社会技能训练对慢性精神分裂症疗效的对照研究

目的:探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效.方法:将100例慢性精神分裂症患者随机分为训练组(50例)和对照组(50例).对训练组按照Liberman RP编写的<社会独立生活技能>训练程式进行训练,共12周.用BPRS、SANS、SDSI和WCST进行评定.结果:(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组,差异有显著性(P<0.05).(2)接受12周社交技能训练后,训练组的SANS量表全部五个因子和总分低于对照组,均有显著差异(P<0.05).(3)训练组和对照组在WCST的5个指标,差异有显著性(P<0.05).(4)SDSI评定结果表明,训练后明显降低,差异有显著性(P<0.05).结论:社会技能训练能够改善慢性精神分裂症的阳性症状、阴性症状及认知功能.     

基于稀疏表示变量选择方法的影像遗传学数据分析

目的:采用影像遗传学研究方法探索精神分裂症的影像遗传学特征。方法:在传统稀疏回归模型的基础上，改进 了其在不同范数条件下进行变量选择的能力，形成一种基于稀疏表示变量选择算法，并将该算法应用于208 个受试者的 41 236个功能磁共振成像数据和722 177个单核苷酸多态性数据的综合分析。通过对两类数据施加不同的权重因子，并 使用不同的Lp （p=0、0.5、1）范数分别对模型进行求解，筛选出两类数据在不同条件下的显著特征。结果:基因DAOA和 HTR2A在3种范数下均被筛选出。此外，在影像学数据方面，发现中央前回、枕上回、顶下缘角回、角回、内侧和旁扣带脑 回、后扣带回脑区与精神分裂症相关，此发现与先前精神分裂症的临床医学研究结果一致。结论:基于稀疏表示变量选择 方法应用于影像遗传学数据分析是一个有效可行的途径，为今后精神分裂症的影像遗传学研究提供了一种新的研究 思路。     

精神分裂症病人大脑两半球功能整合的实验研究

目的：检查精神分裂症患者可能存在的大脑两半球功能整合缺陷。方法：对20名精神分裂症患者和20名正常对照者进行不同复杂度汉字“同-异”判断的半视野速示实验。结果：①“同”判断的正确反应时（895．4毫秒）显著长于“异”判断（767．0毫秒）（F=87．44，P〈0．001），“同”判断的正确反应百分数（62．70）也显著低于“异”判断（95．30）（F=74．32，P〈0．001），表明“同”判断明显难于“异”判断；②患者和正常者一样，“异”判断的正确反应时和正确反应百分数在左视野（右半球）呈现、右视野（左半球）呈现和两视野（两半球）同时呈现三种条件之问均未出现显著差异；③正常人的“同”判断在两视野（两半球）同时呈现条件的正确反应时（674．8～743．4毫秒）明显快于左视野（右半球）（795．4—820．5毫秒）（t=2．89～4．57，均P〈0．001）和右视野（左半球）（798．6—857．1毫秒）（t=2．99—4．51，均P〈0．001），而病人没有出现两视野（两半球）对“同”判断的这种优势效应；④两视野（两半球）同时呈现条件下正常人“同”判断的正确反应百分数（88．3～89．5）与“异”判断（94．5—95．4）没有显著差异，而病人“同”判断的正确反应百分数（69．4—74．1）仍明显低于“异”判断（94．4—96．5）（t=2．39—2．60，均P〈0．05）。结论：精神分裂症患者仅在相对较难的“同”判断任务加工中表现出大脑两半球的功能整合缺陷。     

精神分裂症病人及家属受歧视状况

目的：了解精神分裂症病人及其家属受歧视状况，探讨歧视对精神分裂症病人及其家属的影响。方法：应用自编问卷在北京地区对精神分裂症病人(N=225)、精神分裂症病人家属(N=230)、社区居民(N=257)和精神科医护人员(N=283)进行调查。结果：42％的病人报告他们受到了单位不公正对待，受到同事或同学歧视，被邻居看不起，并导致恋爱或婚姻失败。56%的家属报告为避免歧视把病人患精神病的事对外保密。全部4组受试中85％以上的人相信歧视会降低病人的自信心，75％以上的人相信歧视给家属造成很大的心理压力，70％以上的人相信歧视严重影响病人的生活，60％以上的人相信歧视使病人的家庭成员减少了他们应有的社交活动。与其他三组人群比较，精神科医护人员更同意精神病人及其家属受歧视是常见的现象，更相信歧视会给他们的生活带来严重影响。与病人和家属比较，对歧视现象的存在社区居民的认同较低，但他们同样认为歧视对病人和家属有消极影响。结论：精神分裂症病人遭遇到的歧视突出地表现在与个人基本社会生活密切有关的工作、婚姻和人际交往三个方面。社会歧视对病人及其家属的心理和社会生活产生了严重影响。     

Allele sharing for schizophrenia and schizo‐affective disorder within a region of Homo sapiens specific XY homology

A case (based upon an association with cerebral asymmetry) has been presented for a gene for psychosis within the Xq21.3/Yp region of homology that is specific to Homo sapiens. We tested this hypothesis using the pentanucleotide marker DXYS 156 that is located within this region. In 84 families affected by schizophrenia or schizo‐affective disorder no tendency toward increased allele sharing amongst siblings was observed (χ² = 0.002). We conclude either that this region does not include a gene predisposing to psychosis or that if it does, the relevant variation is epigenetic rather than sequence‐based. With respect to the latter possibility we draw attention to the recent evolutionary history of the Xq21.3/Yp region. Genes within the region are in transition to protection from X inactivation and therefore may be epigenetically labile. © 2002 Wiley‐Liss, Inc.     

Turning point in the design of linkage studies of schizophrenia

Despite extensive genomic scans, linkage studies of multiplex pedigrees have been unable to produce replicable evidence of genes predisposing to schizophrenia. This indicates that it is unlikely that a single gene accounts for a majority of cases of schizophrenia, even in multiplex pedigrees. It is most likely that schizophrenia is caused by the nonlinear interaction of multiple genetic and environmental factors influencing brain development and function. This conclusion has strong implications for the design of linkage and association studies. Recently designed linkage studies involve several improvements to deal with extensive locus heterogeneity and multiplicative interaction. These improvements include much larger samples of pedigrees, systematic ascertainment and sequential extension rules, and standardized procedures at multiple sites to facilitate collaboration and replication. Future improvements are likely to require advances in the assessment of clinical and neurobiological variability in multiplex pedigrees, more systematic environmental assessment, and advances in analytic methods to deal with multiplicative interaction. Rather than focusing only on schizophrenia as one or more discrete disorders, future linkage efforts should also consider the etiology of individual clinical syndromes or dimensional components of risk that interact to cause the complex pattern of syndromal comorbidity observed within schizophrenics and their families. © 1994 Wiley-Liss, Inc.     

A Negative Symptom Rating Scale

Renewed interest in the role of negative symptoms in "defect state" schizophrenia calls for the design of a standardized, easy to use, reliable, and valid instrument to assess these aspects of psychopathology. In order to measure negative symptoms, we developed the Negative Symptom Rating Scale (NSRS). We report on the design, interrater reliability, and construct-validation of NSRS against the most frequently used negative symptom scales or subscales. In summary, the NSRS is a short, sensitive, highly specific, reliable, and apparently valid instrument for measuring negative symptoms in schizophrenia.     

Tardive dyskinesia in schizophrenics. Prevalence, distribution and relationship to neurological "soft" signs in Nigerian patients

The prevalence of tardive dyskinesia (TD) in 70 Nigerian schizophrenics was 37%. Age was related to the presence of TD in males but not in females. Significantly more females had TD in the lower extremities. Comparison of patients with TD and those without revealed no significant differences with regard to the presence of neurological "soft" signs.     

The effect of neuroleptic treatment and of high dosage diazepam therapy onβ-endorphin immunoreactivity in plasma of schizophrenic patients

Summary Synapsin I (Protein I), a neuron-specific phosphoprotein enriched in presynaptic nerve terminals, has been used as a quantitative marker for the density of nerve terminals in five brain regions (caudate nucleus, cingulate gyrus, hippocampus, mesencephalon and putamen) from patients who had suffered from Alzheimer disease/senile dementia of Alzheimer type (AD/ SDAT), from patients with multi-infarct dementia (MID), and from agematched controls. Samples were obtained at autopsy. Lower levels of Synapsin I were observed in the hippocampus of patients with AD/SDAT but not with MID. There were no significant differences in Synapsin I levels between patients and controls in any of the other four brain regions examined.     

品管圈对精神分裂症患者约束率及护理满意度的影响

目的总结和分析精神分裂症患者的护理中采用品管圈活动的临床效果。方法以本院于2017年8月—2019年6月收治的122例精神分裂症患者为研究对象,随机分为品管圈组和常规护理组,各61例。其中常规护理组患者选择传统的常规护理方法,而品管圈组患者则采取品管圈活动。比较两组患者的护理效果,对比指标主要有患者的约束率和护理满意度。结果品管圈组患者各项评价指标均优于常规护理组,差异具有统计学意义(P<0.05)。结论精神分裂症患者采用品管圈活动的总体临床效果较好,可提高患者的约束率,总体满意度高。