为了提高P300对精神疾病识别和诊断的敏感性, 越来越多的研究关注双模态刺激方式的应用, 本文对目前视-听双模态刺激方式的应用研究和相关机制进行综述.

OBJECTIVE:In this study, we investigated auditory-visual stimulation-induced P300 and examined whether P300 was differentially modulated between individuals with clinical depression and healthy controls. We hypothesized that the P300 component would significantly differ between individuals with depression and healthy individuals Specifically, we predicted that the P300 component induced by the bimodal oddball task would be significantly different from that induced by the unimodal task. METHODS:Forty-five individuals with depression and forty-five healthy controls participated in this study. All participants were instructed to complete three oddball tasks-auditory (A), visual (V), and bimodal (AV)-while their electroencephalographic signals were recorded. RESULTS:Individuals with depression had a lower P300 amplitude and a longer latency than controls in the bimodal task. P300 amplitudes in the bimodal task were significantly higher than in the auditory or visual tasks in both groups. In the depression group, the P300 amplitude was negatively correlated with Hamilton Depression Rating Scale (HAM-D) scores in the bimodal task. CONCLUSIONS:Our results, which agree with those reported previously, suggest that there is a heightened P300 amplitude sensitivity in the bimodal task in individuals with depression. Our data also suggest that P300 amplitudes in the bimodal task may reflect the severity of depression. SIGNIFICANCE:The reduced task-related ERP response in individuals with depression suggests significant impairments in these individuals in stimulus integration and response functions.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的研究氟西汀对慢性应激小鼠海马胃泌素释放肽受体（GRPR）表达的影响,探讨氟西汀抗抑郁作用可能的分子机制。方法♂C57BL/6小鼠30只,随机分为对照组、慢性不可预见性应激（CUS）模型组和氟西汀处理组。小鼠经CUS应激处理后,给予氟西汀或生理盐水,进行糖水偏好和旷场行为学测试;蛋白印迹分析和荧光定量PCR法分别检测小鼠海马GRPR蛋白和mRNA的表达水平。结果行为学测试结果显示,CUS模型组小鼠糖水偏好、总行程、平均移动速度及直立次数均低于对照组（P&lt;0.01）;氟西汀组行为学指标均高于CUS模型组（P&lt;0.01）。蛋白印迹与荧光定量PCR结果显示,与对照组比较,CUS组小鼠海马GRPR mRNA及蛋白表达升高（P&lt;0.01）;经氟西汀处理后,GRPR</span>

目的:探讨不同性别青少年精神分裂症患者经抗精神病药物治疗4周前后体质量、空腹血糖(FBG)、血尿酸(UA)和血脂代谢的变化.方法:纳入住院治疗的青少年精神分裂症患者186例,男88例,女98例.给予相应的抗精神病药物治疗4周.比较治疗前、后患者体质量、血UA、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)水平及其变化.结果:与治疗前相比,女性青少年治疗4周后体质量、TG、LDL增高(P<0.05),FBG、TC、UA、HDL的血清水平,高TG血症的发生率和高UA血症发生率差异无统计学意义(P>0.05);男性青少年治疗4周后体质量,TG、LDL、UA的血清水平,高TG血症发生率增高(P<0.05),FBG、TC、HDL的血清水平,高UA血症的发生率差异无统计学意义(P>0.05);治疗4周后15.30％的女性青少年和15.91％的男性青少年体重增加了7％.结论:抗精神病药物治疗对青少年精神分裂症患者血脂和血UA代谢有影响,尤其是男性患者.

Objective To explore the effects of first-generation antipsychotics to influence secretory function of islets cell in isolated rat.Methods A total of 36 healthy female Sprague-Dawley rats were randomly divided into chlorpromazine group(1μmol/L chlorpromazine + 0.1％ DMSO),haloperidol group(1 μ mol/L haloperidol + 0.1％ DMSO),sulpiride group(1 μmol/L sulpiride +0.1％ DMSO)and control group(0.1％ DMSO).They were examined with level of insulin and mean fluorescence intensity after injection and 48 hours of incubation.Results The levels of insulin and mean fluorescence intensity in chlorpromazine group were all significantly lower than those in control group (P ＜ 0.05).Conclusions It's obvious for chlorpromazine to inhibit the secretory function of islets cell in the isolated rat.

Objective:To explore the clinical efficacy of repetitive transcranial magnetic stimulaton(rT-MS)combined with lamotrigine in the treatment of obstinate auditory hallucinations experienced by schizophren-ic patients. Method:Ninety schizophrenic patients were randomly divided into observation group(n = 30), control group 1(n = 30)and control group 2(n = 30). The observation group was administered rTMS and lam-otrigine,control group 1 was administered unreal rTMS and lamotrigine,and control group 2 was administered rTMS and placebo. The course of all administrations was 8 weeks. Before the treatment,at the 4th week,and at the 8th week. Clinical efficacies were assessed with the positive and negative symptom scale(PANSS)and audi-tory hallucinations rating scale( AHRS),and adverse reactions with the treatment emergent symptom scale (TESS). Results:At the end of treatment period,the total score of PANSS and AHRS for observation group were lower than that of control group 1 and than that of control group 2,and the differences between observation group and control groups were statistically significant(F = 6. 739,P < 0. 01;F = 3. 898,P < 0. 05);the total score of PANSS and that of AHRS for each of the three groups showed main effect of time(F = 30. 383,F =18. 232;all P < 0. 001),but there were no time × group interaction effect( F = 1. 607,F = 1. 568;all P >0. 05);no significant difference was found adverse reactions between observation group and control groups(χ2 =0. 752,P > 0. 05). Conclusion:rTMS combined with lamotrigine has more evident clinical effecacy than the single use of rTMS or lamotrigine on schizophrenia with obstinate auditory hallucination.

The glutamate transporter EAAT 2 ( rodent nomencla-ture GLT-1:glutamate transporter 1), which is a predominantly astroglial glutamate transporter in the hippocampus and the pre-frontal cortex , is responsible for the majority of extracellular glu-tamate uptake .The glutamate transporter EAAT 2 can decrease the high levels of glutamate in the synaptic cleft , avoiding gluta-matergic excitotoxicity to damage the glial cells and neurons .&nbsp;Currently, the transporter EAAT2 has become a research hotspot of depression .This article aims to summarize roles of glutamate transporter EAAT2 in the occurrence and treatment of depres-sion.

目的:探讨儿童青少年初次进行心理咨询的特点和存在的问题.方法:对来访者进行自编问卷调查和分析.结果:82.9％的来访者自愿前来就诊;求助途径和求助对象中,父母介绍前来咨询者占55.7％,求助对象的前2位是父母(35.7％)和医生(32.9％);对心理障碍的看法中,61.4％的来访者认为到医院进行心理咨询的都有心理障碍,42.9％的来访者认为有心理障碍不光彩.结论:儿童青少年有主动求助意愿,但因自身认知等原因对心理障碍存在一些偏见.父母是儿童青少年寻求心理咨询帮助的主要途径和求助对象,咨询中可辅助进行家长咨询.

Objective To evaluate the effect of paliperidone palmitate on quality of life and insight in patients with schizophrenia.Methods 97 were given orally 6mg paliperidone tablets for three days before injection,in the case of no allergic reaction,were injected with 150mg paliperidone palmitate,were given 100mg injection at intervals of eight days,then were injected monthly with 75mg-150 mg dose.Change of psychiatric symptoms and therapeutic effect were assessed with the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression scale (CGI).Adverse reactions were evaluated with Treatment Emergent Symptoms Scale (TESS).Quality of life and insight were evaluated with Quality of Life Enjoyment and SatisfactionQuestionnaire(Q-LES-Q),andInsightandTreatmentAttitudeQuestionnaire(ITAQ).Monitoring blood biochemistry in laboratory.With the self-contrast method,to evaluate the efficacy and adverse reactions before treatment and.Results 72 patients were completed.The reduction rate of PANSS scores was 35.2％,51.2％,62.6％,75.3％ in the 4th,8th,12th,24th week after treatment after treatment.As compared with before treatment,Q-LES-Q scores、ITAQ scores were significantly increased in the 4th,Sth,12th,24th week after treatment (P＜0.01 or 0.05).Conclusion Paliperidone palmitate injections take effect obviously after 4 weeks,reach to satisfactory clinical effect,mildly adverse reaction,improves dramatically scores of Q-LES-Q and ITAQ,provides a new choice and possibility for long-term treatment and to restore social function.

目的 了解湖北省精神卫生机构开展健康教育情况,为全省心理健康教育发展提供基础理论依据.方法 采用自制调查表对全省精神卫生机构心理健康教育开展形式、面向人群、开展内容、开展频率、效果自评等进行调查.结果 湖北省精神卫生机构健康教育开展形式主要为讲座、心理辅导和培训,面向人群主要为青少年和老年人,内容以精神疾病健康教育为主,50％以上的机构每月都开展健康教育,44.8％的机构自评达到“良好”.结论 目前湖北省精神卫生机构健康教育工作开展良好,可进一步开展多种教育方式,提升心理健康教育效果.

目的 分析湖北省严重精神障碍网络管理患者的基本情况,为研究制定湖北省严重精神障碍患者救助救治政策提供基础信息.方法 选取截止到2013年12月31日湖北省15岁以上常住人口中明确诊断为严重精神障碍的173 494例在管患者为研究对象,由湖北省各级精神卫生中心或疾病预防控制中心、严重精神障碍管理治疗工作领导小组和省级专家指导组提供医疗技术指导、培训、会诊等服务,以村委会或居委会为基本单位,由基层卫生医疗机构负责采集患者基础信息及随访情况,录入国家数据收集分析系统,按人口学特征和疾病特征进行统计分析.结果 18～44岁严重精神障碍患者占53.43％;严重精神障碍患者小学文化及以下占54.23％;98.03％的严重精神障碍患者为汉族;严重精神障碍患者未婚者占39.12％;离婚及丧偶者占6.72％;有严重精神障碍家族史者占4.35％;农村严重精神障碍患者占65.51％,城市下岗职工或无业人员占14.25％;经济状况处于当地贫困线以下的严重精神障碍患者占64.47％;精神分裂症患者占81.88％;不服药和间断服药患者占54.99％,随访病情不稳定占4.45％,近3年平均肇事肇祸率为1.19％.在纳入网络管理的173 494例患有严重精神障碍患者中,同意接受随访患者133 929例,接受治疗患者71 131例,随访管理率为77.19％,规范治疗率为53.11％.结论 应加强政府领导,完善协调机制,依法对贫困、肇事肇祸严重精神障碍患者免费开展救治救助工作,确保患者得到全程连续性管理治疗服务,促进公共安全和社会稳定.

目的：了解湖北省精神卫生机构和床位资源现状，为全省精神卫生机构设置及体系建设发展规划提供决策。方法采用自制调查表对全省精神卫生机构现状进行调查。结果截至2013年10月，全省17个市州及直管市设有精神卫生机构共119个，21个县级地区无精神卫生机构。机构数量以武汉市、襄阳市居多，神农架林区无精神卫生机构；全省精神科床位16654张（含心理科病床1739张），以武汉市、黄冈市居多；全省平均床位密度2．97张／万人，高于全国1．82张／万人平均水平，以鄂州市最高，其次为黄石市。各级精神卫生机构设置精神疾病防治科74家，占62．2％。结论初步建立了省－市－县精神卫生服务管理网络，全省精神卫生机构与床位资源可满足当前开展严重精神障碍患者服务需求，但主办部门多，资源缺乏有机结合，精神科床位资源地域分布不平衡，地区差异明显。

Objective To investigate the characteristics of the event related potential(ERP) P300 and analyze brain network connections in patients with first-episode depressions.Methods P300 auditory oddball task were administrated on twenty-nine patients and twenty-five healthy controls.The P300 amplitude and latency of two groups were compared,and the brain network connectivity of the two groups were analyzed using Granger's Causality analysis.Results The P300 amplitude in depression group were significantly different from those in control group (C3 of the central regions(15.77±7.35) μV vs (20.90±7.82)μV;C4 of the central regions(16.98±7.21) μV vs (22.11±7.50) μV;P3 of the parietal regions(15.65±6.92) μV vs (19.49±5.73) μV;P4 of the parietal(16.35± 6.46) μV vs P4(19.72±5.18) μV;P=0.009,P=0.007,P=0.017,P=0.024 respectively).However,the P300 latency had no significant difference comparing to the controls(P＞0.05).The results also showed that patients had more connections in the brain network.Conclusion As an effective evaluation index,ERP P300 can play an important role in clinical diagnosis of depression.Patients suffering from depression have significant cognition function deficit.

Objective To understand the development of psychological service in mental health in‐stitutions of Hubei Province ,and provide evidences for enacting appropriate policy .Methods A sampling survey of psychological service at mental health institutions of Hubei Province was made by the self -made questionnaire .Results More than 80% of mental health institutions had developed the psychological counseling and treatment services .The outpatient's amount was less than or equal to 150 times/month in 54 .1% of mental health institutions ,the outpatient's amount was less than or equal to 1000 times/year in 39 .3% of mental health institutions ,the psychological department that only had less than or equal to 30 beds ,accounted for 34 .8% of mental health institutions ,and 37 .0% of institutions'discharged pa‐tients were less than or equal to 250 times/year .The major of educational degree of psychiatrists and psychologists was bachelor degree (40 .9% ) , and the major of title was intermediate certificate (36.9% ) ,the working experience mainly was less than 5 years (32 .4% ) .The average hospital days of mental health institutions was 42 .6 days .The top 5 diseases in psychological department respectively were de‐pression ,anxiety ,schizophrenia ,bipolar disorder and obsessive compulsive disorder .Conclusions At pres‐ent ,the mental health needs of Hubei Province is great .However ,the psychological departments are lack of human resources and service ability ;the distribution of mental health resources is imbalance;and the quality of the people working on psychological department is low .Therefore ,we should provide tar‐geted support to improve .

Objective To investigate the effects of ceftriaxone on depressive-like behavior and changes of hippocampal glutamate transporter-1 (GLT-1) in C57 mice depression model,and to further explore the molecular mechanism of ceftriaxone on antidepressant action.Methods Thirty male C57 mice were randomly divided into control group(group A,n=10),CUS group(group B,n=10) and CUS+ceftriaxone group(group C,n=10).The mice of the CUS group and the CUS+ceftriaxone group were subjected to chronic unpredictable stress (CUS) for 2 sessions per day for 21 days.Then,the mice of the CUS+ceftriaxone group were given ceftriaxone for 21 days.Behavioral changes were assessed by the sucrose preference test and open field test.The GLT-1 protein levels in the hippocampus were detected by Western blot analysis at the end of the ceftriaxone treatment.Results (1) Compared with the control group,the percentage of sucrose preference,the total traveled distance,the moved velocity,and the frequencies of rearing of the CUS group were significantly decreased(P＜0.05) at the 21 days.However,the percentage of sucrose preference ((78.74 ± 3.54) ％),the total traveled distance ((6818.35 ± 505.14) cm),the moved velocity((12.36±0.89) cm/s),and the frequencies of rearing(58.20±4.05) of the CUS+ceftriaxone group at the end of the ceftriaxone treatment were improved significantly compared with the CUS group ((59.46 ± 2.75) ％,(2931.71±271.89) cm,(5.84±0.42) cm/s,(26.20±2.62),P＜0.05).(2) Western blot analysis indicated significant reductions of the GLT-1 protein levels in the hippocampus of CUS group (versus the control mice:P ＜0.05),and chronic ceftriaxone treatment reversed the CUS-induced decrease in the GLT-1 levels(P＜0.05).Conclusion Ceftriaxone might significantly improve depressive-like behavior in C57 mice depression model.Chronic unpredictable stress (CUS) could down-regulate the GLT-1 protein levels in the hippocampus,which are reversed by ceftriaxone.These results further support the notion enhanced expression of the GLT-1 protcin can be molecular mechanism of ceftriaxone on antidepressant action.

目的：分析急性焦虑发作的临床特征，提高非精神科医师对焦虑症的识别能力。方法回顾性分析1例双侧声带息肉术后出现急性焦虑发作患者的临床资料，并复习相关文献，分析其误诊误治的原因。结果该患者女性49岁，双侧声带息肉术后第4天突感呼吸困难，情绪非常惊恐，有濒死感，急行气管切开术后症状缓解，但此后至气管切开术后第5天气管套管堵管期间反复感“呼吸困难”，烦燥，体检无缺氧体征，经精神科医师会诊了解到其术前对手术较恐惧，紧张，结合其临床表现确诊为急性焦虑发作，口服抗焦虑药及心理疏导，一周后出院，继续在精神科门诊抗焦虑治疗一年痊愈。对急性焦虑发作的临床认识不足是该病例误诊误治的原因。结论以呼吸困难为突出表现的急性焦虑发作主要表现为突然发作、反复出现呼吸困难伴强烈惊恐体验及濒死感等，实验室检查及体检均无缺氧征，应采用抗焦虑药物及心理疏导治疗。

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:比较5种临床常用的抑郁症状评定工具,以发现评估精神分裂症患者抑郁症状的最佳选择。方法:在国内4家精神卫生机构入组101例精神分裂症住院患者,入组和抑郁症状评估由两位精神科医生分别独立完成。使用卡尔加里精神分裂症抑郁量表中文版（CDSS-C）、汉密顿抑郁量表17项（HAMD-17）、蒙哥马利抑郁量表（MARDS）、阳性和阴性症状量表抑郁分量表（PANSS-D）及抑郁条目（PANSS-G6）评估抑郁症状,使用Barnes静坐不能量表（BAS）和锥体外系不良反应量表（SAS）评估治疗过程中出现的锥体外系不良反应。比较各工具对精神分裂症患者抑郁症状的评定及诊断效度差异。结果:各抑郁症状评定工具相互之间相关性较高（r=0.62⁰.84,均P&lt;0.05）;HAMD-17、MARDS、PANSSD、PANSS-G6的ROC曲线下面积均小于CDSS-C的ROC曲线下面积（0.881、0.828、0.897、0.932vs.0.954,均P&lt;0.05）;CDSS-C得分与PANSS阴性症状、BAS、SAS得分的相关均无统计学意义（均r=0.08⁰.18,均P&gt;0.05）。结论:卡尔加里精神分裂症抑郁量表中文版评定精神分裂症患者抑郁症状的效果最佳。</span>

目的 分析2011～2013年湖北省在管严重精神障碍患者的失访与死亡情况,为减少失访患者危险行为的发生提供依据.方法 对在管患者随访数据及失访(死亡)患者登记表进行整理,了解失访患者的失访原因、病种,以及死亡患者的死亡原因.结果 2013年较2012年失访与死亡患者增加1.17倍,除其他(37.3％)和死亡(13.3％)外,外出打工、迁居他处、连续3次失访和走失患者合计49.4％;精神分裂症占失访患者84.2％;躯体疾病所致死亡患者占53.6％.结论 加强对精神分裂症和躯体疾病患者的随访,及时流转患者随访信息是预防患者失访和死亡的有效方法.

Childhood adversity has profound and persistent effects on brain functions and has been implicated in the etiology of depression. Brain-derived neurotrophic factor (BDNF) and cAMP response element-binding protein (CREB) play critical roles during brain development to maintain neuronal function and structural integrity in adulthood. We therefore investigated the long-term effects of early life adversity on the depression-related behavior and the expression of BDNF and CREB in the hippocampus. Male Sprague-Dawley newborn rats were subjected to maternal separation for 3 h/day on postnatal days 2-14. After the postnatal day 90, rats with or without the experience of infancy maternal separation received a series of unpredictable chronic mild stress (CMS) for 21 days. Sucrose preference and spontaneous activity in the open field test were recorded, and the expression of BDNF and CREB in the hippocampus was measured by real-time RT-PCR and Western blot analyses. Before exposure to CMS, the rats with maternal separation showed the significant decreases in sucrose preference, spontaneous activity, and hippocampal expression of BDNF and CREB, compared to the animals without maternal separation. In contrast, the rats without maternal separation showed greater decreases of the above indictors after CMS, the levels of which were lower than those observed in the rats with maternal separation. Thus, early life adversity leads to long-term decreases in the capacity of enjoying sweetness, spontaneous activity, and hippocampal expression of BDNF and CREB: Moreover, childhood neglect may decrease the neurobehavioral plasticity, thereby blunting the responses to adulthood stress and increasing the susceptibility to depression.

2015年6月1日晚21:30,“东方之星”客轮在湖北省监利江段翻沉.笔者受湖北省卫生计生委指派,作为灾难现场的心理救援人员于6月2日中午到达监利,开展心理救援工作,直至所有善后工作完成,于16日返回武汉.