OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. DATA SOURCES: O...OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. DATA SOURCES: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive tran- scranial magnetic stimulation", and "hallucination". STUDY SELECTION: Selected studies were randomized controlled trials assessing therapeutic ef- ficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES: The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repeti- tive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%C/: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%C/: 1.39 to 6.24, P =0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repeti- tive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching. CONCLUSION: Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders,展开更多
A new psychobiological model of volitive processes and its implications for the etiopathology of mental disorders is proposed. The model is based on five elementary volitive processes. These are the volition to act;th...A new psychobiological model of volitive processes and its implications for the etiopathology of mental disorders is proposed. The model is based on five elementary volitive processes. These are the volition to act;the volition to self-instrumentalize;the volition to program intentions, the volition to generate realities;and the volition to permanent existence. Imbalances in information processing in tripartite synapses and their network may be responsible for dysfunctions of self-instrumentalization. It is suggested that the volition to permanent existence unconsciously works in mental disorders, but the volition to intentional programming of realities and the volition to generate realities by communication with subjects and objects in their environment are impaired. In depression, the volition to act is constrained by hyperintentional programs that are non-feasible in the environment. In mania volitive processes are totally oriented on events in the environment without any goal-directed pro-gramming. Dysfunctions of volitive processes in schizophrenia are fun-damentally caused by severe impairments of self-instrumentalization. As shown in tripartite synapses a gap between sensory information pro-cessing in the neuronal network and the inner glial networks causes the inability of schizophrenics to distinguish between the self and the other. In delusions, the destiny for communication becomes staged as pseu-do-communication. Together, the study outlines a new model of volitive processes and deduces dysfunctions responsible for communication pa-thology and abnormal reality experiences of patients with mental disor-ders.展开更多
OBJECTIVE: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders.METHODS: A 42-year-old German male outpatient,suffering from long-term schizophrenia a...OBJECTIVE: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders.METHODS: A 42-year-old German male outpatient,suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a non-pharmacological intervention. In addition to his ongoing Western Medicine(pharmacological) treatment, the patient received 12 weekly(non-standardized) acupuncture treatments in the clinic. The Traditional Chinese Medicine(TCM) diagnosis, the psychological assessment and the actiwatch data were compared before and after the acupuncture treatment.RESULTS: The TCM diagnosis revealed a Liver Fire pattern before the acupuncture treatment, which was still present, although to a lesser degree, after the treatment. The psychological assessment revealed no change in the positive symptoms, but a small decrease in the negative symptoms and the general psychopathology of the patient. This was further illustrated by the small decrease in the number of depressive symptoms. The subjective sleep disorders improved markedly after acupuncture treatment, but the daytime sleepiness did not. The actiwatch results showed that after acupuncture treatment, the patient was moving less during sleep, but no significant results were found for the other sleep parameters.CONCLUSION: Acupuncture was found to be an effective non-pharmacological add-on method for treating subjective sleep disorders, and, to a lesser degree, objective sleep disorders and the negative symptoms of chronic schizophrenia. Future larger clinical trials with follow-up measurements are needed in order to replicate the present preliminary beneficial acupuncture findings and in order to determine whether the observed effects can be sustained.展开更多
基金financially sponsored by the Special Funding of Henan Health Science and Technology Innovation Talent Project,No.4173(2010-2015)Xinxiang Medical University of High-Level Personnel of Scientific Research Projects,No.08BSKYQD-004the Key Projects of Science and Technology Research of Department of Education in Henan,No.13A320869
文摘OBJECTIVE: This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. DATA SOURCES: Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive tran- scranial magnetic stimulation", and "hallucination". STUDY SELECTION: Selected studies were randomized controlled trials assessing therapeutic ef- ficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES: The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS: Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repeti- tive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%C/: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%C/: 1.39 to 6.24, P =0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repeti- tive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching. CONCLUSION: Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders,
文摘A new psychobiological model of volitive processes and its implications for the etiopathology of mental disorders is proposed. The model is based on five elementary volitive processes. These are the volition to act;the volition to self-instrumentalize;the volition to program intentions, the volition to generate realities;and the volition to permanent existence. Imbalances in information processing in tripartite synapses and their network may be responsible for dysfunctions of self-instrumentalization. It is suggested that the volition to permanent existence unconsciously works in mental disorders, but the volition to intentional programming of realities and the volition to generate realities by communication with subjects and objects in their environment are impaired. In depression, the volition to act is constrained by hyperintentional programs that are non-feasible in the environment. In mania volitive processes are totally oriented on events in the environment without any goal-directed pro-gramming. Dysfunctions of volitive processes in schizophrenia are fun-damentally caused by severe impairments of self-instrumentalization. As shown in tripartite synapses a gap between sensory information pro-cessing in the neuronal network and the inner glial networks causes the inability of schizophrenics to distinguish between the self and the other. In delusions, the destiny for communication becomes staged as pseu-do-communication. Together, the study outlines a new model of volitive processes and deduces dysfunctions responsible for communication pa-thology and abnormal reality experiences of patients with mental disor-ders.
文摘OBJECTIVE: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders.METHODS: A 42-year-old German male outpatient,suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a non-pharmacological intervention. In addition to his ongoing Western Medicine(pharmacological) treatment, the patient received 12 weekly(non-standardized) acupuncture treatments in the clinic. The Traditional Chinese Medicine(TCM) diagnosis, the psychological assessment and the actiwatch data were compared before and after the acupuncture treatment.RESULTS: The TCM diagnosis revealed a Liver Fire pattern before the acupuncture treatment, which was still present, although to a lesser degree, after the treatment. The psychological assessment revealed no change in the positive symptoms, but a small decrease in the negative symptoms and the general psychopathology of the patient. This was further illustrated by the small decrease in the number of depressive symptoms. The subjective sleep disorders improved markedly after acupuncture treatment, but the daytime sleepiness did not. The actiwatch results showed that after acupuncture treatment, the patient was moving less during sleep, but no significant results were found for the other sleep parameters.CONCLUSION: Acupuncture was found to be an effective non-pharmacological add-on method for treating subjective sleep disorders, and, to a lesser degree, objective sleep disorders and the negative symptoms of chronic schizophrenia. Future larger clinical trials with follow-up measurements are needed in order to replicate the present preliminary beneficial acupuncture findings and in order to determine whether the observed effects can be sustained.