Objective To explore discrepancies and influencing factors of stimulating cumulative charge needed by MECT therapy in different mental disorders. Methods A total of 1 285 inpatients whose symptoms have been improved significantly by MECT were selected and divided into schizophrenia group,bipolar disorder group,depression group and dissociative(conversion) disorder group to compare the differences among their stimulating cumulative charge and to explore their influencing factors. Results Significant differences of stimulating cumulative charge were found among four groups by ANOVA analysis. The stimulating cumulative charge needed by males was significantly higher than that needed by females(P < 0. 05) . The ages and treatment times of patients were positively correlated with the needed stimulating cumulative charge(P < 0. 05) . Hierarchical linear regression analysis showed that male,older age,more treatment times and schizophrenia were predicting factors for higher stimulating cumulative charge,which explained 33. 3％ variation. Conclusion There are differences of needed stimulating cumulative charge among different mental disorders with schizophrenia needing the highest. Moreover,gender,age and treatment times are impacting factors for stimulating cumulative charge.

目的 本研究旨在确定药物代谢相关酶CYP2D6、CYP3A5、CYP1A2基因的遗传多态性,研究常见的等位基因CYP2D6*2、*10、*14、CYP3A5*3、CYP1A2*1C在汉族人群中人群中的分布.方法 用荧光原位杂交(FISH)检测基因多态性.结果 CYP2 D6*10等位基因是最常见的变异(47.52％),且高于白种人(P<0.05),其次为*1等位基因(34.65％),*2等位基因(14.36％),*14(3.47％)且高于既往中国的研究(P<0.05),CYP2D6*10/*10(IM),*1/*10(EM)和*1/*1(EM)基因型最多,占中国汉族人群的29.70％、25.75％和17.82％,没有发现*14/*14.CYP3A5*3和CYP1A2*1C分别是最常见的等位基因(72.08％和41.07％),*3/*3(PM)是CYP3A5最常见的基因型(57.50％),1A/1A是CYP1A2(40.48％)最常见的基因型,并且和1A/1C基因型非常接近(36.90％).而在性别的比较中发现,男性CYP2D6以EM为主,CYP1A2以UM为主;女性CYP2D62D6以IM为主,CYP1A2以IM和PM为主,而CYP3A5的基因型性别的差异不明显.结论 在中国汉族人群中CYP2D6仅发现正常代谢型(EM)和中间代谢型(IM),且以正常代谢型为主,CYP3A5以慢代谢型(PM)为主,CYP1A2以超快代谢(UM),中间代谢(IM)为主,且两个基因型接近.CYP2D6和CYP1A2代谢型存有性别差异.

Objective To explore the effects of ziprasidone and risperidone on cognitive inhibition function through visual pathway of patients with paranoid schizophrenia.Methods In the open-label,flexible-dosage trial,124 patients with paranoid schizophrenia were randomly divided into ziprasidone group (120-160 mg/d)and risperidone group(4-8 mg/d) for treatment of 8 weeks.They were assessed with computerized Color Word Test (CWT) and Continuous Performance Test(CPT) through visual pathway for cognitive inhibition function,Positive and Negative Syndrome Scale for efficacy on baseline and 8th weekend.Results After treatment with ziprasidone,the error number (3.12 ± 5.23 ),the time per correct answer( ( 1.92 ± 1.38 ) s) of CWT,as well as the doubledigit mistaken number (2.31 ± 3.76)and the three-figure mistaken number( 3.15 ±2.80) of CPT reduced more than those before medication ( (4.60 ± 6.80),( 2.74 ± 1.52 ) s,(3.85 ± 3.62 ),(4.42 ± 3.53 ) ) (P ＜ 0.05 ).In risperidone.group,the double-digit mistake number of CPT(3.39 ± 3.59) after pharmacotherapy reduced more than that before pharmacotherapy(4.23 ± 3.88) (P＜ 0.05).After treatment the time per correct answer of CWT and the mistaken numbers of CPT in ziprasidone group were less than those in risperidone group(P＜ 0.05 ),meanwhile,the scores of PANSS in two groups were significantly lower than those before treatment (P ＜ 0.01 ).Conclusion It is effective for ziprasidone and risperidone to improve the function of cognitive inhibition on patients with paranoid schizophrenia,but there is more dramatic for ziprasidone in short-term treatment.

Objective To explore the efficacy and side effects of quetiapine combined with sertraline for schizophrenic patients with depressive symptoms.Methods A total of 123 schizophrenic patients with depressive symptoms were randomly divided into study group(63 cases) treated with quetiapine combined with sertraline and control group(60 cases) treated with quetiapine monotherapy for 8 weeks.The efficacy and side effects were evaluated with Positive and Negative Symptoms Scales(PANSS),Clinical Global Impression(CGI) and Treatment Emergent Symptom Scale(TESS) at baseline and at the 2nd,4th,8th weekend of the treatment.Results Kay factor score of PANSS in study group were significantly lower than that in control group(P0.05) at the 2nd,4th and 8th weekend of the treatment.At the 4th and 8th weekend,total score of PANSS and factor score of negative symptoms in study group were significantly lower than those in control group(P0.05).Score of CGI in study group was significantly lower than that in control group(P0.05) at the 4th and 8th weekend.There was no severe side effects in two groups.Conclusion Quetiapine combined with sertraline can improve depressive symptoms and negative symptoms effectively and rapidly in schizophrenic patients with depressive symptoms.

Objective:To explore efficacy and medication adherence of three kinds of atypical antipsychotics combined with lithium in the treatment of acute mania in women. Methods: Eighty-four female patients with acute mania were randomly divided into three groups and received olanzapine, risperidone or clozapine combined with lithium. Acute phase efficacy during hospitalization period was evaluated for at least 4 weeks, using Bech-Rafaelsen manic scale and clinic global impression. Medication adherence during follow-up period was examined for 8 weeks, using self-made scales based Morisky's questionnaire, as rated by patients and their family members. Results:Median time to onset of action during hospitalization period for olanzapine group was 3 days, significantly shorter than that of risperidone (7 days) (Z = 4.75,P < 0.01). There was no significant difference between clozapine ( 3 days) and olanzapine in term of time to onset of action. At week 2 and week 4, reduction in BRMS scores was comparable between olanzapine and clozapine groups (Z= 0.54、0.67,P=0.40、0.49), and was significantly larger in olanzapine group than in risperidone group (Z=3.04、1.98,P<0.01、P=0.04). Score of adherence during follow-up period was higher in olanzapine group than in risperidone and clozapine groups. Conclusion:Olanzapine combined with lithium has more rapid onset of action in female patients with acute mania and has good adherence during follow-up period. Common adverse events include over-sedation, dizziness and weight gain.

Objective To compare the efficacy of olanzapine with perphenazine in the treatment of schizophrenia. Methods Sixty schizophrenic patients with marked positive symptoms were randomly divided into two groups received olanzapine or perphenazine for the treatment of six weeks. PANSS and TESS were used before treatment and at the second,and forth and sixth weekend after treatmeat. Results At the second and forth weekend, there had significant differences on efficacy between two groups(χ2=18.61,P=0.006) 、χ2=17.34,P=0.031),and at the sixth weekend, the difference was not found between the two groups (χ2=7.59,P=0.061 ). The scores of PANSS in olanzapine group at the second,forth and sixth weekend were significantly lower than those before treatment (P <0.05), and in perphenazine group the score significantly dicreased at the forth sixth weekend after treatment (P< 0.05). At the forth sixth weekend, there had significant differences on the scores of TESS between two group(t=2.386,P=0.039)、(t=2.295,P=0.016).Conclusion Olanzapine could be faster and more effective for controlling the positive psychotic symptoms of schizophrenia than perphenazine, and with lower EPSs.

Objective To investigate the influence of B_12 on the efficacy of fluoxetine in the patients with major depressive disorder. Methods Serum vitamine B_ 12 levels in 30 patients with major depressive disorder were determined at baseline. The patients were treated with fluoxetine (20mg/day) for 8 weeks. The 17-item Hamilton Depression Rating Scale(HAMD) was used at baseline and eighth weekend. Results The vitamine B_ 12 level and HAMD score had no signficant correlation at baseline(r=-0.11, P>0.05).Significant differences were found in vitamine B_12 levels between patients in full response, partial response and non-response groups(F=10.34,P<0.01). Conclusion Higher vitamine B_12 level may increase the efficacy of antidepressant.

Objective To explore the relationship between recognition and controlling capalities and their influenciny factors in patients with brain organic personality change. MethodsThe assessment data of 62 patients with brain organic personality chang were analysed. ResultsThe main factors influencing recognition and controlling capacities were with or without intellegent disorder,severity of intellegent disorder,psychotic symptom,conscious disorder,relationship between criminal motivation and criminal behavior. ConclusionThe assessment of responsibility should meet both medical and forensic criteria. Recognition and controlling capacities are influenced by many factors.

Objective To explore depressive symptoms and related factors in patients with chronic prostatitis.Methods A total of 200 patients with chronic prostatitis were evaluated with SDS and related factors inventory.Results The prevalence rate of depression in patients was 35.50%,and significantly higher than that in controls.Dissatisfaction with life,the low income and unmarried status were risk factors of depressive symptoms.Conclusion Patients with chronic prostatitis often suffer from depression,adequate notice and synthetic measures should be made.

目的:认知功能损害是老年痴呆的重要病理特征,近年来许多研究表明同型半胱氨酸水平升高是引起老年认知功能损害的一个重要因素.为此,对同型半胱氨酸与老年人认知功能关系的研究结果进行回顾,以阐明同型半胱氨酸引起老年人认知功能损害的机制,进而及早采取有效干预措施.资料来源:应用计算机检索Medline数据库1990-01/2004-12期间的关于同型半胱氨酸对老年人认知功能影响的文章,检索词"homocysteine,senile dementia,cognitivefunction",限定文章语言种类为"English".资料选择:对资料进行初审,选取流行病学研究、随机对照临床试验和实验研究.资料提炼:共收集到35篇关于同型半胱氨酸与老年人认知功能损害关系的流行病学研究、随机对照临床试验和实验研究,15项研究符合纳入标准,排除的20项研究中,11项研究因系重复的同一研究,9项为Meta分析或综述.资料综合:老年痴呆患者血浆同型半胱氨酸水平升高,认知功能损害与同型半胱氨酸水平显著相关,B族维生素、相关基因、年龄和性别等因素引起同型半胱氨酸水平升高,同型半胱氨酸在大脑通过神经毒性作用和血管作用引起认知功能损害.结论:同型半胱氨酸水平升高可能是老年性痴呆的一个重要危险因素,是其认知损害的独立危险因素;B族维生素缺乏是同型半胱氨酸水平升高的主要影响因素.在认知功能损害和大脑病理变化出现前用B族维生素治疗可能是有效的预防性干预措施.

精神分裂症患者及配偶的婚姻质量较社会平均水平明显下降,研究表明与患者的精神症状、社会角色、经济状况、性生活、家庭内的情感表达、性格相容性等因素密切相关.因此,婚姻质量状况会影响患者的治疗和预后,有关研究正日益受到重视.

目的:了解独生子女精神分裂症患者父母的心理健康状况.方法:于2000-07/2002-03选择山东省精神卫生中心、济南市精神卫生中心、济宁市精神病防治院及沂南县精神病医院住院的87例独生子女精神分裂症患者的父母173人为观察对象(患者组).同期选择济南市、济宁市、沂南县在性别、年龄、职业、文化程度等均与患者组相匹配的93名正常独生子女的父母186人为对照组.以自制一般情况调查表调查人口学方面内容.以症状自评量表评定心理健康状况.症状自评量表共90个项目,包括躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性9个因子,采用5级评分,1从无,2轻度,3中度,4重度,5严重,评定标准参照全国成人常模标准:因子分＜1.8分为正常;1.8～2.0分为轻度异常;2.1～3.0分为中度异常;＞3.0分为重度异常.在发放问卷时使用统一指导用语,将收集到的问卷当即核实,发现缺漏项,及时补正.主要观察患者组及对照组症状自评量表评分情况以及患者组与全国常模的比较.结果:发放问卷353份,收回合格问卷353份,有效率100%.①患者组及对照组症状自评量表评分比较:独生子女精神分裂症患者父母症状自评量表总分及各因子分均明显高于正常独生子女父母,差异有显著性(t=2.75～5.71,P＜0.01).并以抑郁、焦虑、恐怖、精神病性更为突出.②患者组父亲与正常组父亲,患者组母亲与正常组母亲症状自评量表比较:父亲间的对照,患者父亲相对突出的症状为偏执、恐怖、敌对、抑郁、焦虑,而躯体化、人际关系因子分与正常组父亲比较差异无统计学意义;母亲间的比较,患者母亲相对突出的症状为抑郁、恐怖、躯体化、敌对、精神病性.人际关系及偏执因子分与正常组母亲比较差异无显著性.③患者组症状自评量表评分与全国常模的比较:独生子女精神分裂症患者父母症状自评量表总分及各因子分明显高于全国常模,除人际关系因子分外,差异均有显著性(t=4.47～9.49,P＜0.001),其中以躯体化、抑郁、焦虑、恐怖、敌对、精神病性更为突出.(④患者组父亲与母亲症状自评量表评分比较:患者父亲偏执分较母亲高,且差异有显著性(P＜0.05);母亲的躯体化和抑郁因子分较父亲偏高[(1.83±0.56,1.65±0.40,t=2.44,P＜0.05);(1.98±0.51,1.81±0.54,t=2.10,P＜0.05)].父亲的偏执因子分高于母亲(1.81±0.59,1.62±0.58,t=2.13,P＜0.05).结论:独生子女精神分裂症患病给其父母心理上造成的压力,带来许多心理卫生问题.独生子女患者父母的症状自评量表总分及各因子分均明显高于正常独生子女的父母及全国常模,且差异有显著性.其中以躯体化、抑郁、焦虑、恐怖、精神病性等因子更为突出.

Aim: To explore the mental health status and the quality of sleep, and their relationship in patients with chronic prostatitis. Methods: A total of 200 patients with chronic protatitis were involved in the study. The mental health status and the quality of sleep were evaluated with Pittsburgh sleep quality index(PSQI), symptom checklist (SCL-90) and self-made related factors inventory. Results: There were 51.5% of the patients with problem of sleep. The factors of SCL-90(except human relationship and hostility), total score, SAS and SDS total score of patients with PSQI ≥ 8 were significantly higher than those with PSQI≤7; the higher the score of PSQI was, the higher the scores of SCL-90 factors, total score, SAS and SDS were(F = 1.424 - 34.648, P < 0.01 - 0.05). The quality of sleep was positively related to somatization, compulsion, depression, anxiety, panic and insanity of SCL-90, and there was also a positive relation of sleep quality with other seven factors and total score(r = 0.0097 - 0.6317, P < 0.01 - 0.05). The quality of sleep was influenced by multiple factors, they were sexual dysfunction, local uncomfort of body, age of first episode, negative life events and bad relation with spouse in order(r = 0.009 2 - 0.056 1). Conclusion: Sleep disorder is one of the main symptoms in patients with chronic protatitis, and it has a close relation with mental health status, anxiety and depression.

目的比较博乐欣与丙咪嗪治疗抑郁症的疗效和副反应.方法将符合CCMD-2-R抑郁症诊断标准的门诊及住院病人60例,随机分为2组、分别给予博乐欣或丙咪嗪治疗,疗程6周.用HAMD量表在用药前及用药后1、2、4、6周评定药物疗效;用TESS量表评定副反应.结果博乐欣与丙咪嗪疗效相当,但博乐欣起效快,副反应比丙咪嗪轻.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">本文对１９９７年１月—１９９７年６月住院精神分裂症患者的家庭成员１８０名进行了情绪调研。其中：男性９６名，女性８４名。患者配偶６１名，患者父母５９名，患者子女６０名。平均年龄４１±１３岁。在对患者家庭成员使用Ｚｕｎｇ抑郁自评量表（ＳＤＳ）［１］、焦虑...</span>