目的:美洲和欧洲的精神分裂症患者的吸烟率是社区人群对照的3至4倍,与阴性症状和锥体外系综合征的减少及认知功能的改善有关。本研究的目的是在中国精神分裂症患者中观察这些因素的临床关联性。方法:采用尼古丁依赖自评量表(Fagerstrom ...目的:美洲和欧洲的精神分裂症患者的吸烟率是社区人群对照的3至4倍,与阴性症状和锥体外系综合征的减少及认知功能的改善有关。本研究的目的是在中国精神分裂症患者中观察这些因素的临床关联性。方法:采用尼古丁依赖自评量表(Fagerstrom Test for Nicotine Dependence,FTND)和重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS),我们对776例男性和560例男性社区对照进行了比较。患者也测评了阳性和阴性症状量表(Positive and Negative Symptom Scale,PANSS)、Simpson -Angus锥体外系副反应评定量表(Simpson and Angus Extrapyramidal Symptom Rating Scale,SAES)和不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)。结果:精神分裂症患者终生吸烟率较社区对照人群高(79%比63%),同时严重吸烟者与对照组之间有更明显的差异(61%比31%)。现在吸烟者的PANSS阴性症状和SAES帕金森综合征得分均低于非吸烟者。吸烟的精神分裂症患者在RBANS认知功能测试中表现最差,非吸烟精神分裂症患者较差,之后是吸烟者,非吸烟者对照表现最好。结论:中国精神分裂症患者的吸烟率高于社区对照人群,但精神分裂症患者和对照组之间尼古丁依赖率与美洲观察到的情况有很大的差异。吸烟与较低水平的阴性症状,较少的锥体外系综合征及较少的帕金森综合征相关联,提示自我治疗的存在。但是,吸烟在精神分裂症患者和对照组人群中都与显著的认知功能损害相关联。展开更多
Neuroinflammation has been proposed as a strong biological factor underlying the development of neuropsychiatric diseases.A role for dysregulation of the immune system was initially suggested in depressive disorders a...Neuroinflammation has been proposed as a strong biological factor underlying the development of neuropsychiatric diseases.A role for dysregulation of the immune system was initially suggested in depressive disorders and subsequently extended to other illnesses,including bipolar disorder(BD).Indeed,there is growing evidence confirming the presence of a generalized pro-inflammatory state in BD patients,involving alterations in cytokine,acute-phase proteins,and complement factor secretion,white blood cell differentiation,microglial activation,arachidonic acid signaling pathways,and increased oxidative stress markers.Medications commonly used to treat BD,such as lithium,antiepileptics and antipsychotics,show some immunoregulatory activity both in vitro and in vivo.The aim of our study was to review the role of different inflammatory mechanisms,specifically in the development of excitatory symptoms,via a systematic PubMed search of the literature.Despite the high variability of results among studies,we found evidence indicating specific alterations of the inflammatory response during manic and mixed states of BD.These findings may help to clarify some of the complex mechanisms underlying the development of excitatory symptoms and suggest a potential role for drugs targeting the inflammatory system as new therapeutic options.展开更多
基金Supported by grants from the Stanley Medical Research Institute (03T-459 and 05T-726)the Department of Veterans Affairs,VISN16,Mental Illness Research,Education and Clinical Center(MIRECC) and National Institute on Drug Abuse K05-DA0454 and P50 -DA18827
文摘目的:美洲和欧洲的精神分裂症患者的吸烟率是社区人群对照的3至4倍,与阴性症状和锥体外系综合征的减少及认知功能的改善有关。本研究的目的是在中国精神分裂症患者中观察这些因素的临床关联性。方法:采用尼古丁依赖自评量表(Fagerstrom Test for Nicotine Dependence,FTND)和重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS),我们对776例男性和560例男性社区对照进行了比较。患者也测评了阳性和阴性症状量表(Positive and Negative Symptom Scale,PANSS)、Simpson -Angus锥体外系副反应评定量表(Simpson and Angus Extrapyramidal Symptom Rating Scale,SAES)和不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)。结果:精神分裂症患者终生吸烟率较社区对照人群高(79%比63%),同时严重吸烟者与对照组之间有更明显的差异(61%比31%)。现在吸烟者的PANSS阴性症状和SAES帕金森综合征得分均低于非吸烟者。吸烟的精神分裂症患者在RBANS认知功能测试中表现最差,非吸烟精神分裂症患者较差,之后是吸烟者,非吸烟者对照表现最好。结论:中国精神分裂症患者的吸烟率高于社区对照人群,但精神分裂症患者和对照组之间尼古丁依赖率与美洲观察到的情况有很大的差异。吸烟与较低水平的阴性症状,较少的锥体外系综合征及较少的帕金森综合征相关联,提示自我治疗的存在。但是,吸烟在精神分裂症患者和对照组人群中都与显著的认知功能损害相关联。
基金the FIRB project code RBFR12LD0W_002a grant of the Italian Ministry of Research.
文摘Neuroinflammation has been proposed as a strong biological factor underlying the development of neuropsychiatric diseases.A role for dysregulation of the immune system was initially suggested in depressive disorders and subsequently extended to other illnesses,including bipolar disorder(BD).Indeed,there is growing evidence confirming the presence of a generalized pro-inflammatory state in BD patients,involving alterations in cytokine,acute-phase proteins,and complement factor secretion,white blood cell differentiation,microglial activation,arachidonic acid signaling pathways,and increased oxidative stress markers.Medications commonly used to treat BD,such as lithium,antiepileptics and antipsychotics,show some immunoregulatory activity both in vitro and in vivo.The aim of our study was to review the role of different inflammatory mechanisms,specifically in the development of excitatory symptoms,via a systematic PubMed search of the literature.Despite the high variability of results among studies,we found evidence indicating specific alterations of the inflammatory response during manic and mixed states of BD.These findings may help to clarify some of the complex mechanisms underlying the development of excitatory symptoms and suggest a potential role for drugs targeting the inflammatory system as new therapeutic options.
