Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cogni...Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.展开更多
Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-...Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.展开更多
目的:分析首发未治疗精神分裂症住院患者并发高尿酸血症的相关因素。方法:纳入2021年1月至2022年12月在首都医科大学附属北京安定医院住院的首发未治疗的精神分裂患者,根据尿酸结果分为无高尿酸血症组(n=127)和有高尿酸血症组(n=73),对...目的:分析首发未治疗精神分裂症住院患者并发高尿酸血症的相关因素。方法:纳入2021年1月至2022年12月在首都医科大学附属北京安定医院住院的首发未治疗的精神分裂患者,根据尿酸结果分为无高尿酸血症组(n=127)和有高尿酸血症组(n=73),对两组患者的一般人口学资料及相关指标进行比较,采用二项Logistic回归分析首发未治疗精神分裂症住院患者并发高尿酸血症的相关因素。结果:与无高尿酸血症患者组相比较,有高尿酸血症患者组的年龄及发病年龄小、精神疾病家族史阳性者比例高、吸烟者比例高、白蛋白低、三酰甘油高、高密度脂蛋白低、体质量指数(body mass index,BMI)高、有高血压及高血脂的比例高(P均<0.05)。分析结果显示,BMI高、阳性症状评分高均是首发未治疗精神分裂症住院患者患高尿酸血症的危险因素(OR均>1.00,P均<0.05);年龄小、不吸烟、未患有高血压及高血脂均是首发未治疗精神分裂症住院患者患高尿酸血症的保护因素(OR均<1.00,P均<0.05)。结论:首发未治疗精神分裂症患者的尿酸水平与精神症状相关,阳性症状、BMI指数、年龄、吸烟、高血压、高血脂是其患高尿酸血症的独立危险因素。展开更多
目的:探讨精神分裂症病人出院1年预后风险列线图模型的构建及验证。方法:回顾性分析2020年1月—2021年6月医院收治的150例精神分裂症病人,使用功能大体评定量表(Global Assessment of Function,GAF)调查其出院1年后预后情况,将其分为发...目的:探讨精神分裂症病人出院1年预后风险列线图模型的构建及验证。方法:回顾性分析2020年1月—2021年6月医院收治的150例精神分裂症病人,使用功能大体评定量表(Global Assessment of Function,GAF)调查其出院1年后预后情况,将其分为发生组(GAF≤60分)及未发生组(GAF>60分),收集其精神分裂治疗前后相关数据,对其进行危险因素分析及风险列线图模型构建,另收取2021年6月—2022年1月医院收治70例精神分裂症病人,将其设为验证组,收集其治疗前后相关数据,对风险列线图模型进行验证。结果:多因素分析显示,两组病人中有精神疾病家族史、PANSS量表以阴性症状为主、精神病未治期较长、慢性起病及首次治疗效果较差为精神分裂症病人出院1年后预后良好的独立危险因素,以此建立风险列线图模型,Logit(p)=1.558×家族史+2.140×PANSS量表+0.626×精神病未治期+1.362×起病情况+2.017×首次治疗效果-11.936。其受试者工作特征(ROC)曲线下面积为0.956,95%CI(0.928,0.985),灵敏度为89.1%,特异度为91.9%,Youden指数为0.810,P<0.001,Hosemer-Lemeshow检验显示χ2=6.874,P=0.550。结论:本研究构建的风险列线图模型可对精神分裂症病人出院1年后预后不良的高风险病人进行早期识别,可为临床上精神分裂症病人个性化治疗护理方案的制定与修改提供参考意见,具一定的早期预警价值。展开更多
Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode ...Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode schizophrenia(adult group)and forty cases of juvenile patients with the firstepisode schizophrenia(juvenile group)treated in our hospital from March 2013 to March 2015 were selected for oral administration of risperidone.The clinical efficacy,adverse effect,brief psychiatric rating scale(BPRS)score before and after the therapy,brain-derived neurotrophic factor(BDNF)and blood lipid level were compared between the two groups after eight weeks’treatment with risperidone,and meanwhile,the multivariable linear regression analysis was performed to the related factors possibly influencing the efficacy of risperidone.Results The difference of total effective rate between the adult group(86%)and the juvenile group(82.5%)was not significant(P>0.05).The total score of BPRS,TC,TG,and LDL-C levels in the two groups after the treatment were significantly decreased compared with that before the treatment,while BDNF was significantly increased.The difference of inter-group comparison was significant before and after the treatment(P>0.05).However,the comparison difference between two groups was not significant before and after the treatment(P>0.05).The multivariable linear regression equation was used to analyze the longer duration of untreated psychosis(DUP),BPRS total score before treatment and BDNF levels that influence the efficacy of risperidone on patients with schizophrenia.Conclusion the treatment efficacy of risperidone on adult patients and juvenile patients with first-episode schizophrenia was similar and it was safe and effective.The DUP,BPRS total score before treatment and BDNF levels were associated with the efficacy of risperidone.展开更多
Background Schizophrenia is considered to be a disorder of dysconnectivity characterized by abnormal functional integration between distinct brain regions.Different brain connection abnormalities were found to be corr...Background Schizophrenia is considered to be a disorder of dysconnectivity characterized by abnormal functional integration between distinct brain regions.Different brain connection abnormalities were found to be correlated with various clinical manifestations,but whether a common deficit in functional connectivity(FC)in relation to both clinical symptoms and cognitive impairments could present in first-episode patients who have never received any medication remains elusive.Objective To find a core deficit in the brain connectome that is related to both psychopathological and cognitive manifestations.Methods A total of 75 patients with first-episode schizophrenia and 51 healthy control participants underwent scanning of the brain and clinical ratings of behaviors.A principal component analysis was performed on the clinical ratings of symptom and cognition.Partial correlation analyses were conducted between the main psychopathological components and resting-state FC that were found abnormal in schizophrenia patients.Results Using the principal component analysis,the first principal component(PC1)explained 37%of the total variance of seven clinical features.The ratings of GAF and BACS contributed negatively to PC1,while those of PANSS,HAMD,and HAMA contributed positively.The FCs positively correlated with PC1 mainly included connections related to the insula,precuneus gyrus,and some frontal brain regions.FCs negatively correlated with PC1 mainly included connections between the left middle cingulate cortex and superior and middle occipital regions.Conclusion In conclusion,we found a linked pattern of FC associated with both psychopathological and cognitive manifestations in drug-na¨ıve first-episode schizophrenia characterized as the dysconnection related to the frontal and visual cortex,which may represent a core deficit of brain FC in patients with schizophrenia.展开更多
目的了解精神分裂症患者首次正式开始治疗前的疾病未治疗期间(duration of untreated illness,DUI)和精神病未治疗期间(duration of untreated psychosis,DUP)及其影响因素。方法应用诺丁汉起病症状量表(Nottingham onset schedule,NOS...目的了解精神分裂症患者首次正式开始治疗前的疾病未治疗期间(duration of untreated illness,DUI)和精神病未治疗期间(duration of untreated psychosis,DUP)及其影响因素。方法应用诺丁汉起病症状量表(Nottingham onset schedule,NOS)调查上海市精神卫生中心的精神分裂症患者,共收集117例。同时,应用自编问卷对患者家属进行访谈,调查可能影响患者及时就诊的因素。结果①精神分裂症患者DUI中位数是181天,DUP中位数是84天。②首发非特异性精神症状以失眠和情绪障碍最为常见,出现频度超过50%;首发精神病性症状以幻听和被害妄想最为常见,出现频度达到47%。③影响患者就诊的主要因素是家属不认识精神病和患者不愿接受诊治。④以DUI中位数181天将患者区分为长DUI组和短DUI组,发现:长DUI组中回答家庭成员意见不一致是延误就诊因素的比例显著高于短DUI组(χ2=3.9,P<0.05)。结论精神分裂症患者从发病到开始治疗的疾病未治疗期间较长。影响DUI和DUP的因素是多方面的,值得进一步深入研究。展开更多
目的:从护理观察的角度,探讨精神病未治疗期(duration of untreated psychosis,DUP)对精神分裂症男性病人疾病状况的影响。方法:收集88例慢性精神分裂症男性病人,按DUP中位数分为长DUP组、短DUP组,两组各44例。采用阳性和阴性症状量表(P...目的:从护理观察的角度,探讨精神病未治疗期(duration of untreated psychosis,DUP)对精神分裂症男性病人疾病状况的影响。方法:收集88例慢性精神分裂症男性病人,按DUP中位数分为长DUP组、短DUP组,两组各44例。采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、护士用住院病人观察量表(Nurses Observation Scale for Inpatient Evaluation,NOSIE)评价病人精神及日常状况。结果:本研究纳入病人DUP中位数为14个月;短DUP组PANSS阴性症状分量表评分[(16.6±4.4)分]低于长DUP组[(19.3±5.3)分],NOSIE社会能力因子、总积极因子评分及NOSIE总分高于长DUP组,激惹因子、迟缓因子、抑郁因子、总消极因素低于长DUP组,差异均有统计学意义(均P<0.05);DUP与PANSS阴性症状、NOSIE激惹因子、精神病因子、总消极因素呈正相关,与社会能力因子评分及NOSIE总分呈负相关(P<0.05)。结论:DUP对精神分裂症病人的疾病状况影响显著;由护理团队主导的精神卫生健康宣教工作可能有利于缩短DUP,促进病人康复。展开更多
目的:调查2007年1月1日至2008年12月31日浦东新区精神卫生中心门诊首次就诊精神分裂症患者(FES)的疾病未治疗时间(DUP,duration of untreated psychosis),分析其可能存在的社会心理影响因素。方法:采用自编的调查量表,将数据输入SPSS 11...目的:调查2007年1月1日至2008年12月31日浦东新区精神卫生中心门诊首次就诊精神分裂症患者(FES)的疾病未治疗时间(DUP,duration of untreated psychosis),分析其可能存在的社会心理影响因素。方法:采用自编的调查量表,将数据输入SPSS 11.0,采用参数及非参数统计方法进行分析。结果:共计43例首次发作的精神分裂症患者加入本试验,DUP平均(24.00±337.21)周,男(76.00±164.21)周,女(237.38±391.77)周。Pearson相关分析发现,DUP与就诊年龄呈显著统计学意义的正相关(r=0.404,P=0.007);同胞陪诊的患者DUP明显比直系亲属陪同的要长,差异有显著统计学意义(I-J=404.07,P=0.006)。将疾病未治疗时间(DUP)(周)按中位数24周为界分为长和短DUP两组(≤24周为短DUP组,>24周为长DUP组),长DUP组中女性比例明显增高,BPRS评分较低,差异有统计学意义(x2=4.532,P=0.033;t=2.537,P=0.015);风险因素分析显示,只有性别与DUP>24的相关性具有统计学意义(r=1.613,P=.037)。结论:女性、就诊时年龄偏大、同胞陪诊、精神症状不突出的精神分裂症患者的疾病未治疗时间(DUP)更长,即更难得到及时诊断和治疗。展开更多
文摘Background Compromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population. Aim To provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES. Methods An independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size. Results 56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as 'high quality' according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=-1.60,95% Cl -1.82 to -1.38,厂=67%) and all seven cognitive domains, with the SMD ranging from -0.87 to -1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=-1.90), Trail Making Test (TMT)(SMD=-1.36), Continuous Performance Test-Identical Pairs (SMD=-1.33), Hopkins Verbal Learning Test (SMD=-1.24), Brief Visuospatial Memory Test (SMD=-1.18), Mazes (SMD=-1.16), Category Fluency (SMD=-1.01), Spatial Span (SMD=-0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=-0.38). Conclusions Our meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.
基金supported by researchgrants from the National Natural Science foundationof China (81471365, 81601169) Major Brain Program of Beijing Science and Technology Plan (Z161100002616017)Beijing Municipal Administration of Hospitals ClinicalMedicine Development of Special Funding Support(ZYLX201807).
文摘Objective:Published studies have found prepulse inhibition(PPI)in schizophrenia is impaired,suggesting PPI may be a biomarker of schizophrenia.We aim to examine whether PPI deficits exist in antipsychotic-na-ve,first-episode schizophrenia,and evaluate the effect size of PPI deficits between patients and healthy controls.Methods:The effect size of PPI deficits was evaluated for PPI%by calculating standard mean differences(SMDs)between patients with antipsychotic-na-ve,first-episode schizophrenia and healthy controls.Results:Twelve studies met the inclusion criteria,consisting390antipsychotic-na-ve,first-episode schizophrenia and406healthy controls.The effect sizes of76dB PPI in60ms and120ms interstimulus interval(ISI)were-0.19and-0.41respectively,and the76dB PPI overall effect size was-0.30.The effect sizes of85/86dB PPI in30ms,60ms and120ms ISI were-0.25,-0.42and-0.59respectively,and the85/86dB PPI overall effect size was-0.46.One study were excluded due to heterogeneity in the85/86dB,120ms ISI group,the pooled effect size of the PPI differences between patient group and health control dropped to-0.42,and the overall effect size changed to-0.39.There were no statistical differences in startle magnitude(overall effect size=-0.18)and habituation%(overall effect size=-0.17)between patients and healthy controls.Conclusions:Antipsychotic-na-ve,first-episode schizophrenia patients exhibit robust and reliable deficits in PPI,85/86dB PPI deficit was more severe than76dB PPI,and85/86dB,60-ms ISI PPI was more likely to be a biomarker for schizophrenia,it suggested that the parameters of PPI are particularly significant to affect the effect size so that should be interpreted with cautions in the future studies.
文摘目的:分析首发未治疗精神分裂症住院患者并发高尿酸血症的相关因素。方法:纳入2021年1月至2022年12月在首都医科大学附属北京安定医院住院的首发未治疗的精神分裂患者,根据尿酸结果分为无高尿酸血症组(n=127)和有高尿酸血症组(n=73),对两组患者的一般人口学资料及相关指标进行比较,采用二项Logistic回归分析首发未治疗精神分裂症住院患者并发高尿酸血症的相关因素。结果:与无高尿酸血症患者组相比较,有高尿酸血症患者组的年龄及发病年龄小、精神疾病家族史阳性者比例高、吸烟者比例高、白蛋白低、三酰甘油高、高密度脂蛋白低、体质量指数(body mass index,BMI)高、有高血压及高血脂的比例高(P均<0.05)。分析结果显示,BMI高、阳性症状评分高均是首发未治疗精神分裂症住院患者患高尿酸血症的危险因素(OR均>1.00,P均<0.05);年龄小、不吸烟、未患有高血压及高血脂均是首发未治疗精神分裂症住院患者患高尿酸血症的保护因素(OR均<1.00,P均<0.05)。结论:首发未治疗精神分裂症患者的尿酸水平与精神症状相关,阳性症状、BMI指数、年龄、吸烟、高血压、高血脂是其患高尿酸血症的独立危险因素。
文摘目的:探讨精神分裂症病人出院1年预后风险列线图模型的构建及验证。方法:回顾性分析2020年1月—2021年6月医院收治的150例精神分裂症病人,使用功能大体评定量表(Global Assessment of Function,GAF)调查其出院1年后预后情况,将其分为发生组(GAF≤60分)及未发生组(GAF>60分),收集其精神分裂治疗前后相关数据,对其进行危险因素分析及风险列线图模型构建,另收取2021年6月—2022年1月医院收治70例精神分裂症病人,将其设为验证组,收集其治疗前后相关数据,对风险列线图模型进行验证。结果:多因素分析显示,两组病人中有精神疾病家族史、PANSS量表以阴性症状为主、精神病未治期较长、慢性起病及首次治疗效果较差为精神分裂症病人出院1年后预后良好的独立危险因素,以此建立风险列线图模型,Logit(p)=1.558×家族史+2.140×PANSS量表+0.626×精神病未治期+1.362×起病情况+2.017×首次治疗效果-11.936。其受试者工作特征(ROC)曲线下面积为0.956,95%CI(0.928,0.985),灵敏度为89.1%,特异度为91.9%,Youden指数为0.810,P<0.001,Hosemer-Lemeshow检验显示χ2=6.874,P=0.550。结论:本研究构建的风险列线图模型可对精神分裂症病人出院1年后预后不良的高风险病人进行早期识别,可为临床上精神分裂症病人个性化治疗护理方案的制定与修改提供参考意见,具一定的早期预警价值。
基金Public Health Research Program of Wuhan Municipal Health Burea(WG13A02)--A Analysis of the Death Distribution and Life Lost of Cerebrovascular Disease among Wuhan Urban and Rural Residents in 2013
文摘Objectives To explore the treatment effect of risperidone on patients with firstepisode schizophrenia at different ages and analyze its influencing factors.Methods fifty cases of adult patients with the first-episode schizophrenia(adult group)and forty cases of juvenile patients with the firstepisode schizophrenia(juvenile group)treated in our hospital from March 2013 to March 2015 were selected for oral administration of risperidone.The clinical efficacy,adverse effect,brief psychiatric rating scale(BPRS)score before and after the therapy,brain-derived neurotrophic factor(BDNF)and blood lipid level were compared between the two groups after eight weeks’treatment with risperidone,and meanwhile,the multivariable linear regression analysis was performed to the related factors possibly influencing the efficacy of risperidone.Results The difference of total effective rate between the adult group(86%)and the juvenile group(82.5%)was not significant(P>0.05).The total score of BPRS,TC,TG,and LDL-C levels in the two groups after the treatment were significantly decreased compared with that before the treatment,while BDNF was significantly increased.The difference of inter-group comparison was significant before and after the treatment(P>0.05).However,the comparison difference between two groups was not significant before and after the treatment(P>0.05).The multivariable linear regression equation was used to analyze the longer duration of untreated psychosis(DUP),BPRS total score before treatment and BDNF levels that influence the efficacy of risperidone on patients with schizophrenia.Conclusion the treatment efficacy of risperidone on adult patients and juvenile patients with first-episode schizophrenia was similar and it was safe and effective.The DUP,BPRS total score before treatment and BDNF levels were associated with the efficacy of risperidone.
基金This study was supported by the National Natural Science Foundation of China(Grant Nos.8212018014,82071908,81761128023,and 82101998)Sichuan Science and Technology Program(Grant Nos.2021JDTD0002 and 2020YJ0018)+4 种基金Post-Doctor Research Project,West China Hospital,Sichuan University(Grant No.2020HXBH005)the Fundamental Research Funds for the Central Universities(Grant No.2020SCU12053)Miaozi Project in Science and Technology Innovation Program of Sichuan Province(Grant No.2021028)1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(Project Nos.ZYYC08001 and ZYJC18020)Dr Lui acknowledges the support from Humboldt Foundation Friedrich Wilhelm Bessel Research Award and Chang Jiang Scholars(Program No.T2019069).
文摘Background Schizophrenia is considered to be a disorder of dysconnectivity characterized by abnormal functional integration between distinct brain regions.Different brain connection abnormalities were found to be correlated with various clinical manifestations,but whether a common deficit in functional connectivity(FC)in relation to both clinical symptoms and cognitive impairments could present in first-episode patients who have never received any medication remains elusive.Objective To find a core deficit in the brain connectome that is related to both psychopathological and cognitive manifestations.Methods A total of 75 patients with first-episode schizophrenia and 51 healthy control participants underwent scanning of the brain and clinical ratings of behaviors.A principal component analysis was performed on the clinical ratings of symptom and cognition.Partial correlation analyses were conducted between the main psychopathological components and resting-state FC that were found abnormal in schizophrenia patients.Results Using the principal component analysis,the first principal component(PC1)explained 37%of the total variance of seven clinical features.The ratings of GAF and BACS contributed negatively to PC1,while those of PANSS,HAMD,and HAMA contributed positively.The FCs positively correlated with PC1 mainly included connections related to the insula,precuneus gyrus,and some frontal brain regions.FCs negatively correlated with PC1 mainly included connections between the left middle cingulate cortex and superior and middle occipital regions.Conclusion In conclusion,we found a linked pattern of FC associated with both psychopathological and cognitive manifestations in drug-na¨ıve first-episode schizophrenia characterized as the dysconnection related to the frontal and visual cortex,which may represent a core deficit of brain FC in patients with schizophrenia.
文摘目的了解精神分裂症患者首次正式开始治疗前的疾病未治疗期间(duration of untreated illness,DUI)和精神病未治疗期间(duration of untreated psychosis,DUP)及其影响因素。方法应用诺丁汉起病症状量表(Nottingham onset schedule,NOS)调查上海市精神卫生中心的精神分裂症患者,共收集117例。同时,应用自编问卷对患者家属进行访谈,调查可能影响患者及时就诊的因素。结果①精神分裂症患者DUI中位数是181天,DUP中位数是84天。②首发非特异性精神症状以失眠和情绪障碍最为常见,出现频度超过50%;首发精神病性症状以幻听和被害妄想最为常见,出现频度达到47%。③影响患者就诊的主要因素是家属不认识精神病和患者不愿接受诊治。④以DUI中位数181天将患者区分为长DUI组和短DUI组,发现:长DUI组中回答家庭成员意见不一致是延误就诊因素的比例显著高于短DUI组(χ2=3.9,P<0.05)。结论精神分裂症患者从发病到开始治疗的疾病未治疗期间较长。影响DUI和DUP的因素是多方面的,值得进一步深入研究。
文摘目的:从护理观察的角度,探讨精神病未治疗期(duration of untreated psychosis,DUP)对精神分裂症男性病人疾病状况的影响。方法:收集88例慢性精神分裂症男性病人,按DUP中位数分为长DUP组、短DUP组,两组各44例。采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、护士用住院病人观察量表(Nurses Observation Scale for Inpatient Evaluation,NOSIE)评价病人精神及日常状况。结果:本研究纳入病人DUP中位数为14个月;短DUP组PANSS阴性症状分量表评分[(16.6±4.4)分]低于长DUP组[(19.3±5.3)分],NOSIE社会能力因子、总积极因子评分及NOSIE总分高于长DUP组,激惹因子、迟缓因子、抑郁因子、总消极因素低于长DUP组,差异均有统计学意义(均P<0.05);DUP与PANSS阴性症状、NOSIE激惹因子、精神病因子、总消极因素呈正相关,与社会能力因子评分及NOSIE总分呈负相关(P<0.05)。结论:DUP对精神分裂症病人的疾病状况影响显著;由护理团队主导的精神卫生健康宣教工作可能有利于缩短DUP,促进病人康复。
文摘目的:调查2007年1月1日至2008年12月31日浦东新区精神卫生中心门诊首次就诊精神分裂症患者(FES)的疾病未治疗时间(DUP,duration of untreated psychosis),分析其可能存在的社会心理影响因素。方法:采用自编的调查量表,将数据输入SPSS 11.0,采用参数及非参数统计方法进行分析。结果:共计43例首次发作的精神分裂症患者加入本试验,DUP平均(24.00±337.21)周,男(76.00±164.21)周,女(237.38±391.77)周。Pearson相关分析发现,DUP与就诊年龄呈显著统计学意义的正相关(r=0.404,P=0.007);同胞陪诊的患者DUP明显比直系亲属陪同的要长,差异有显著统计学意义(I-J=404.07,P=0.006)。将疾病未治疗时间(DUP)(周)按中位数24周为界分为长和短DUP两组(≤24周为短DUP组,>24周为长DUP组),长DUP组中女性比例明显增高,BPRS评分较低,差异有统计学意义(x2=4.532,P=0.033;t=2.537,P=0.015);风险因素分析显示,只有性别与DUP>24的相关性具有统计学意义(r=1.613,P=.037)。结论:女性、就诊时年龄偏大、同胞陪诊、精神症状不突出的精神分裂症患者的疾病未治疗时间(DUP)更长,即更难得到及时诊断和治疗。