目的·分析首发精神分裂症患者基于事件前瞻记忆(prospective memory,PM)与正常人的差异,探索其可能的心理机制。方法·共纳入34例未服药的首发精神分裂症患者(首发精神分裂症组)及31名健康志愿者(健康对照组)。应用基于事件前...目的·分析首发精神分裂症患者基于事件前瞻记忆(prospective memory,PM)与正常人的差异,探索其可能的心理机制。方法·共纳入34例未服药的首发精神分裂症患者(首发精神分裂症组)及31名健康志愿者(健康对照组)。应用基于事件前瞻记忆任务测评被试的PM,其中线索识别PM任务主要测评被试的线索识别能力,意向提取PM任务测评被试的意向提取能力。同时,应用字母数字广度任务测评被试的言语性工作记忆,应用理解记忆测验测评被试的回溯记忆,应用修订版六元素测验(modified six elements test,MSET)测评被试执行多重任务的能力。应用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、精神病症状维度评定量表(Clinician-Rated Dimensions of Psychosis Symptom severity,CRDPS)及临床疗效总评量表(Clinical Global Impression,CGI)评估患者精神症状及其严重程度。结果·首发精神分裂症组的线索识别PM任务及意向提取PM任务均显著低于健康对照组(均P<0.05),言语性工作记忆及回溯记忆成绩均显著低于健康对照组(均P=0.000),而多任务执行能力的组间差异无统计学意义。控制工作记忆、回溯记忆及执行功能后,线索识别和意向提取的组间差异仍具有统计学意义(均P=0.000)。精神分裂症的线索识别能力、意向提取能力与临床症状之间无显著相关性。结论·精神分裂症患者中基于事件前瞻记忆的线索识别缺陷和意向提取缺陷可能均属于原发性认知缺陷。展开更多
背景:目前的精神分裂症治疗常常只是部分有效。目的:评估在精神分裂症的治疗中使用辅助性内观疗法可能带来的益处,该疗法是一种源于日本、基于内省的认知方法。方法:在急性精神病性症状缓解后,235例具有初中以上学历的精神分裂症住院患...背景:目前的精神分裂症治疗常常只是部分有效。目的:评估在精神分裂症的治疗中使用辅助性内观疗法可能带来的益处,该疗法是一种源于日本、基于内省的认知方法。方法:在急性精神病性症状缓解后,235例具有初中以上学历的精神分裂症住院患者被随机分为对照组(n=112)或干预组(n=123)。前者接受常规药物治疗和住院康复治疗,后者在此基础上接受辅助性内观疗法,每天2小时,每周5天,为期4周。对所有患者在出院后进行12个月的随访。在基线、干预1个月后以及随访12个月后,采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、个人和社会功能量表(Personal and Social Performance scale,PSP)以及自知力与治疗态度问卷(Insight and Attitude Questionnaire,ITAQ)分别对患者进行评估。对评估者使用盲法,隐瞒患者的分组情况。结果:在12个月的随访中干预组只有13例(10.6%)复发,但是对照组有23例(20.5%)复发(X2=4.50,p=0.034)。使用修正的意向治疗分析和重复测量方差分析,内观疗法组的PANSS、PSP和ITAQ总分均在12个月的随访中比对照组有更显著的改善。尽管两组之间药物剂量(氯丙嗪等效剂量)随时间变化趋势的差异并无统计学意义,但从入组到随访终点,干预组的平均剂量显著减少而对照组的减少在统计学上并不显著。结论:本研究有力支持了内观疗法作为辅助治疗在精神分裂症康复期是有效的。相比于常规治疗,辅以内观疗法可以维持急性治疗期间所取得的精神病性症状改善的疗效、提高对疾病的自知力、提高社会功能,并在一年的随访期内减少复发。这值得我们在更大、更多样化的精神分裂症患者样本中进一步研究这种治疗方法。展开更多
Objective:To explore the effects of combining application of diagnosis and treatment technologies of Event Related Potentials(ERP)and Psychic Rehabilitation Intervention(PRI)on rehabilitation of schizophrenia.Methods:...Objective:To explore the effects of combining application of diagnosis and treatment technologies of Event Related Potentials(ERP)and Psychic Rehabilitation Intervention(PRI)on rehabilitation of schizophrenia.Methods:PRI and ERP were used in schizophrenia rehabilitation in this research.232 patients were divided into study group(SG)and control group(CG),and the rehabilitation effects were compared.Results:(1)After the implementation of the PRI,more score of the Brief Psychiatric Rating Scale(BPRS)was reduced on SG than the score on CG;more decreased scores of insight and on Social Disability Screening Schedule(SDSS),and more increased scores of treatment compliance questionnaire scores were observed on SG,comparing with CG(P<0.05 or 0.01).(2)After the implementation of the PRI,more decreased factor scores of Symptom Checklist 90 were observed on SG patients family members(P<0.05 or 0.01).(3)PRI significantly improved the patients’social functions,family members’relationship and prevented the recurrence of schizophrenia.(4)Improved P2,P3 amplitudes were also detected on SG compared with CG(P<0.05).Conclusions:(1)PRI interventions may improve schizophrenia patients’social function.(2)ERP may be used to evaluate the schizophrenia patients’rehabilitation,and is worth being popularized.展开更多
Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood sa...Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the associa- tion between methadone blood levels and the outcomes of methadone maintenance treatment （MMT）. Outcome dif- ferences between participants who had high （≥2） or low （〈2） peak-to-trough ratios were also compared using an independent sample t-test. The blood level of methadone was not correlated with the clinical outcome of MMT with the moderate range of doses given. However, the retention of patients who had a free peak-to-trough ratio 〉2 was significantly poorer than those whose ratio was 〈2. Thus, monitoring plasma methadone levels is unlikely to be effective for guiding dosing decisions in situations where compliance with MMT is already very high or when themethadone dose is no longer the dominant factor in determining the clinical outcome. However, monitoring plasma methadone levels is still helpful for guiding the dosage for patients with a rapid metabolism.展开更多
文摘目的·分析首发精神分裂症患者基于事件前瞻记忆(prospective memory,PM)与正常人的差异,探索其可能的心理机制。方法·共纳入34例未服药的首发精神分裂症患者(首发精神分裂症组)及31名健康志愿者(健康对照组)。应用基于事件前瞻记忆任务测评被试的PM,其中线索识别PM任务主要测评被试的线索识别能力,意向提取PM任务测评被试的意向提取能力。同时,应用字母数字广度任务测评被试的言语性工作记忆,应用理解记忆测验测评被试的回溯记忆,应用修订版六元素测验(modified six elements test,MSET)测评被试执行多重任务的能力。应用阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、精神病症状维度评定量表(Clinician-Rated Dimensions of Psychosis Symptom severity,CRDPS)及临床疗效总评量表(Clinical Global Impression,CGI)评估患者精神症状及其严重程度。结果·首发精神分裂症组的线索识别PM任务及意向提取PM任务均显著低于健康对照组(均P<0.05),言语性工作记忆及回溯记忆成绩均显著低于健康对照组(均P=0.000),而多任务执行能力的组间差异无统计学意义。控制工作记忆、回溯记忆及执行功能后,线索识别和意向提取的组间差异仍具有统计学意义(均P=0.000)。精神分裂症的线索识别能力、意向提取能力与临床症状之间无显著相关性。结论·精神分裂症患者中基于事件前瞻记忆的线索识别缺陷和意向提取缺陷可能均属于原发性认知缺陷。
文摘背景:目前的精神分裂症治疗常常只是部分有效。目的:评估在精神分裂症的治疗中使用辅助性内观疗法可能带来的益处,该疗法是一种源于日本、基于内省的认知方法。方法:在急性精神病性症状缓解后,235例具有初中以上学历的精神分裂症住院患者被随机分为对照组(n=112)或干预组(n=123)。前者接受常规药物治疗和住院康复治疗,后者在此基础上接受辅助性内观疗法,每天2小时,每周5天,为期4周。对所有患者在出院后进行12个月的随访。在基线、干预1个月后以及随访12个月后,采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、个人和社会功能量表(Personal and Social Performance scale,PSP)以及自知力与治疗态度问卷(Insight and Attitude Questionnaire,ITAQ)分别对患者进行评估。对评估者使用盲法,隐瞒患者的分组情况。结果:在12个月的随访中干预组只有13例(10.6%)复发,但是对照组有23例(20.5%)复发(X2=4.50,p=0.034)。使用修正的意向治疗分析和重复测量方差分析,内观疗法组的PANSS、PSP和ITAQ总分均在12个月的随访中比对照组有更显著的改善。尽管两组之间药物剂量(氯丙嗪等效剂量)随时间变化趋势的差异并无统计学意义,但从入组到随访终点,干预组的平均剂量显著减少而对照组的减少在统计学上并不显著。结论:本研究有力支持了内观疗法作为辅助治疗在精神分裂症康复期是有效的。相比于常规治疗,辅以内观疗法可以维持急性治疗期间所取得的精神病性症状改善的疗效、提高对疾病的自知力、提高社会功能,并在一年的随访期内减少复发。这值得我们在更大、更多样化的精神分裂症患者样本中进一步研究这种治疗方法。
文摘Objective:To explore the effects of combining application of diagnosis and treatment technologies of Event Related Potentials(ERP)and Psychic Rehabilitation Intervention(PRI)on rehabilitation of schizophrenia.Methods:PRI and ERP were used in schizophrenia rehabilitation in this research.232 patients were divided into study group(SG)and control group(CG),and the rehabilitation effects were compared.Results:(1)After the implementation of the PRI,more score of the Brief Psychiatric Rating Scale(BPRS)was reduced on SG than the score on CG;more decreased scores of insight and on Social Disability Screening Schedule(SDSS),and more increased scores of treatment compliance questionnaire scores were observed on SG,comparing with CG(P<0.05 or 0.01).(2)After the implementation of the PRI,more decreased factor scores of Symptom Checklist 90 were observed on SG patients family members(P<0.05 or 0.01).(3)PRI significantly improved the patients’social functions,family members’relationship and prevented the recurrence of schizophrenia.(4)Improved P2,P3 amplitudes were also detected on SG compared with CG(P<0.05).Conclusions:(1)PRI interventions may improve schizophrenia patients’social function.(2)ERP may be used to evaluate the schizophrenia patients’rehabilitation,and is worth being popularized.
基金supported by the Research Project of Shanghai Municipal Health and Family Planning Commission, China(2013SY011 and 2014ZYJB0002)the National Natural Science Foundation of China(81271468)+1 种基金Doctoral Supervisor Funding from the Ministry of Education of China(20120073110089)Research Funding from Shanghai Key Laboratory of Severe Mental illness,China(13dz2260500)
文摘Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the associa- tion between methadone blood levels and the outcomes of methadone maintenance treatment （MMT）. Outcome dif- ferences between participants who had high （≥2） or low （〈2） peak-to-trough ratios were also compared using an independent sample t-test. The blood level of methadone was not correlated with the clinical outcome of MMT with the moderate range of doses given. However, the retention of patients who had a free peak-to-trough ratio 〉2 was significantly poorer than those whose ratio was 〈2. Thus, monitoring plasma methadone levels is unlikely to be effective for guiding dosing decisions in situations where compliance with MMT is already very high or when themethadone dose is no longer the dominant factor in determining the clinical outcome. However, monitoring plasma methadone levels is still helpful for guiding the dosage for patients with a rapid metabolism.
