O bjective: To evaluate the effect and safety of paliperidone ER in the treatment of autism.Methods: Sixty-three cases of autism were randomly divided into two groups which were respectively treated with paliperidone ER(n=31)and risperidone tablets(n=32) for 8 weeks.Clinical Global Impression-Severity Scale(CGI-S),Autism Treatment Assessment Scale(ATEC)were adopted to assess clin ical effect;Treatment satisfaction of patient's relatives was measured by Medication Satisfaction Questionnaire(MSQ);adverse reactions were evaluated with Treatment Emergent Symptom Scale(TESS).Results: Compared with those before treatment,scores of CGI-S,ATEC at the end of 1st week in paliperidone ER group were lower(P0.05),and at the end of 2nd,4th and 8th week the scores were significantly lower(P0.01).In addition,no significant score change before and after treatment was found in social factors in ATEC scale.Speech perception and behavior scores were increased to varying degrees.The treatment satisfaction was 93.5% among relatives of patients.Compared with those before treatment,scores of CGI-S,ATEC at the end of 2nd week in risperidone group were lower(P0.05),and at the end of 4th and 8th week the scores were significantly lower(P0.01).The treatment satisfaction was 71.9% among relatives of patients.The CGI-S score,ATEC total score and behavior items score of ATEC in paliperidone ER group were lower than those in risperidone group,and the difference was statistically significant(P0.05);No statistically significant difference was found in the treatment at the end of 4th week and 8th week(P0.05).Adverse reactions were all mild,and most can be alleviated by itself,and the satisfaction treatment paliperidone ER was significantly higher than that in risperidone group(P0.01).Conclusion: Paliperidone ER can effectively control the symptoms of autism irritability.Paliperidone ER and risperidone were comparable in efficacy and safety.Paliperidone ER with more rapid onset,simple medication,good compliance are worthy of being applied in autism.

Objective:To understand current situation of psychiatric hospitalization services in Tianjin.Methods:A total 365 hospitals were surveyed for bed distribution and psychiatric hospitalization services using a questionnaire in 18 districts and counties in Tianjin in 2006.Results:In 2006,psychiatric hospitalization service was available in 21 hospitals in Tianjin,in which there were 497 psychiatric doctors (4.76 persons per 100 thousand),876 psychiatric nurses (8.4 persons per 100 thousand) and 4281 psychiatric beds (4.11 beds per 10 thousand).Overall number of hospitalization was 10 449 during this year.Mental health resources were mainly distributed in central urban districts,in psychiatric specialty hospitals and in tertiary hospitals.Hospitalization services were mainly utilized in central urban districts and in psychiatric specialty hospitals.Conclusion:Psychiatric hospitalization services resources in Tianjin were at a relatively higher level.However,distribution of psychiatric hospital beds was uneven.

目的:了解天津市医疗机构抗精神病药的使用情况。方法:依据《天津市医疗机构精神卫生服务状况调查问卷》内容,调查2006年天津市365家医院抗精神病药使用情况。结果:2006年天津市各级医院抗精神病药使用以典型抗精神病药为主,使用前5位的是奋乃静、氯氮平、氯丙嗪(25 mg)、舒必利、氟哌啶醇。抗精神病药使用主要集中在精神专科医院,使用比例为88.4%。不同级别医院中以三级医院的使用量最大,比例占到69.6%。结论:本市的抗精神病药使用种类丰富,精神专科医院是抗精神病药主要使用的医院,抗精神病药使用以典型抗精神病药为主。

Objective:To compare the efficacy and safety of aripiprazole and risperidone in patients with schizophrenia.Methods:50 adult patients with the disease conforming to the CCMD-3 Diagnostic Criteria for Schizophrenia were randomly allocated to the aripiprazole group(n=25) or the risperidone group(n=25).The subjects were given aripiprazole and risperidone respectively for eight weeks.Positive and Negative Syndrome Scale(PANSS)and Treatment Emergent Side effect Scale(TESS)were used for the evaluation of the efficacy and the adverse drug effects of the two drugs before the treatment and at the ends of two,four and eight weeks after the treatment respectively.Results:The markedly effective rates at the end of eight weeks were 72% in aripiprazole group and 76% in risperidone group,exhibiting no significant differences between the two groups(P>0.05).There also were no significant differences in the scores of PANSS recorded before and at two,four,six and eight weeks after the treatment(P>0.05) in either group.The mostly common adverse effects of aripiprazole were insomnia,nausea or anorexia.Menstrual disorder in aripiprazole group was significantly lower than that in risperidone group(P<0.05).Conclusion:Aripiprazole and risperidal show the similar efficacy and fewer adverse drug effects when used for schizophrenia.They are efficient and safe.

Objective To investigate the mental service resources and its utilizations in hospitals in Tianjin.Methods With self-established questionnaire about mental health services provided by medical institutes,365 registered hospitals from 18 districts and counties in Tianjin were surveyed by the questionnaire on mental services status of these hospitals in 2006,exploring the distributions of mental health resources as well as the delivery and utilization of mental health services.Results In 2006,there were 60 hospitals in Tianjin to provide mental services,in which there were 561 psychiatric doctors(5.38 doctors per 100 thousand residents) and 885 psychiatric nurses(8.49 nurses per 100 thousand residents) and 4 281 psychiatric beds(4.11 beds per 10 thousand residents).The total person time of outpatient was 434 120,and the total person time of inpatient was 10 449.According to area division,resources of mental health services relatively concentrated in central districts and quasi-central districts.Psychiatric hospital had more mental health resources than general hospital did.There were more resources in tertiary hospitals than in primary and secondary hospitals.Inpatient services were mainly in central districts and psychiatric hospitals,and outpatient services mainly in central districts and general hospitals.Conclusion Though mental health resources of Tianjin were in a relatively high level,the distribution of mental health resources and utilizations of service were imbalanced,with relatively short and under-utilized resources.

Objective To investigate the Public's cognition towards Depressive disorder in Tianjin. Methods 720 cases of community residents were selected randomly,and investigate these people's cognition towards depressive disorder with public suicide attitude questionairre drawed up by epidemiology teaching and research sectiono of beijing huilongguan hospital. Then analyze these cognitions. Results 582 cases of residents completed questionnaire survey. In which,76.4% had heard the depressive disorder,only 8.1% thought the depressive patients were crazy,91.2% belived the person with the depressive disorder would commit suicide. Compared psychotherapy,the publics prefered to drug treatments. Conclusion Urban publics had cogniton mistakes towards depressive disorder. The attitude toward depressive disorder was influenced by public's age,sex and education. We must consider these conditions when establishing psychoeducation about depression.

<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

目的 了解城市居民社会支持与生活质量状况及相关因素.方法 选择天津市作为调查地点,分层随机抽取调查样本居民,利用社会支持评定量表、生活质量评定量表及自制调查表对564名居民进行一对一的入户调查.结果 生活质量评分男性高于女性(t=3.321,P=0.001),社会支持总分(t=5.222,P=0.002)、主观社会支持分(t=5.751,P=0.000)及社会支持利用度评分(t=1.984,P=0.048)年轻组高于老年组,客观社会支持分男性高于女性(t=1.975,P=0.049);各项评定与受教育程度呈正相关,社会支持利用度与年龄成负相关,生活质量评分与家庭年收入呈负相关,各项评定与心理疾病及躯体疾病受限呈负相关.结论 心理健康教育的关注点应该落在老年、女性、受教育程度相对较低的群体.

目的:了解天津市医疗机构使用抗抑郁剂的分布特点。方法:使用《天津市医疗机构精神卫生服务状况调查问卷》调查2006年天津市364家各级医院传统抗抑郁剂和新型抗抑郁剂的使用情况。结果:2006年天津市抗抑郁剂的使用以新型抗抑郁剂为主,占54.9%。前五位使用的药物依次为氟哌塞吨美利曲辛、氯丙米嗪、多虑平、帕罗西汀和阿米替林,主要由市内六区的三级医院使用。综合医院使用的抗抑郁剂占使用总量的40%。结论:我市可获得的抗抑郁剂种类丰富,综合医院使用的比例接近精神专科医院。有必要评估综合医院抗抑郁剂的使用是否合理。

Objective To investigate the current state of bed distribution and services of psychiatric department in Tianjin in 2006. Methods Total 365 hospitals from 18 districts and counties were investigated by a questionnaire on bed distribution and services for mental inpatient in Tianjin in 2006. Results There were total 4281 beds for mental inpatients, about 4.11 beds per 10 thousands persons. The utility rate of the beds was 93.8%. Conclusion The distribution of psychiatric beds in Tianjin was extremely imbalance; there was a short of service resources and underutilization of beds.

目的:了解思瑞康治疗急性期精神分裂症的疗效、安全性和耐受性。方法:对33例符合CCMD-3精神分裂诊断标准的患者进行8周的开放性研究,给予思瑞康的起始剂量为100 mg/d,3~6 d内加量至400~800 mg/d,以简明精神病评定量表(BPRS)和临床总体印象量表(CG I)评定疗效,以不良反应量表(TESS)评定药物不良反应。结果:思瑞康显效率81.82%,平均治疗剂量(600±86.92)mg/d,起效时间1~2周,不良反应有失眠、嗜睡、体重增加、静坐不能、血压变化、头晕和转氨酶增高等,但发生率较低,多能耐受,大多自行缓解。结论:思瑞康治疗急性期精神分裂症显效率高,疗效肯定,起效快,安全,患者对药物耐受性和依从性好。

Objective To study the relationship between serum concentration of risperidone and clinical effects and side effects in treatment of patients with schizophrenia,and to determine the treatment range of risperidone.MethodsA total of 52 schizophrenic inpatients (28 male, 24 female) were evaluated before and after treatment with PANSS,TESS,ESRS.HPLC was used to measure the concentration of risperidone at week 4,8 after treatment with risperidone.ResultsThe serum concentrations at week 4,8 after treatment with risperidone (2~8mg/d) were (37.68±15.26)nmol/l and (49.21±16.23)nmol/l. Serum concentration of risperidone was significantly related to PANSS,TESS,ESRS.When serum concentration of risperidone was over 65nmol/l, clinical effects did not improve with the increased dosage,but the side effects increased.ConlusionRisperidone is safe and effective when the drug dosage is (2~6)mg/d and serum concentration is (30~65)nmol/l.

目的:观察多美康治疗睡眠障碍的临床疗效及安全性.方法:对44例患者给予多美康系统治疗,观察4周.以睡眠状况自评量表(SRSS)评定疗效.入组前治疗后行心电图、血生化常规检查,记录不良反应,以观察其副作用.结果:多美康能改善各种形式的睡眠障碍,尤其对入睡困难者,有效率可近100%,且副作用少,结论:多美康改善睡眠疗效确切,可作为临床治疗的首选药物.

目的对140例全面分析,探讨综合医院的精神医学心理咨询,看综合医院应有医学心理专业人员进行咨询的必要.方法收集门诊、会诊病例140份,就诊1442人次,采用<中国精神障碍分类与诊断标准-3>(CCMD-3)诊断,对资料进行全面分析.结果神经症发病率最高,女性发病高于男性,中青年及中等文化者占多数.结论心理卫生咨询回归综合医院是现代医学发展的一种趋势,其研究及防治工作是医学临床的重要课题.

目的:检验低剂量奥贝汀治疗抑郁症的疗效和安全性.方法:对100例抑郁症患者分别以低剂量奥贝汀或阿米替林治疗,疗程6周,以汉密尔顿抑郁量表(HAMD)评定药物疗效,以不良反应症状量表(TESS)评定不良反应.结果:奥贝汀组与阿米替林组的有效率差异无显著性,但显效率更高,且不良反应显著低于阿米替林组.结论:低剂量奥贝汀治疗抑郁症疗效确切,不良反应少,可作为门诊一线用药.

目的:探讨利培酮治疗精神分裂症时对其心电图的影响,并与氯丙嗪、氯氮平对照研究,以观察利培酮的安全性.方法:将病人随机分为利培酮、氯丙嗪、氯氮平3组,分别于治疗前及治疗高量期(6周±)检查心电图,观察心电图变化.结果:利培酮所致心电图异常发生率最小,3组药物间的心电图异常存在明显的差异,(χ2=59.30,P<0.01).结论:利培酮所致心电图改变明显低于氯丙嗪,更低于氯氮平.虽然3组药物对心电图均有影响,表明利培酮相对安全,对既往有心脏病史、年老体弱者,建议优先选用利培酮.

目的:探讨抗精神病药物对心肌肌钙蛋白(CTN)水平的影响,确认CTN是抗精神病药物所致心肌损伤的早期诊断和心原性猝死回顾性诊断的最佳指标.方法:对精神分裂症住院患者230例,在服药前、高剂量服药后第1天和1周末,以及减药后1周末,观察CTN(两项)和心肌酶(MCE)(四项)水平的变化.结果:230例服药前CTN两项和MCE四项检验值均在正常范围;高剂量服药后第1天CTN-T 18例、CTN-I 14例、GOT/AST 7例、LDH 4例、CK5例和CK-MB 9例检验值异常升高(发生率依次为7.83%、6.09%、3.04%、1.74%、2.17%和3.91%);高剂量服药后1周末仍发生CTN-T 18例、CTN-I 14例(7.83%和6.09%)及MCE四项不同程度升高.减药后1周末230例的该六项大多恢复至原水平,仅有4例(2例CTN两项、1例CTN两项和GOT/AST一项、1例CTN两项和LDH一项)仍未恢复至正常值.结论:CTN两项是抗精神病药物所致心肌损伤的早期诊断和心原性猝死回顾性诊断的最佳指标.