse only. They were treated for 8 weeks. The efficacy and safety were evaluated at the baseline and at the end of week 1, 2,4,8 respectively. Results:At the end of the study,The Duloxetine group was significantly improved. The scales of HAMD/ HAMA decreased significantly at the end of week 1,2,4,8 in Duloxetine group(P <0. 05). The Duloxetine group was significantly lowered down the patients alcohol craving. Conclusion:Duloxetine is a safe and effective drug in the treatment of alcohol abuse patients with depression.

Objective To explore the efficacy and safety of aripiprazole vs .olanzapine in the treatment of mental disorders due to alcohol (MDA) .Methods Sixty-six MDA patients were randomly divided into two groups taking orally aripiprazole or olanzapine respectively for 8 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) before and after treatment and adverse reactions with the Treatment Emergent Syndrome Scale (TESS) .Results At the end of the 8th week ,obvious and total ef-fective rate were respectively 87 .5% and 96 .9% in aripiprazole and 88 .2% and 97 .0% in olanzapine group ,which showed no significant differences (χ2 =0 .19 ,0 .00 ;P>0 .05) .Adverse reactions of both groups were mild ,mainly headache ,insomnia etc .in aripiprazole and hypersomnia and weight gain etc .in olanzapine group .Conclusion Both aripiprazole and olanzapine could improve mental symptoms of MDA quickly ,their total efficacy are equivalent ,both have higher safety ,but manifestations of adverse reactions are somew hat different ,so different pharmacotherapies should be selected according to different patients clinically .

目的：探讨酒依赖与焦虑障碍之间的共病特征，以发病率为切入点进行深入分析。方法选取某院精神科收治的58例焦虑障碍患者作为本次的研究当中的研究组，另外选取58例具有酒依赖现象的焦虑障碍患者作为对照组，对两组患者的发病率进行对照比较。结果从性别方面来看，女性焦虑障碍患者在酒精使用障碍方面的发病率明显高于男性患者，另外两组患者之间进行对比，治愈难度具有明显的差异。结论酒依赖与焦虑障碍之间的关系较为密切，目前绝大多数的精神障碍共病特征均与酒精使用的情况直接相关，因此对于焦虑障碍患者的治疗当中应将予以酒依赖现象改善的措施作为治疗的主要方向，进而使得患者恢复至健康的精神状态。

酒精是一种具有亲神经特质的麻醉剂，对人的大脑有直接的神经毒性作用，可使血脑屏障通透性增加致使中枢神经严重损害，对中枢神经系统有抑制作用［1-2］。长期无节制的饮酒、酗酒是影响健康最为严重的问题之一［3］，严重者可以出现不可逆的神经系统损害，其危害之大仅次于毒品。认知功能是人脑通过感知觉、记忆、思维等过程反映客观事物的特征、联系或关系的心理过程，是识别和恰当处理复杂任务（信息的接受、编码、储存、提取和使用）的能力，他取决于复杂的相互联结神经网络的功能［4-5］，认知功能有广泛的内涵，包括注意、记忆、学习、语言、理解、推理、判断、逻辑思维以及执行功能等方面。酒精依赖患者长期大量饮酒，易引起洒精性认知功能损害，出现不同程度的反应缓慢、记忆力差、注意力不集中等表现。本文对酒精依赖患者认知功能损害研究现状作一综述，现报告如下。

Objective:To investigate the effect of family intervention on the patients of alcohol dependence.Methods:70 patients with alcohol dependence were randomly divided into intervention group(35patients) and control group(35patients),both groups were followed for one year using family assessment device(FAD),family adaptability and cohesion scale(FACES Ⅱ-CV) to assess the family condition,and compare the effect of both groups recovery drinking rate/rehospitalization rate.Results:At the end of follow-up,the family function and family adaptability and cohesion of intervention group were significantly improved(p <0.01),the scores of negotiation、roles、emotional response、emotional involvement、behavior control and total function were lower in intervention group than control group(all p<0.01);the scores of adaptability and cohesion in intervention group was higher than that in control group(p < 0.01);The recovery drinking rate/rehospitalization rate in intervention group was lower than that in control group(p <0.01).Conclusion:family intervention is helpful to improve family function、adaptability and cohesion and reduce relapse drinking rate.

Objective: To investigate effects of the social support and coping styles on the quality of life in patients with alcoholic dependence. Methods: Forty three cases with patients of alcoholic dependence( study group) and forty five cases of local citizens without a history of alcohol abuse( control group) were surveyed with Social Support Rating Scale( SSRS) 、Coping Styles Questionnaire( CSQ) and the Generic Quality of Life Inventory 74( GQOLI-74),and the relevant factors were analyzed.Results:( 1) The total scores and the scores of all dimensions except material life in GQOLI-74 in study group were significantly lower than those of the control group( P < 0. 01); The scores of total social support and three sub-dimensions in study group were significantly lower than those of control group( P < 0. 01); The coping styles in study group were self accusation,mirage,retreat and rationalization;( 2) It was revealed that SSRS total score and three sub-dimensions and the total score of GQOLI-74 in study group had positive correlation( P < 0. 01); the total score of GQOLI-74 and solving difficulties had positive correlation( P < 0. 05) in study group,and there were negative correction between the GQOLI-74 total score and the rationalization and retreat( P < 0. 01). Conclusion: The quality of 1ife in patients with alcoholic dependence decreased obviously,the patients with alcoholic dependence received less social support than the normal population,and their coping style were in a bad way. It is necessary for alcohol dependent patients to receive the positive support and intervention in order to improve their quality of life.

<正>喹硫平和利培酮为目前常用的新型非典型抗精神病药,为多种神经递质受体拮抗剂,其对急、慢性精神分裂症的阳性和阴性症状均有效。笔者探讨非典型抗精神病药喹硫平和利培酮在临床

Objective:To explore the gender difference of the mental health status and coping style in the psychiatric nursing staff. Methods: 40 male psychiatric nurses and 40 female psychiatric nurses were tested with SCL-90 and coping style questionnaire.The total score and factor-scores of questionnaire about the male and female psychiatric nurses were compared.Results: The total scores,interpersonal sensitivity scores and anxiety depression factor scores of the female nurses were lower than that of the male nurses,there was significant difference between the two group.In the survey of coping style,except rationality factor scores,the others were significantly difference between the male and female psychiatric nurses.The factor scores of problem-solving and recourse of female nurses were significantly higher than that of the male,and the scores of illusion,self-accusation,withdrawal were significantly lower than that of the male. Conclusion:The mental health status and the coping style of the female psychiatric nurses are better than the male nurses.

本文对近年来有关精神分裂症与2型糖尿病在遗传,代谢,内分泌等方面的相互关系及抗精神病药对糖代谢的影响做一综述。

<正>抑郁症是以显著而持久的心境低落为主要特点的精神障碍,虽然可以通过临床治疗得到有效控制,但大部分患者存在反复发作倾向[1]。近年关于抑郁症患者抑郁情绪状态下认知功能改变的问题得到了社

Objective To investigate the quality of life and its correlated factors of elderly inpatients in mental hospital.Methods 78 inpatients and 80 normal controls aged 65 or over were assessed with the short-form questionnaire(SF-36)and social support rating scale(SSRS).Results The quality of life of elderly inpatients was much lower than that of the normal controls,which could be shown from the decreased scores of 8 related aspects in the investigating group.They had lower score than the control group in total score and availability score of SSRS;Correlation analysis demonstrated the quality of life was found to bear close relationship with several factors,in which the positive correlation existed with the total score and availability score of SSRS and the level of education,and the negative correlation appeared between the quality of life with both the duration of disease and the occurrence of hospitalization.Conclusion There is a significantly decreased in quality of life of elderly inpatients,its correlated factors may provide strategies for interventions.

帕金森病(Parkinson's disease PD)作为一种常见的老年性疾病已越来越多的受到关注,对其治疗也日趋规范[1] .一部分患者会伴发精神病性症状,不仅治疗困难,也阻碍了运动症状的进一步改善,严重影响晚期PD患者的生活质量.公认的处理帕金森病患者伴精神病性症状的第一步处理策略是减少抗帕金森病药物. 但当此方法不能改善精神病性症状时,医生会选择使用抗精神病药物.与第一代或传统抗精神病药相比,第二代抗精神病药引起较少与较轻的锥体外系反应和血清泌乳素升高,安全性相对较高.现就使用第二代抗精神病药物治疗帕金森病患者伴发精神病性症状综述如下.

Objective: To study the relationship between the change of serum prolactin concentrations in female schizophrenia patients and quetiapine and risperidone.Methods:sixty-four female schizophrenia patients who met the diagnostic standard were randomly divided into quetiapine group and risperidone group.The subjects were treated with drugsfor eight weeks.Positive and Negative Symptoms Scale(PANSS) was adopted to assess the subjects in the two groups before and at week 4 and week 8 treatment respectively and serum prolactin concentrations were also determined at the same time.Results: The total scores of PANSS determined at week 4 and week 8,compared with scores before treatment,showed no significant difference(P>0.05) in two groups.serum PRL concentrations determined before and after treatment had no statistically significant differences in patients with quetiapine(P>0.05) whereas serum PRL concentrations determined before and after treatment exhibited significant increase in patients with risperidone(P<0.01).Conclusion: Quetiapine can't cause obvious rise of PRL while risperidone can.

Objective To explore the effect of social and psychological intervention on quality of life in chronic schizophrenia.Methods 80 chronic schizophrenia patients were randomly divided into intervention group(n=40)and control group(n=40)and control group(n=40).The control group were only treated with drugs and the intervention group were treated with drugs plus social and psychological intervention.They were evaluated with PANSS、SDSS and GQOLI-74 before the trial 6,12 month later.Results The total scores of SDSS in intervention group were significantly louer than those in control group in 6th and 6th month.The scores of GQOLI-74 in intervention group were significantly higher than those in control group in 6th and 12th month except the substance dimension.There was no significan difference batween two groups in the scores of PANSS.Conclusion Social and psychological intervention can improve the social ability and the quality of life in chronic schizophrenia.

目的探讨住院精神分裂症患者在服用抗精神病药物的治疗过程中血液流变学的变异特征.方法对108例住院的精神分裂症患者分别于治疗前,治疗第4、8及12周进行血液流变学测定.检测指标包括:全血比低切粘度、全血比高切粘度、血浆粘度、红细胞压积、红细胞沉降度,然后进行比较分析.结果上述所测项目在治疗第4、8及12周与治疗前相比,均呈升高趋势,尤其是在治疗第4、8周明显升高(P＜0.01).联合用药组在治疗第4、8及12周时其全血比低切粘度、全血比高切粘度、血浆粘度、红细胞压积均高于同期单一用药值,差异有显著性(P＜0.01);而血沉的变化无显著性(P＞0.05).结论住院精神分裂症患者在服用抗精神病药物的治疗期间,随着药物的增量有发生心脑血管疾病的危险.作者认为,临床应严格遵守用药原则,尽可能单一用药.

目的探讨利培酮与奋乃静对精神分裂症患者的日常生活能力的影响.方法对67例精神分裂症患者分别给予利培酮、奋乃静治疗,治疗前及出院3个月时用日常生活能力量表(ADL)评定患者日常生活能力,用简明精神病评定量表(BPRS)评定疗效.结果利培酮组ADL评分在出院3个月时显著低于奋乃静组(P＜0.01),BPRS评分两组无显著性差异(P＞0.05).结论利培酮组和奋乃静组相比,两组疗效相当,但利培酮组的日常生活能力优于奋乃静组.