Opioid addiction is a chronic brain disease with a high heritability. However, the genetic underpinnings remain uncertain. DNA methylation is involved in the adaptive changes in neuroplasticity after prolonged drug use. The dopamine receptor D4 (DRD4) has an essential role in the reward processes associated with addictive drugs. To further elucidate the potential role and mechanism of the DRD4 gene variants in heroin addiction, we detected the methylation level of 46 CpG sites in the promoter region and the genotypes of three SNPs in the DRD4 gene. Correlations between the SNPs and methylation levels of the CpG sites, i.e., the analysis of methylation quantitative trait loci (mQTLs) was conducted. Following the identification of mQTLs that are unique in the heroin addiction group, we performed an association study between the mQTLs and traits of heroin addiction. Our results revealed that there were several correlations of SNPs rs3758653 and rs11246226 with the methylation levels of some CpG sites in the DRD4 gene. Among these SNP-CpG pairs, rs3758653-DRD4_04, rs3758653DRD4_05, rs3758653-DRD4_13 and rs3758653-DRD4_03 were unique in the heroin addiction group. Moreover, we found that mQTL rs3758653 was associated with duration from first heroin exposure to addiction, and the expression level of the DRD4 gene in human brain regions of the frontal cortex and hippocampus. Our findings suggested that some mQTLs in the genome may be associated with traits of opioid addiction through implicating the processes of DNA methylation and gene expression.

目的 了解某三级精神病专科医院灾害脆弱性事件,为提升医院应急管理水平提供参考.方法 应用Kaiser模型,设计灾害脆弱性评分标准,对医院灾害事件进行调查与评估.结果 医院灾害脆弱性事件居前10位的分别是:医务人员人身伤害事件、患者自伤自杀、患者伤人毁物、医务人员职业暴露、患者拒食拒药、患者出走、电梯故障、患者制动被伤事件、患者噎食、信息系统故障.结论 三级精神病专科医院灾害脆弱性事件因其服务对象的特殊性,有着自身特点.医院应以灾害脆弱性分析结果为依据,尽快制定和完善应急预案,以防范风险,保障员工与患者安全.

目的 探讨情志护理干预对美沙酮维持治疗受治者睡眠障碍的影响.方法 将2014年1月至12月在西安市精神卫生中心参加维持治疗的伴睡眠障碍受治者60例随机分为试验组和对照组,各30例.对照组进行常规护理,试验组在此基础上进行情志护理,比较两组患者护理效果.结果 对照组护理总有效率为63.3%,明显低于试验组的86.7%,差异有统计学意义(P<0.05);试验组睡眠质量、入睡时间、睡眠时间、睡眠效率、催眠药物的使用、白天睡眠障碍及PSQI总分均显著优于对照组,差异有统计学意义(P<0.05).结论 实施情志护理,可改善美沙酮维持治疗受治者的睡眠障碍.

目的：探讨跨文化接触早期援外医疗队员的心理健康状况及其与应对方式之间的关系。方法采用网络自填调查问卷的方法对援外医疗队队员共42名（研究组）进行调查，按照年龄和性别1∶4匹配选取的健康成年人168名作为对照组。采用症状自评量表（SCL-90）、应对方式问卷（CSQ）进行问卷调查。结果研究组中阳性组8名，阴性组34名。研究组积极应对方式因子评分高于对照组，消极应对方式因子评分低于对照组（ P＜0．01）。研究组中的阳性组积极应对方式评分低于阴性组（P＜0．05），而消极应对方式评分高于阴性组（P＜0．01）。焦虑和抑郁与积极应对方式呈负相（P＜0．05）。结论援外医疗各级管理人员和个体应该重视队员的心理健康情况，采取积极的干预措施和社会支持系统，缓解患者的心理应激，使患者保持健康的心理。

目的：探讨通过结对康复的方法进行干预对美沙酮维持治疗受治者长期依从性的影响。方法：将60例维持治疗患者随机分为研究组和对照组，每组30例。在常规美沙酮维持治疗不变的情况下，研究组采用结对康复疗法进行干预，分别在治疗前、治疗后3个月、6个月、12个月评定自编量表、抑郁自评量表、焦虑自评量表、社会支持评定量表、家庭支持量表等，比较两组量表结果和维持率、尿检阳性率。结果：治疗12个月后，研究组和对照组各量表的评分均优于治疗前；组间比较差异有显著性，研究组的疗效优于对照组。研究组康复治疗的维持率高于对照组。研究组治疗4～6个月、6～12个月内尿检阳性率低于对照组，有显著性差异。结论：结对康复疗法对美沙酮维持治疗疗效满意，有利于患者的康复和社会功能的恢复和保持。

Objective:To investigate the life quality improvement and infect factors of major depression patients after six weeks treatment of fluoxetine .Methods :100 major depressive patients and 100 healthy controls were selected in this study .All patients were accepted six-week therapies of fluoxetine (20~40mg/d) and assessed with HAMD ,SF-36 and TESS before and after therapy .Healthy controls were assessed with above scales .Results :Life qualities of patients were significantly lower than those in normal group either before or after treatment .Six-week treatment later ,each factor score of SF-36 has a significant difference compared with the score before therapy . There was a certain direct correlation between HAMD reductive ratio and life quality .In addition ,side reactions were also influence the life quality .The scores of PF and VT in side reactions group were lower than those in group without side reactions .Conclusion :Life quality of major depression decrease significantly .Fluoxetine can improve life quality of patients notably in six weeks ,but can not reach the normal level in short term .There is a certain posi-tive correlation between the effect of fluoxetine and improvement of life quality in patients .Meanwhile life quality is also influenced by other factors such as side reactions of drug and so on .

Objective:To investigate the efficacy of various stages of comprehensive individual psychological intervention in patients undergoing methadone maintenance treatment(MMT). Methods:100 cases of heroin addicts were divided into methadone combined with individual psychological intervention(study group)and MMT groups(control group). The retention rate,self-rating depression scale(SDS),self-rating anxiety scale(SAS)and family support scale at 12 months after treatment were statistically compared between two groups. Results:Various stages of comprehensive individual psychological intervention could improve the retention rate of heroin addicts treated with MMT. SDS,SAS and family support scale mean scores significantly differed between two groups at 12-month after treatment(P < 0. 05). Conclusion:Individual psychological intervention is able to bolster patients’desire,eliminate negative feel-ings,improve family relationship,promote the goal of rehabilitation and return to society.

Objective:To understand the personality of the patients on methadone maintenance treatment(MMT) patients. Methods:The personality of 118 MMT patients who voluntarily received MMT was tested with Eysenck Personality Questionnaire (EPQ). All subscales of EPQ scores of MMT patients were compared with the adult norm. Results:Compared with the adult norm,all subscales of EPQ scores of MMT patients showed a significant difference(P<0.001). Differences between male and female in P,N,L subscales were also observed. Conclusion:Obviously,MMT patients have abnormal personality,and there are differences between men and women. Psychological intervention should be conducted accordingly.

阿立哌唑为非典型抗精神病药,系多巴胺-5羟色胺系统稳定剂(DSSs)的典型代表.利培酮是第二代抗精神病药,为5-HT/DA受体平衡拮抗剂(SDA)的典型代表[1].对我院使用阿立哌唑及利培酮治疗精神分裂症进行对照分析,现报告如下.

本文通过对自杀的概念、流行病学资料、自杀的危害性、影响自杀的危险因素、自杀者的人格特点、心理特征、自杀的过程、自杀前的征兆及关于自杀的预防的综合述评,意在使人们认识自杀、研究自杀,并采取积极有效的办法降低和减少自杀。

2003～2005年12月我院采用米氮平联用电抽搐治疗难治性抑郁症20例,疗效满意,现报告如下. 临床资料 1 一般资料 本组37例患者符合难治性抑郁症的诊断标准,汉密尔顿抑郁量表(HAMD)17项评分≥17分;排除有器质性疾病、无药物依赖和滥用史、非妊娠或哺乳妇女、排除电抽搐治疗的禁忌证,将37例患者随机分成两组:米氮平联用电抽搐治疗组20例,男11例,女9例,年龄19～47岁,病程7周至3年,平均(6.4±4.5)个月;米氮平单用组17例,男11例,女6例,年龄18～53岁,病程7周至3.8年,平均(6.5±4.8)个月.