目的:探究脑力疲劳前后前注意能力的变化.方法:以长时间(≥8 h)持续驾驶建立脑力疲劳模型,应用事件相关电位(event related potential,ERP)技术对招募来的30名长途车司机诱发其脑力疲劳前后的失匹配负波(mismatch negativity,MMN),分析疲劳前后MMN成分潜伏期及波幅的变化.结果:脑力疲劳后MMN成分平均面积较驾驶前显著下降,但潜伏期均无统计学差异.结论:脑力疲劳状态下前注意能力受损,MMN可作为评价脑力疲劳状态下前注意能力的客观指标.

目的:探究氨磺必利对精神分裂症伴抑郁患者正负性情绪及应对方式的影响.方法:招募精神分裂症伴抑郁患者60例作为研究组,予以氨磺必利治疗4周.另选取健康志愿者20例作为对照组.比较两组治疗前正负性情绪量表(PANAS)及特质应对方式问卷(TCSQ)评分.比较研究组治疗前后简明精神病评定量表(BPRS)、PANAS、TCSQ及贝克抑郁自评量表(BDI)评分.结果:治疗前,研究组正性情绪、积极应对方式评分低于对照组,而负性情绪、负性应对方式评分高于对照组(均P<0.05).治疗后,患者BPRS及BDI评分降低(均P<0.05);正性情绪评分和积极应对方式评分明显高于治疗前(均P<0.05),负性情绪评分和消极应对方式评分与治疗前比较无统计学差异(均P>0.05).结论:氨磺必利可改善精神分裂症伴抑郁患者精神症状及部分抑郁症状,负性情绪、消极应对方式可能是患者经药物治疗后社会功能恢复欠佳的重要因素.

目的:探讨P300在舍曲林治疗抑郁障碍中的应用效果.方法:对28名首发抑郁障碍患者使用舍曲林治疗4周,对比其治疗前和治疗后汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分及P300成份变化.结果:经过4周舍曲林治疗,抑郁障碍患者HAMD评分显著降低.治疗后P300成份的波幅较治疗前增高(P＜0.05),潜伏期无明显变化.结论:舍曲林可显著改善首发抑郁障碍患者临床症状,可部分改善认知功能,P300可作为评估抑郁障碍患者病情变化的有效工具.

Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence. A total of 281 depressed patients who had achieved stable full or partial remission on a 6-month antidepressant (ADP) run-in treatment were randomly assigned to an rTMS ( n = 91), ADP ( n = 108), or combined (rTMS + ADP, n = 82) treatment group for 12 months. Monthly clustered rTMS was conducted in 5–10 sessions over a 3–5-day period. Maintenance outcomes were assessed using time to relapse/recurrence and relapse/recurrence rate. Overall, 71.2% (200/281) of the participants completed the treatment per the protocol. rTMS + ADP and rTMS significantly reduced the risk of relapse/recurrence compared with ADP ( P = 0.000), with hazard ratios of 0.297 and 0.466, respectively. Both rTMS-containing regimens produced significantly lower relapse/recurrence rates than ADP (15.9% and 24.2% vs. 44.4%, P < 0.001). In the relapsed/recurrent subgroup, first-episode depressed, rTMS-treated patients had a markedly lower relapse/recurrence rate than ADP-treated patients. Five patients on the ADP-containing regimens, but none on rTMS alone, developed acute mania. The rTMS-containing regimens had considerably more certain side effects than did the ADP group. We concluded that TMS, whether as a mono- or additional therapy, is superior to antidepressants in preventing depressive relapse/recurrence, particularly in first-episode depressed patients. The treatment does not increase the risk of manic switch, but may increase the risk of certain side effects.