气功所致精神分裂样障碍随访对照研究

目的：研究气功所致精神分裂样障碍的临床特征和近期疗效。方法：比较分析气功所致精神障碍84例、气功所致精神分裂样障碍44例和精神分裂症37例的近期疗效。结果：精神分裂症的发作次数明显多于气功所致精神障碍。精神分裂症和气功所致精神分裂样障碍者的精神功能减退比气功所致精神障碍者明显。结论：气功所致精神分裂样障碍近期治疗效果比精神分裂症要好，但是，停止治疗和继续练功也可能导致疾病复发。     

气功相关精神障碍患者82例随访对照分析

目的：对气功所致精神障碍与气功相关的精神分裂症的临床特点差异进行探讨。方法：收集在1990年至2000年间连续入院患者中与气功相关的精神病性障碍患者82例，其中住院时诊断为气功所致精神障碍46例，精神分裂症36例。收集两组病例的人口统计学、临床表现等资料并作5年以上随访。结果：气功所致精神障碍（气功组）与精神分裂症（分裂症组）比较，在性别、婚姻、年龄、接受教育年限、起病年龄及病程方面差异均有显著性（P均〈0．001）。获得68例5年以上的随访资料，其中气功组38例，分裂症组30例。至随访结束，气功组中84％（32例）、分裂症组中57％（17例）维持原诊断，二者差异有显著性（P〈0．001）。气功组的精神障碍缓解程度达89％（34例），而分裂症组的缓解程度仅33％（10例），差异有显著性（P〈0．001）。气功组的社会功能也明显优于分裂症组（P〈0．01）。结论：气功所致精神障碍与气功相关的精神分裂症是两种不同类型的疾病，根据临床特点，二者可以鉴别。     

气功所致精神障碍与分裂样精神病对照研究

目的：对气功所致精神障碍和分裂样精神病的异同进行探讨。方法：收集连续住院患者中符合中国精神疾病分类方案与诊断标准第2版修订本气功所致精神障碍诊断标准的病例22例，分裂样精神病66例，进行对照分析，并作3年随访。结果：气功所致精神障碍组19例、分裂样精神病组38例维持原诊断。两组在性别、发病年龄、婚姻、职业、人格特征、智能及精神症状方面差异有显著性。结论：气功所致精神障碍与分裂样精神病有明显差异，是两种性质不同的精神疾病。     

气功所致精神分裂样障碍与精神分裂症的对照研究

比较气功所致精神分裂样障碍与精神分裂症在临床上有无区别。以３０例前者与３３例后者作对照比较。前者发病年龄较大，起病较快，病期较短，预后较好，气功所致精神分裂样障碍有别于精神分裂症。     

癫痫性精神分裂样精神病的临床分析

目的探讨癫痫性精神分裂样精神病的临床特点及其与精神分裂症在临床上的差异。方法以５２例前者与５２例后者作对照比较。结果癫痫性精神分裂样精神病患者的精神症状出现于癫痫发作９１年之后，与精神分裂症组比较，其精神症状出现年龄较大，发病多无诱因，急性、亚急性起病较多，病前性格多为外向，思维粘滞、病理性赘述、幻听、易激惹的出现率较高，其抗精神病药物用量较低，疗效与精神分裂症组无差异。结论癫痫性精神分裂样精神病与精神分裂症在临床上存在差异。     

气功引起精神障碍12例的临床随访

随访气功所致精神障碍以期了解其本质。随访１９８８年至１９９０年诊断的气功所致精神障碍１２例３－５年。３例完全正常；４例再入院，其中１例诊断精神分裂症，１例癔症，２例原来诊断；５例在家服抗精神病药，未定论。气功究竟是病因还是诱因尚难定论。     

酒中毒性幻觉症和妄想症与精神分裂症的比较

酒中毒性幻觉症和妄想症由长期饮酒引起，患者意识可以清晰，有时与精神分裂症不易鉴别，现对此作一比较。在60例酒精所致精神障碍的患者中，能符合CCMD—2—R酒中毒性幻觉症和酒中毒性妄想症的诊断标准，饮酒5年以上，排除其他精神障碍，无精神分裂症及情感性精神障碍家族史者46例（饮酒组）；与首次发病在30岁以后，以偏执症状为主要表现的精神分裂症（含分裂样精神病，均符合CCMD－2－R诊断标准）30例（分裂症组）进行比较。两组患者均男性，年龄、病程和复发次数、病前性格、文化程度、婚姻和职业皆无显著差异（P均＞0．05）。饮酒…     

癫痫性精神分裂样精神病与精神分裂症的对照研究

本文对癫痫性精神分裂样精神病与精神分裂症各52例进行对照分析,结果发现癫痫性精神分裂样精神病患者精神症状出现于癫痫发作9.12年之后;与精神分裂症相比,其精神症状出现年龄较大,发病多无诱因,多为急性、亚急性起病,病前性格外向者较多,其癫痫家族史的比率较高,而其精神病家族史的比率较低,其幻听、思维粘滞、病理性赘述、易激惹的出现率较高,而感知综合障碍、破裂性思维、关系妄想、被害妄想、钟情妄想、情感淡漠、情感不协调、意志行为减退的出现率较低,其抗精神病药用量较低,而疗效与精神分裂症组无显著性差异。最后,对癫痫与精神分裂样精神病的关系进行了讨论。     

关于《CCMD-3》的4点意见

根据我们的临床实践经验 ,现对中国精神障碍分类与诊断标准第 3版 (CCMD 3)提出以下几点意见 :1　心境障碍中的双相障碍应放于抑郁发作的后面 ,即双相障碍的编码应为 32 ,抑郁发作的编码应为 31。原因 :先分别介绍躁狂发作及抑郁发作 ,然后再介绍双相障碍。2　分裂样精神病应归入分裂症中去原因 :①诊断标准 :分裂样精神病的诊断标准与分裂症基本相同 ,唯病程不足 1个月 ;②用药时间 :分裂样精神病的病人在服药种类及时间上与分裂症相对一致 ,需较长时间应用抗精神病药维持 ;而短暂性精神病则不需要长期用药 ,如旅途精神病则不需长期用药 …     

对精神疾病患者就诊途径的调查

作者对精神疾病患者就诊途径进行了调查 ,现报告于后。1　对象与方法1.1　调查对象　为 1999年 8月～ 2 0 0 0年 8月首次入院的精神疾病患者 ,共计 2 6 0例。其中 ,男 15 8例 ,女 10 2例 ,平均年龄 (34 .7± 10 .9)岁 ,大专以上文化 16例 ,中专 19例 ,高中 78例 ,初中 81例 ,小学以下 6 6例 ,城市 172例 ,农村 88例 ,平均病程 (85 .4± 41.7)天。诊断为精神分裂症 12 5例、分裂样精神病 9例、偏执性精神病 3例、情感性精神障碍 38例、酒精所致精神障碍 9例、颅脑创伤所致精神障碍 8例、癫疒间 所致精神障碍 10例、阿尔茨海默病 3例、气功所…     

Personality disorders and the persistence of anxiety disorders: Evidence of a time-of-measurement effect in NESARC

Recent studies using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) have found that some personality disorders (PDs) increase the persistence of several Axis I disorders. However, these effects are potentially confounded with the data collection wave in which PDs were assessed. Our aim was to extend published analyses to the case of anxiety disorders and to determine the robustness of the associations to analyses examining time-of-measurement effects. Persistence of anxiety disorders was defined either as follow-up diagnosis among participants diagnosed at baseline (“prediction”) or baseline diagnosis among participants diagnosed at follow-up (“post-diction”). Results revealed a robust pattern of higher odds ratios for post-diction among PDs assessed at baseline, and lower odds ratios for post-diction among PDs assessed at follow-up, suggesting a time of measurement artifact. Although only 4% of associations were robust to both predictive and post-dictive analyses, these were consistent with previous research.     

Alexithymia in somatoform and depressive disorders

OBJECTIVE: Alexithymia and its association with attribution styles, amplification and illness attitudes was studied among subjects with somatoform disorders, depressive disorders and normal subjects. METHODS: Two groups of 30 subjects each, bearing diagnoses of somatoform disorder and depressive disorder respectively (ICD-10 DCR), and one group of 30 normal controls were recruited. The study subjects were assessed using the Toronto Alexithymia Scale and scales for assessing attribution styles, amplification and illness attitudes. RESULTS: Mean alexithymia scores in the somatoform (60.4) and depressive disorder groups (62.5) were higher than in normal subjects (54.2). In the somatoform disorder group, total alexithymia and 'difficulty describing feelings' scores positively correlated with psychological attribution (the latter correlation was also noted in the depressive disorder group), but not with the illness attitudes, amplification, somatic attribution scores or any of the sociodemographic variables. Compared with normal subjects, those with somatoform and depressive disorder had greater difficulty in identifying bodily sensations and feelings. Subjects with depressive disorder had more difficulty in expressing feelings compared to somatoform disorder subjects. CONCLUSIONS: While total alexithymia scores do not differentiate somatoform from depressive disorders, the two diagnostic groups do differ in that depressed subjects have greater difficulty in expressing feelings. However, all three groups had mean scores within the non-alexithymic range. Alexithymia and difficulty in expressing feelings were associated with psychological attribution of innocuous bodily sensations in the somatoform disorder group suggesting that alexithymic subjects are more able to psychologize bodily symptoms than non-alexithymic subjects. Somatoform and depressive disorder subjects and normals differ from each other in certain alexithymic characteristics, which could have potential therapeutic implications.     

Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders

Background Functional gastrointestinal disorders or ‘functional gastrointestinal disorder‐like’ symptoms (FGIDs) occur commonly in eating disorders (ED), but it is not known if these disorders are stable over time. The aims were to evaluate the turnover of FGIDs in patients with ED, and to relate this turnover to changes in body mass index (BMI), ED behaviors, and psychological variables. Methods Patterns and repeated measures analysis of presence of individual FGIDs and regional FGID categories (esophageal, gastroduodenal, bowel, and anorectal) in ED patients (n = 73) at admission to hospital and at 12‐month follow‐up, using change in BMI and ED behaviors as between patient variables. Key Results Functional gastrointestinal disorders prevalence was 97% at admission and 77% at follow‐up. The only individual FGIDs to decrease over time were functional heartburn (admission 53%, follow‐up 23%) and functional dysphagia (21%, 7%). There was significant patient variation in the disappearance, persistence, and appearance of both individual FGIDs and FGID regional categories. Twenty‐five (34%) of patients acquired at least one new FGID regional category at follow‐up. There was no relationship between changes in BMI, self‐induced vomiting, laxative use, binge eating, anxiety, depression, somatization, and the turnover of individual or regional FGIDs. Conclusions & Inferences Functional gastrointestinal disorders remain common after 12 months in patients with an ED. Considerable turnover of the FGIDs occurs, however, and the appearance of new FGIDs is not restricted to the original FGID regional category. There is no apparent relationship between the turnover of the FGIDs and ED behaviors, psychological variables or body weight change. These findings have implications for the clinical evaluation and management of FGIDs in ED patients.     

Prevalence of gastrointestinal disorders in adult clients with pervasive developmental disorders

Background In clients with pervasive developmental disorders (PDD), some authors have noticed the presence of gastrointestinal disorders and behavioural disorders. An augmented prevalence of different histological anomalies has also been reported. The aim of our study is to highlight the prevalence of gastrointestinal disorders in this adult with PDD sample and to demonstrate the importance of accurate evaluation of gastrointestinal disorders in clients with PDD. Methods The present comparative study involved 118 clients. Our research was motivated by the clinical observation that behavioural disorders sometimes disappeared with administration of anti‐gastric acid or anti‐ulcerous medications. It focused on two samples of clients with intellectual disability – those with associated PDD and those without. The presence of gastrointestinal disorders was assessed retrospectively on the basis of hospital records. Results The prevalence of gastrointestinal disorders reported in clinical files was 48.8% in clients with PDD, as compared with 8.0% in non‐PDD clients (P < 0.00001). Conclusion Gastrointestinal disorders, and especially gastro‐oesophageal reflux, if neglected, may contribute to behavioural disorders in PDD clients. Moreover, gastrointestinal disorders may be considered as a feature of PDD. We highlight the fact that somatic disorders may coexist in persons with PDD.     

Acute and transient psychotic disorders versus persistent delusional disorders: a comparative longitudinal study

Aim: The aim of this work is to investigate differences between two non‐schizophrenic, non‐organic psychotic disorders, namely persistent delusional disorders (PDD) and acute and transient psychotic disorders (ATPD) according to ICD‐10. Method: In a prospective and longitudinal study, we compared all 43 inpatients with PDD who were treated at Halle‐Wittenberg University Hospital during a 14‐year period to a previously investigated cohort of 41 patients with ATPD in regard to demography, long‐term symptomatic outcome, and social consequences. Sociobiographical data were collected using a semi‐structured interview. Follow‐up investigations were performed at a mean of 10–12 years after the onset of the disorder using standardized instruments. Results: With the exception of the duration of the psychotic symptoms, the PDD patients were significantly different from the ATPD patients on various levels, such as sex ratio (female predominance only in ATPD), age at onset (older in PDD), the number of preceding stressful life‐events in the index hospitalization (more frequent in ATPD), richness and variety of symptoms (higher in ATPD), and persistence of positive psychotic symptoms (in PDD). Patients with PDD had significantly less re‐hospitalizations during the course of their illness. Long‐term outcome was marked by chronicity of delusional symptoms and lower global functioning in PDD than in ATPD, while negative symptoms and loss of independence were infrequent in both conditions. Conclusions: PDD differs from ATPD not only in the duration of the psychotic symptoms, but also in a variety of significant variables. They appear to be two separate entities within a psychotic spectrum.     

酒依赖患者的情绪障碍和述情障碍

目的：探讨酒依赖患者的情绪障碍和述情障碍。方法：采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、多伦多述情障碍量表（TAS）以50例酒依赖患者和50例正常对照组进行比较研究。结果：酒依赖组与对照组在焦虑、抑郁情绪和述情障碍方面存在明显差异。结论：纠正情绪和述情障碍可能有利于戒酒成功。     

Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: results from the national epidemiologic survey on alcohol and related conditions

The objective of this study was to determine the prevalence and co-occurrence of DSM-IV personality disorders (PDs) among individuals with current DSM-IV mood and anxiety disorders in the US population and among individuals who sought treatment for such mood or anxiety disorders. Face-to-face interviews were conducted with 43,093 individuals, 18 years and older, in the National Institute on alcohol abuse and alcoholism's 2001-2002 National epidemiologic survey on alcohol and related conditions (NESARC). Odds ratios (ORs) were calculated to determine the prevalence and associations between current DSM-IV axis I and axis II disorders. Associations between mood, anxiety and PDs were all positive and statistically significant. Avoidant and dependent PDs were more strongly related to mood and anxiety disorders than other PDs. Associations between obsessive-compulsive PD and mood and anxiety disorders were significant, but much weaker. Paranoid and schizoid PDs were most strongly related to dysthymia, mania, panic disorder with agoraphobia, social phobia and generalized anxiety disorder, while histrionic and antisocial PDs were most strongly related to mania and panic disorder with agoraphobia. Results of this study highlight the need for further research on overlapping symptomatology, factors giving rise to the associations and the treatment implications of these disorders when comorbid.