北京市心理援助热线有精神障碍诊断史求助者的特征

目的:分析北京市心理援助热线有精神障碍诊断来电者的特征,以便有针对性地为他们提供热线心理干预服务。方法:应用北京市心理援助热线电脑咨询操作系统收集的资料进行统计分析。数据为2002年12月-2008年12月间拨打北京市心理援助热线的24 217例来电者,根据来电者自我报告是否有精神机构就医诊断史将其分为有精神障碍诊断史组(n=6516)和无精神障碍诊断史组(n=17 701),比较两组在求助问题类型、人口学特征及自杀相关因素上的差异性。结果:有精神障碍诊断组咨询的前五位问题为精神疾病、精神疾病相关知识、家庭关系、工作问题及家庭外的人际关系,在两组中,精神疾病问题均为首个咨询问题;相比之下,女性、20~29岁和30~44岁两个年龄组、教育年限≥10年和非现职者更多见于有精神障碍诊断组。来电者11个自杀相关因素评估结果显示,有精神障碍诊断史组在来电时的自杀意念或行为、既往自杀未遂史、高抑郁情绪、严重躯体疾病、受虐待史、害怕被攻击、亲友自杀行为史、高无望感的出现率均高于无精神障碍诊断史组(P0.001或0.05)。结论:热线咨询员对有精神障碍诊断的来电者进行热线干预时要特别注意评估来电者的抑郁程度以及其他自杀相关因素;为这些人群提供帮助时,要注意识别和处理他们生活中各种应激事件。     

昆明市15岁及以上居民自杀相关问题现况调查

目的:了解昆明市居民自杀问题的检出率及其相关因素。方法:按照分层容量比例概率随机抽样法,以昆明市≥15岁5033人为调查对象。在复合性国际诊断交谈检查2.1版(Composite InternationalDiagnostic Interview-version2.1,CIDI-2.1)回答后进行自杀相关问题调查,并分析人口学相关危险因素。结果:调查5033人中有自杀意念者占5.89%(95%CI,5.24%～6.54%),计划自杀1.71%(95%CI,1.35%～2.06%),曾有过自杀行为者0.76%(95%CI,0.52%～1.00%)。女性自杀意念、自杀计划及行为的发生率均高于男性(7.50%vs.4.15%,2.65%vs.0.84%,1.32%vs.0.24%;均P0.001)。城镇居民更易出现自杀意念(6.27%vs.3.42%;P0.001);离婚、分居、丧偶、受教育程度低者更易出现自杀计划(P0.05)。各年龄段、汉族和少数民族自杀问题检出率差异无统计学意义。患有焦虑障碍、物质使用障碍、情感障碍、躯体形式障碍者多易出现自杀相关行为。结论:昆明市居民中自杀问题突出,患有几类精神障碍是发生自杀问题的危险因素,应针对自杀行为进行有效干预。     

自杀与其它伤害死亡全国性对照研究

目的:了解国内的自杀现状及其特征.方法:用自制的意外死亡研究问卷按"心理解剖"的调查方法从全国20个农村和3个城市疾病监测点抽取895例自杀和701例其它伤害死亡案例.对每个案例的家属及周围知情者单独进行持续约3小时的调查.结果:自杀案例中67%为服毒自杀(大多数为存放在家中的物品);63%自杀当时有精神障碍(39.8%为抑郁症);27%有过自杀未遂;91%从未看过精神科医生;近一年最常见的负性生活事件为经济困难(40%)、患急重病(38%)或夫妻不和(35%);自杀前两天内25%有突出的人际关系冲突;自杀当时10%有他人在现场.与其它伤害死亡者比较自杀者女性多、年龄偏大、读书年限少、家庭收入低并出现慢性和急性负性生活事件多.结论:我国自杀为多因素相互作用的结果,相当一部分属于冲动行为,与其它国家比自杀当时患精神障碍的比例低.     

8年间老年精神障碍患者住院概况

目的:通过回顾性分析某院2009年-2016年8年间住院老年精神障碍患者疾病构成比,为制定防治政策提供数据支持。方法:收集2009-2016年期间65岁及以上老年住院精神障碍患者的一般资料,疾病诊断等信息,并逐年对比,分析其疾病构成的变化。结果:某院2009年至2016年8年间老年住院患者共1513例,其中男性568例(37.54%),女性945例(62.46%),男女比例为1:1.66;年龄65～86岁,平均年龄为69.13±4.13岁,主要集中在65～70岁,占比70.85%;8年间精神障碍构成比相对稳定,疾病顺位前4位分为抑郁症、精神分裂症、器质性精神障碍、双相情感障碍,抑郁症及双相情感障碍所占比例呈上升趋势,精神分裂症所占比例呈下降趋势。结论:抑郁症、精神分裂症、器质性精神障碍及双相情感障碍为老年住院患者的主要精神障碍,以女性患者为主。     

有、无精神障碍的农村老年自杀者的特征比较

目的:了解农村老年自杀者的特征并比较其中有、无精神障碍者的特征。方法:运用心理解剖方法对山东、湖南、广西三省符合标准的242例自杀案例的家属和周围知情人进行访谈,比较有、无精神障碍者在人口学资料,自杀行为,自杀意图,社会支持,抑郁症状,孤独和绝望等方面的差异。结果:与无精神障碍的自杀者相比,有精神障碍的自杀者不稳定婚姻比例少、留守比例高、发生近期生活事件多、自杀意图强、抑郁症状严重、绝望程度大,且差异有统计学意义(P0.05);多因素分析结果显示:留守(OR=3.64,95%CI=1.61～8.21)和中重度抑郁(OR=10.46,95%CI=2.23～48.97)的自杀者更有可能是精神障碍患者。结论:两组自杀者可能来自两个不同的人群,应该针对不同人群采取不同的自杀预防措施。     

住院重型颅脑损伤患者的精神障碍分析

目的 :探讨颅脑损伤与精神障碍的关系。方法 :分析 1993年 9月至 2 0 0 1年 2月间收治的 15 0例重型颅脑损伤患者住院期间出现精神障碍的情况 ,并与 2 0例无精神症状的重型颅脑损伤者对比分析。结果 :重型颅脑损伤伴精神障碍患者 ,占同期重型颅脑损伤病例的 2 0 8% ,占同期全部脑外伤的 5 2 %。 15 0例重型颅脑损伤伴精神障碍患者中 ,10 7例 (71 3 % )有下腔出血 ;2 7例 (18% )颅底骨折 ,而与同期无精神障碍的重型颅脑外伤者相比 ,精神症状的出现与外伤的严重程度有关 ;脑外伤伴意识障碍、谵妄是早期精神障碍的特征 ;记忆力障碍、情感障碍是其主要表现形式。结论 :出血性脑挫裂伤或脑挫伤伴蛛网膜下腔出血与精神障碍的发生有关。     

251例慢性酒精中毒所致精神障碍临床分析

目的 探讨慢性酒精中毒所致精神障碍的精神神经症状及躯体损害.方法 对1985～2005年251例慢性酒精中毒所致精神障碍住院患者临床资料进行分析.结果 主要精神症状出现率分别为:记忆和智能障碍69.72%,人格改变66.93%,幻觉61.75%,妄想52.19%,冲动行为50.60%.主要神经系统症状出现率分别为:肢体震颤79.28%,共济失调62.55%,末梢神经炎41.04%,意识障碍26.69%,癫痫样发作21.51%,构音障碍18.33%.颅脑CT90.48%示脑萎缩.脑电图异常率为74.90%.伴各种躯体疾病者65.34%.本病复发率高达84.00%.结论 慢性酒精中毒可造成严重精神障碍、神经及躯体损害,应引起全社会对本病防治的重视.     

各类精神障碍对自杀相关行为的影响

目的了解各类精神障碍对自杀意念、自杀计划、自杀行为的影响。方法在对昆明市精神障碍现况调查的同时,用分层容量比例概率随机抽样法抽取5033名年龄15岁以上的居民进行自杀问题的问卷调查。结果自杀意念、自杀计划、自杀行为的发生率(95%CI)分别为:5.89%(5.24%～6.54%)、1.71%(1.35%～2.06%)、0.96%(0.52%～1.00%)。精神障碍影响自杀相关行为较高的有双相情感障碍、精神分裂症、疼痛障碍、特殊恐怖、酒精依赖等。结论人群中有自杀意念及自杀行为的发生率较高,其中精神障碍是产生自杀相关问题的主要危险因素。     

酒精所致精神障碍127例临床分析

目的　对酒精中毒所致精神障碍 1 2 7例的回顾性临床分析。方法　用统计学方法将被入组者的各种临床资料进行分类。结果　患者均为男性 ,年龄以 31～ 5 1岁居多 ,文化程度中等及轻体力劳动者较多 ,精神障碍以幻觉、妄想及人格改变多见 ;躯体障碍中脑萎缩者较多 ;复发率高且治疗困难。结论　慢性酒精中毒所致精神障碍发病率在增加 ,危害大 ,应提倡科学饮酒。     

服农药与其他方式自杀未遂者的特征

目的:比较服农药与其他方式自杀未遂留院观察者的特征。方法:本研究是横断面研究,以我国6省市9所市县级综合医院为研究现场,由经培训的调查员用自制调查表对留院观察的617例自杀未遂者及家属等知情者进行调查,主要了解自杀意图强度、生活事件、生命质量等,并由精神科医师做精神科诊断。诊断依据美国精神障碍分类与诊断标准第4版(the Diagnostic and Statistical Manual of Mental Disorders-IV DSM-IV)进行。用非条件logistic回归模型分析自杀的危险因素。结果:617例被试以女性为主,占74%,平均年龄(33±13)岁,平均受教育年限(5.5±3.4)年。将被试分为服农药组468例,其他方式组149例,服农药组居住农村比例高(OR=4.7,95%CI=3.1~7.1)。控制居住地、性别和年龄后,服农药组受教育年限低(OR=2.6,95%CI1.6~4.1),家庭人均月收入低(OR=1.8,95%CI=1.2~2.8),生命质量高(OR=1.9,95%CI=1.2~2.8),前2天有急性严重生活事件影响(OR=2.6,95%CI=1.7~3.8),客观自杀意图强度低(OR=3.4,95%CI=2.2~5.1),诊断为精神障碍比例低(OR=0.4,95%CI=0.3~0.6),既往有自杀未遂史者所占比例低(OR=0.4,95%CI=0.2~0.6),但亲友或熟人自杀者所占比例高(OR=1.9,95%CI=1.3~2.9)。结论:服农药自杀者客观自杀意图强度低,且自杀前多存在急性严重生活事件。     

伊痛舒运用于颈源性头痛的治疗及护理

颈源性头痛好发于中老年或长期处于工作紧张状态的电脑工作及文字工作者,已成为疼痛门诊中的常见病种,其病因较为繁杂.随着对头痛不断研究,越来越多的学者发现,颈部疾病可以导致头痛,颈源性头痛在头痛人群中与偏头痛相近,大约为17.18%[1-2].我科采用伊痛舒及香丹注射液行颈2椎旁神经组滞治疗该病,取得了良好的疗效.现报告如下.     

Comparison of education and occupation of adults with achondroplasia with same-sex sibs

We compared the education and occupation of 20 adults with achondroplasia with their same-sex sibs. While the mean number of years of formal education reported by affected males and females was comparable to that of their same-sex sib, we found differences in the level of occupation between the groups. In general, affected females had a significantly lower occupational level compared to their unaffected sisters. In males and females the number of years of formal education and whether or not individuals had achondroplasia were the 2 most important factors determining occupational level when contrasting affected persons with their unaffected sibs. Education alone accounted for 28 and 42% of the observed variance in occupational level, respectively, for females and males.     

抑郁症和广泛性焦虑症病人临床特征的对照研究

在临床上 ,由于抑郁和焦虑症状合并存在 ,抑郁症患者伴有明显的焦虑症状 ,而焦虑症病人又有抑郁情绪 ,常常导致二者难以区别。本文探讨了抑郁症和广泛性焦虑症病人在人格和精神症状方面的差异性 ,为临床上对二者进行鉴别提供依据。对象　抑郁组、焦虑组均来源于2 0 0 1年 5月至 2 0 0 2年 6月中山三院心理科住院病人 ,入组标准为分别符合CC MD -2 -R[1 ] 有关抑郁症 (单次发作或者反复发作 )、焦虑症 (广泛性焦虑症 )的诊断标准 ;其中抑郁组共 3 8例 ,男性 12例 ,女性 2 6例 ;年龄 17-5 6岁 ,平均年龄 41 3 2± 13 0 6岁。焦虑组共 3 0名…     

Co-ordination of breathing with rhythmic head and eye movements and with passive turnings of the body

In the present study, we investigated co-ordination of breathing with active horizontal head and eye movements and with passive body turnings. The main purpose was to compare co-ordination with active voluntary and with passive movements. Co-ordination was defined according to the relative phases (RPs) between breathing and additional rhythms. It was present when at least five consecutive RPs scattered less than 25% of breath duration or at least three consecutive RPs scattered less than 10%. Additionally, we studied the influence of factors such as size of active muscle groups, mechanical interactions or involuntary motor activities. In consecutive experimental conditions, 17 healthy volunteers performed voluntary rhythmic head (with eyes open and closed) and eye movements and were moved passively (also with eyes open and closed). Co-ordination occurred in all experimental conditions. The highest percentage of co-ordinated breaths was found during active head movements with closed eyes but the difference with other conditions was not significant. However, periods of stable entrainment were observed only in this condition. The results demonstrate that co-ordination is possible even in the absence of voluntary rhythmic movements. Size of active muscle groups or mechanical interactions do not necessarily affect the degree of co-ordination. On the other hand, involuntary motor activities such as reflex eye movements associated with vestibular stimulation may have a considerable influence on co-ordination between other motor processes. These results strongly support the theory of co-ordination as an unconscious nervous interaction that is not based on mechanical or intentional factors.     

Treatment with a piperacillin and netilmicin combination of patients with agranulocytosis

Sixty infections episodes in granulocytopenic patients have been treated in first line with a piperacillin and netilmicin combination. Treatment has been successful in 78% bacterial infections. So, this antibiotic combination appears as a very effective therapy of infection in neutropenic patients.     

Staining of the sections with mixtures of gallocyanin with picrofuchsin and eosin]

Instead of two-stage staining with hematoxylin-eosin and hallocyanin-picrofuchsin a technique for simultaneous staining in mixtures of hallocyanin and eosin or picrofuchsin is suggested. The stains-cocktails are well preserved for 4-5 weeks and may be used repeatedly.     

Follow-up study of patients with panic disorder and agoraphobia with panic attacks treated with tricyclic antidepressants

One hundred and seven patients with panic disorder or agoraphobia with panic attacks were studied 1-4 years after treatment with a tricyclic antidepressant. At follow-up more than 80% of the patients remained symptomatic but fewer than half were experiencing panic attacks and only 40% were avoiding phobic situations. Although patients with agoraphobia were more severely ill and had been ill longer than those with panic disorder, their response to tricyclics and eventual outcome was similar to that for patients with panic disorder. Panic and agoraphobic patients who had the most severe symptoms initially showed the least improvement. The results suggest that panic disorder and agoraphobia with panic attacks are variants of a single illness and that, despite its chronicity, this illness has a favorable outcome.