首发偏执型精神分裂症血清NO/NOS水平的研究

目的探讨首发偏执型精神分裂症血清一氧化氮/一氧化氮合成酶（NO/NOS）水平及与精神症状的关系。方法共收集首发偏执型精神分裂症患者26例（研究组）,健康对照者30例（对照组）,采用阳性与阴性症状量表（PANSS）评定患者的精神症状,同时检测血清NO/NOS水平。结果首发偏执型精神分裂症血清NO/NOS水平均显著高于健康对照组（t=2.08,P〈0.05;t=2.72,P〈0.05）,血清NO/NOS水平与精神症状无显著相关性（P〉0.05）;血清NO水平与血清NOS水平两者存在显著正相关（r=0.41,P〈0.05）。结论首发偏执型精神分裂症患者存在血清NO/NOS水平病理性增高。     

偏执型和非偏执型精神分裂症的神经心理学差异

在所有与精神分裂症相关的神经心理学研究中都显示各亚型之间的认知功能如注意缺损存在差异。这使研究者认为,精神分裂症的每一亚型都存在独特的神经心理学损害模式。事实上,偏执型病人的精神功能比非偏执型病人较少衰退,这已被临床广泛接受。Ｓｅｉｄｍａｎ等复习了有关精神分裂症神经生理学和神经心理学的研究发现,提出了精神分裂症各亚型之间认知功能的一些有意义的差异,但至今尚未弄清偏执型和非偏执型之间神经心理学的真正差异。对各亚型认知功能特征的识别,有助于提炼出精神分裂症多种病因途径的理论。例如精神分裂症的大量异源性症状…     

偏执型与非偏执型首发精神分裂症患者认知功能及精神症状的比较

目的　探讨偏执型与非偏执型精神分裂症患者认知功能及精神症状的特征。方法　以美国精神障碍诊断与统计手册第 4版诊断标准 ,将 1 64例首发精神分裂症患者分为偏执型组 (1 1 9例 )及非偏执型组 (45例 ) ;分别进行韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、利手测验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验及自编言语流利性测验 1 0项神经心理测查 ,并评定简明精神病评定量表 (BPRS)、修订的阴性症状评定量表 (SANS)、临床总体印象量表、功能总体评定量表 (GAF)。结果　 (1 )认知功能 :偏执型组与非偏执型组各项认知功能的差异均无显著性 (均P >0 0 5)。 (2 )临床症状 :偏执型组与非偏执型组BPRS中的迟滞因子 [分别为 (5 2±1 3)分和 (7 0± 2 7)分 ]、思维障碍 [分别为 (1 3 9± 2 6)分和 (1 2 5± 3 0 )分 ]、SANS总分及各项因子分、GAF评分 [分别为 (37 1± 7 2 )分和 (32 7± 8 1 )分 ]的差异均有非常显著性 (均P <0 0 1 )。结论精神分裂症不同亚型的认知损害不具特征性 ,不能依此作为诊断依据     

偏执型精神分裂症患者Stroop操作的功能磁共振研究

目的利用功能磁共振显像(fMRI)技术探讨精神分裂症患者注意障碍的脑功能基础。方法对14例精神分裂症患者(患者组)和16名正常人(对照组)检测Stroop测验刺激下的fMRI。结果(1)激活脑区计数(个)：Stroopl刺激下,患者组左侧额下回(11/3)、左侧颞上回(6/8)、左侧颞下回(6/8)脑区激活计数均多于对照组(分别为6/10、1/15、1/15),差异有统计学意义(P＜0.05)；Stroop2刺激下,患者组左侧前扣带皮质(ACC,4/10)、右侧额中回脑区激活计数(4/10)均少于对照组(分别为12/4、14/2),差异有统计学意义(P＜0.05),患者组左额上回激活计数(9/5)多于对照组(3/ 13),差异有统计学意义(P＜0.05)。(2)激活脑区体积(体素)：Stroop1刺激下,患者组右侧前额叶背外侧区(DLPFC,256±579)、左侧ACC(18±59)激活体积小于对照组(分别为298±597、67±87),差异有统计学意义(P＜0.05)；Stroop2刺激下,患者组两侧DLPFC(分别为73±190、80±245)、左侧ACC(17±28)激活体积小于对照组(分别为425±800、414±703、76±98),差异有统计学意义(P＜0.05)。结论精神分裂症患者的注意障碍可能与前额叶、ACC、颞叶神经回路功能障碍密切相关。     

精神分裂症患者的生活质量——缓解期偏执型精神分裂症患者生活质量调查

目的：调查缓解期偏执型精神分裂症患者的生活质量。方法：采用生活质量综合评定问卷（CQOLI-74）、简明精神病评定量表（BPRS）和治疗中出现的症状量表（TESS）了解患者的生活质量、精神状态、药物不良反应对生活质量的影响。结果：患者组的生活质量总分、躯体功能、心理功能、社会功能明显低于对照组，并涉及到心身健康的多个方面。BPRS分与生活质量呈负相关。结论：缓解期偏执型精神分裂症患者的生活质量明显低于正常人群。     

偏执型精神分裂症30年随访

对本院1958年初次住院的115例偏执型精神分裂症，进行30年后随访研究，采用GAF量表及症状清单评定。结果表明：1、社会功能保持较好，妄想及幻觉仍为其主要临床表现，其中关系、被害妄想出现频率居首。2、妄想伴有幻觉由27.9%上升到51.6%。3、多因素分析发现影响预后的主要因素为：治疗干预、躯体疾病、家庭、社会支持、经济婚姻状况。4、女性较男性社会功能好（P＜0.05)。5、预后与病前性格、近期疗效、维持用药及起病诱因相关。     

不同性别偏执型精神分裂症患者凶杀行为特征的比较

有研究表明凶杀行为精神病的病种依次为精神分裂症、精神发育迟滞、器质性精神障碍、情感性精神障碍,同时还显示男性患者占87·9%[1]。另据翟金国等[2]的研究,偏执型精神分裂症更可能发生攻击行为。故本研究对不同性别的偏执型精神分裂症患者的暴力行为进行调查如下。1资料与方     

Cross-cultural study of a biochemical abnormality in paranoid schizophrenia

We studied 24-hour urinary excretion of phenylethylamine (PEA) and creatinine in 50 schizophrenic (39 paranoid and 11 nonparanoid) and 19 nonpsychiatric patients from Bombay, India. Methods for diagnosis, clinical assessment, and 24-hour urine collection were identical to those used in an earlier study done in a Washington, D.C. hospital. Clinical evaluations were done in Bombay, while urinary PEA and creatinine estimations were performed at NIMH, Washington, without knowledge of the subjects' identity. Paranoid schizophrenic patients had significantly greater 24-hour urinary excretion of PEA than both nonparanoid schizophrenic patients and nonpsychiatric controls. The mean amount of PEA per g creatinine in urine was also highest for paranoid schizophrenic patients. Our findings provide cross-cultural support to the possibility of abnormal PEA metabolism in at least some patients with paranoid schizophrenia.     

氯硝西泮对偏执型精神分裂症的辅助治疗作用

目的 :评价利培酮配合氯硝西泮注射液治疗偏执型精神分裂症的疗效。　方法 :对病程 <3年的 80例首次住院 ,选用利培酮治疗的偏执型精神分裂症患者 ,随机分为合用氯硝西泮 (合用组 )和未合用氯硝西泮 (对照组 )各 4 0例 ,进行 8周治疗。采用阳性症状与阴性症状量表 (PANSS)评定疗效 ,副反应量表 (TESS)评定不良反应。　结果 :合用组治疗 2周后PANSS量表总分、阳性症状分、精神病理因子分及症状群中激活性、偏执、攻击性分值均显著下降 ;治疗 4周末时利培酮剂量合用组显著低于对照组。　结论 :利培酮配合氯硝西泮注射液治疗偏执型精神分裂症可缩短疗程 ,改善其阳性症状及攻击行为     

躁狂症患者血清一氧化氮水平研究

目的：了解躁狂症患者的血清一氧化氮(NO)水平。方法：对20例躁狂症患者的血清NO水平进行检测，采用Bech-Rafaelsen躁狂量表(BRMS)进行评定。以18例正常体检者为对照。结果：躁狂症组的血清NO水平明显高于正常对照组，血清NO水平与BRMS分之间未发现有相关性。结论：躁狂症患者存在相对较高的血清NO水平，可能是躁狂发作的病理生理基础。     

Dimensions of psychopathology in paranoid schizophrenia

Recently, there has been a great deal of interest in understanding the latent organisation of the phenomenology of schizophrenia through examination of the fit of dimensional models to observed symptoms date. A group of 66 DSM-IV paranoid schizophrenic in-patients were assessed three times using the SAPS, SANS, BPRS and PAS. The interrelations between individual symptoms of each scale were examined by means of principal component analysis. The results of factor analysis of the findings from SANS and SAPS confirm the three-factor model, composed of a negative, disorganisation and psychotic factor. Extending the range of symptomatology using BPRS resulted in a five-factor model, composed of the following factors: paranoid, negative, affective, cognitive and disorganised behaviour. In view of the findings based on Strauss’ work (1974) the PAS has been added to the SANS, SAPS and BPRS, whose results were examined by factor analysis. The findings indicate that it is possible to consider a six-factor model, composed of the following dimensions: paranoid, negative, affective, cognitive, disorganised behaviour and premorbid social adjustment deficits. The number of factors that best reflect the structure of the symptomatology of paranoid schizophrenia depends on the range of the symptoms under study, i.e., on the type of scales. It follows from our study that six-factor model appears to be the most suitable and clear model in rendering the multidimensionality of paranoid schizophrenia phenomenology. Received: 19 March 1998 / Accepted: 9 September 1999     

Effects of 4 weeks treatment with chlorpromazine and/or trihexyphenidyl on the pituitary-gonadal axis in male paranoid schizophrenics

Summary Serum prolactin (PRL), luteinizing hormone (LH) and testosterone (T) levels were estimated in a group of 30 male paranoid schizophrenics before and after 4 weeks treatment with chlorpromazine and/or trihexyphenidyl, and in a group of 14 healthy male individuals. After treatment with chlorpromazine (100 mg t.i.d., p. o.), 10 patients presented a significant increase in serum PRL values and a significant decrease in serum T values. A significant increase in serum PRL values was also found in 10 patients who were treated with chlorpromazine (100 mg t.i.d., p. o.) plus trihexyphenidyl (5 mg t.i.d., p. o.). No significant difference in any of the investigated endocrine parameters was detected in 10 patients after 4 weeks administration of trihexyphenidyl (5mg t.i.d., p.o.). Following chlorpromazine treatment with or without concomitant administration of trihexyphenidyl, 20 patients showed a significant increase in serum PRL levels and a significant decrease in serum LH and T levels.     

Differential impairment on measures of attention in patients with paranoid and nonparanoid schizophrenia

The purpose of the present study is to investigate whether patients with different subtypes of schizophrenia are differentially impaired on measures of attention. Forty-eight patients with schizophrenia (19 paranoid and 29 nonparanoid) and 48 healthy controls (matched on chronological age, sex, and years of education) were administered five measures of attention including the Stroop Color-Word Test (SCWT; Stroop, 1935), the Digit Vigilance Test (DVT; Lewis, 1992), the Symbol Digit Modalities Test (SDMT; Smith, 1982), the Backward Digit Span Test (BDST; Wechsler, 1987), and the Color Trails Test (CTT; D'Elia et al., 1996) to assess selective attention, sustained attention, switching attention, and attentional control processing by the latter two tests respectively. Results from the present study showed that patients with schizophrenia performed poorer on the SCWT, the DVT, and the SDMT, relative to their healthy counterparts. Furthermore, patients with different subtypes of schizophrenia also had different degrees of attentional impairment. While patients with paranoid schizophrenia performed worse on the SCWT, those with nonparanoid schizophrenia performed worse on the SDMT. Nevertheless, these findings may suggest that patients with paranoid and nonparanoid schizophrenia may have different profiles with respect to their performances on measures of attention.     

无痉挛电休克治疗对偏执型精神分裂症患者认知功能改善的临床比较研究

目的探讨无痉挛电休克治疗对偏执型精神分裂症患者认知功能康复的作用,从而选择最优方式改善患者的预后。方法随机抽取我院近2年接受无痉挛电休克治疗的偏执型精神分裂症45例为研究组,按照病程、病情、性别、年龄等与之匹配的服用奥氮平治疗的45例为对照组,治疗4周后比较两组威斯康星卡片分类测验和韦氏记忆测验的评分。结果研究组在WCST持续反应数和持续错误数评分较对照组显著降低（P〈0.05）;WCST总正确数、总错误数、完成分类数评分显著高于对照组（P〈0.05）。韦氏记忆测验的评分研究组低于对照组,前者优于后者（P〈0.05）。结论无痉挛电休克治疗在改善偏执型精神分裂症患者的部分认知功能方面优于药物治疗,但对记忆功能的影响不容忽略。     

A psychoendocrine study in male paranoid schizophrenics with delusional ideas of homosexual content

The serum prolactin (PRL), luteinizing hormone (LH), testosterone (T) and estradiol (E) levels were investigated in a group of male paranoid schizophrenics with delusional ideas of homosexual content, in a group of male paranoid schizophrenics without delusional ideas of homosexual content, and in a group of healthy, male heterosexual subjects. Only male paranoid schizophrenics with delusional ideas of homosexual content had significantly lower serum PRL values and significantly higher serum E levels than those of the age-matched group of normal, male heterosexual controls; also, these patients tended to have higher (though not to a statistically significant degree) serum LH and T levels than those of normal controls. Findings of this study are discussed within the framework of the possible involvement of endocrine factors in the occurrence of delusional ideas of homosexual content in male patients with paranoid schizophrenia.     

An objective study of relationships and discontinuities between paranoid schizophrenia and Kretschmer's syndrome of sensitive delusions of reference

The nosological status of Kretschmer's syndrome of sensitive delusions of reference (Sensitiver Beziehungswahn) has been a matter of discussion over many years. In an attempt to resolve the matter, a series of 147 consecutive patients who had been diagnosed as schizophrenic were reviewed. A group of 13 patients met specified criteria for Kretschmer's syndrome of sensitive delusions of reference, and these patients were compared with the remainder in a variety of ways. The patients with the syndrome of sensitive delusions of reference differed from the remainder in their antecedents (family history and premorbid personality), their EEG status, stresses at time of onset, and response to treatment. The evidence offered here points to the separateness of this syndrome from the other schizophrenic illnesses displayed by the patients reviewed.