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This paper reported a case of a 29-year-old male patient with mental disorder caused by prion disease was misdiagnosed as depressive episode with somatic symptoms. The patient's symptoms were initially predominantly psychiatric， with progressive worsening of somatic symptoms， and he died more than 1 year after his first onset. Prion disease caused various manifestations of mental symptoms， which can easily lead to missed diagnosis and misdiagnosis. This paper discussed the case， in order to provide references for the clinical diagnosis of mental disorder caused by prion disease.
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Objective To investigate the relationship between the serum concentrations of brain derived neurotrophicfactor (BDNF) and its G196A polymorphism in the amphetamine induced-psychosis inpatients.Methods The cross-sectional study included 233 amphetamine abuses and 110 healthy participants who served as controls.The serum concentration of BDNF was measured by sandwich ELISA,and the genotype of BDNF G196A polymorphism was determined used polymerase chain reaction (PCR) techniques.The data were analyzed using SPSS 12.0 statistics software.Results The serum concentration of BDNF in case group((205.81±75.36) pg/ml) were significantly higher than that in control group((95.04±31.63) pg/ml;t=15.02,P＜0.01).There was no significant difference about the BDNF serum concentrations between the inpatients with the amphetamine induced psychosis and the inpatients with the amphetamine abuse (P＞0.05).The BDNF serum concentration showed no significant difference in the genotype distributions and allele frequencies (P＞0.05).The genotype distributions and allele frequencies of BDNF G196A showed no significant difference among three groups(P＞0.05).Conclusion The BDNF serum concentration is correlated with methamphetamine abuse,while the BDNF G196A gene polymorphism may not be associated.
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Objective To explore the relative factors of aggressive behaviors in inpatients with schizophrenic.Methods 178 cases of continuously admitted schizophrenic patients were divided into attack group and non aggressive group according to the aggressive behavior of preadmission.Single factor analysis and multi factor regression analysis was applied to two groups in situation(such as age,gender,education level,course of disease,past aggressive behaviors and so on),Brief Psychiatric Rating Scale (BPRS) and Eysenck Personality Questionnaire (EPQ).Results By single factor analysis,attack group had significantly longer course of disease(7.73±6.67) than non aggressive group (5.22 ± 5.47,t =2.631,P＜ 0.01).The score of hostile suspicious factor in BPRS (13.73 ± 3.098) in attack group was significantly higher than that in nonaggressive group(11.47±3.93) (t=4.063,P＜ 0.01),but anxiety factor (7.18± 3.583) was significantly lower than that in nonaggressive group (8.70 ± 3.89) (t=2.679,P＜0.01).The score of E scale of EPQ(11.99±4.340) in attack group was significantly higher than that in nonaggressive group(10.67±4.293) (t=1.990,P＜0.01).Attack group's proportion of patients of previous attacks (71.1％) was significantly higher than that in non aggressive group (16.0％),(x2 =39.082,P＜ 0.01).(2) Logistic analysis showed that hostile suspicious factor in BPRS and past aggressive behaviors entered the regression equation.Condusions Aggressive behavior in schizophrenic patients occurs mainly with psychiatric symptoms and the past history of aggressive behavior.The patients should be treated actively to control the symptoms and prevent the disease recurrence.
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Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.
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ObjectiveTo understand the behavioral characteristics,strength on suicide ideation and mental disorder diagnosis among suicide attempers,so as to provide consultation for crisis intervention of suicide.Methods232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled.They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-Ⅳ Disorders axis Ⅰ for patient (SCID/I-P).Results( 1 ) In the total of 232 cases,female was more than male with the gender ratio of 2.87 (female vs male).The highest proportion rate (56.9％) existed between 16 years old to 35 years old.Oral application pesticide was the most commom suicide pattern (83.2％),91.4％ of the suicide attempt occurred in the their homes.The top three reasons leading to suicide were family contrary (61.2％),depressive mood (15.1％)and fail in love (9.5％).(2) In all cases,83.6％ did not think if they were found,84.1％ did not adopted any precaution measures,over 60.0％ did not tell anyone their attempted plans,and 90％ had no dying structions and /or dying testaments before their attempted behaviors.At the moment of attemp behaviors,62.9％ did not contact with someone.The 60.0％ of all the cases had wanted strongly to die,otherwise 7.3％ had wanted to manipulate others.(3) The diagnosis rate of mental disorder on DSM-Ⅳ was 45.3％,in which the mood disorder was most.ConclusionThere are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province.Their strength of suicide ideation are moderate,and a certain proportion of suicide attempters may be impulsive suicide attempters.There is more relationship between mental disorder and suicide attempt.
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ObjectiveTo compare the clinical and social-psychological characteristics of patients with and without mental disorder.MethodsBase the diagnosis of mental disorder,232 suicide attempters were divided into two groups:suicide attempter with mental disorder ( 105 cases) and suicide attempter without mental disorder (127 cases).The Structured Clinical Interview for DSM-Ⅳ,the Strength of Suicide Ideation,Health Questionnaire of WHO,Questionnaire of Life Measure (QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale (BAS),Social Support Rate Scale and Questionnaire of Coping Style (QCS) were conducted.ResultsThe 105 suicide attempters with a mental disorder were older than the 127 suicide attempter without a mental disorder ( 37.9 ± 14.5 vs 32.9 ± 13.3,t =2.710,P =0.007 ),and the percentage of female was lower in the former than in the later(65.7％ vs 81.1％,x2 =7.099,P =0.008 ).In the total of 232 cases,female was more than male with the gender ratio of 2.87 ( female vs male).The strength level of suicide ideation was higher ( 7.1 ± 2.8 vs 4.8 ± 2.3,t =6.498,P =0.000).The scores of health questionnaire of WHO,BDI and BAI were higher in the suicide attempters with a mental disorder than those without a mental disorder,otherwise the scores of QLM,BIS and its three sub-scales were higher.Among QCS,the sub-score of Self-blaming was higher,and the sub-scores of Question solvation and Asking for help were lower.ConclusionThere are distinguished differences on the sociodemographic and psychological characteristics among the suicide attempters with and without a mental disorder.Mental diseases play an important role in the development of suicide attempter with a mental disorder.
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Objective To explore the roles on psychosocial factors of suicide behavior in the suicide attempters.Methods132 suicide attempters and 132 matched controls treated in the emergency department were assessed using certain psychosocial questionnaires,such as Health Questionnaire of WHO,Questionnaire of Life Measure ( QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory ( BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale ( BAS),Social Surpport Rate Scale and Questionnaire of Coping Style (QCS).Results( 1 ) The results of single-factor analysis showed that the scores of Health Questionnaire of WHO and QL were lower in the suicide attempter group than those in the control group( suicide attempter group:17.07±3.07 and 9.76 ±7.11; control group:13.42 ±3.31 and 17.08 ±3.81,all P＜0.05),otherwise the scores of BDI,BAI,BIS and BAS were higher( suicide attempter group:15.22 ± 11.22,27.87 ± 7.24,87.67 ±20.08 and 73.74 ± 19.61 ; control group:6.87 ± 6.36,26.22 ± 5.44,73.34 ± 14.54 and 63.78 ± 16.44,all P ＜ 0.05 ).Among QCS,the sub-score of self-blaming was higher( 3.42 ± 2.44 VS 2.35 ± 2.04,P ＜ 0.05 ),otherwise the sub-scores of question solvation,asking for help and rationalization were lower( all P ＜ 0.05 ).( 2 ) The result of multi-factors analysis showed that gender,mean education times,the scores of QL,HQ,BDI,and BIS,sub-score of rationalization,and so on,entried the Logistic aggressive equaltion.Conclusion The status of health,quality of life,depressive and anxious mood,impulsive and aggressive personality,and certain coping style play important role.
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Objective To explore the association between disrupted in schizophrenia 1(DISC1) genepolymorphism and schizophrenia and different subtype depression.To verify if DISC1 gene is the common predisposing gene for schizophrenia and depression.Methods The genotypes and alleles in 260 cases of schizophrenicpatients,96 cases of depressive patients with psychotic symptoms,124 cases of depressive patients without psychotic symptoms,and 100 normal controls were examined with polymerase chain reaction(PCR),denaturing polyacrylamide gel elcctmphoresis separation technique.The association was analyzed between DISC1 gene single nncleotide polymorphisms(SNP) locus rs821616 and schizophrenia and different subtype depression.Results The frequeneies of the genotypes T/T,A/T,and A/A were 3.5%,28.0%and 69.5%respectively,the frequencies of alleles T and A were 9.6%and 90.4% respectively in schizophrenia group.The frequencies of the genotypes T/T,A/T,and A/A were 3.1%,24.0% and 72.9% respectively,the frequencies of alleles T and A were 15.6% and84.4% respectively in depression 1 group;The frequencies of the genotypes T/T,A/T,and A/A were 2.4%,23.4% and 74.2% respectively,the frequencies of alleles T and A were 15.3% and 84.7% respectively in depression 2 group;The frequencies ofthe genotypes T/T,A/T,and A/A were 1.0%,16.0% and 83.0% respectively,the frequencies of alleles T and A were 17.0% and 83.0% respectively in control group.There were significant differences in the frequencies of the genotypes (Chi-Square=8.072,P=0.045)and alleles(Chi-Square=8.564,P=0.036) of DISC1 gene among the four groups with non-parametric Kruskal-Wallis test.After pairwisecomparison each other in the four groups we found that there were significant differences in the frequencies of thegenotypes(Z=-2.802,P=0.005)and alleles(Z=-2.837,P=0.005) of DISC1 gene between patients withschizophrenia and normal controls with non-parametric Mann-Whitney test(two-tailed),there were no significantdifferences between other groups(P>0.05).Conclusion Our results suggest that DISC1 gene polymorphism is associated with schizophrenia significantly,but it is not associated with different subtype depression.This finding do not support the viewpoint that DISC1 gene is the common predisposing gene for schizophrenia and depression.
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Objective To explore the impulsivity and aggressivity,and its treatment outcomes of the inpatients with intemet addiction disorder (IAD) by intergration interview. Methods Barratt Impulsiveness Scale ( BIS), Buss Aggressive Scale (BAS) were used to assess the impulsiveness and aggressivity in 58 IAD patients, at the first week and after the point of intergration interview 3 months,54 normal subjects in the control group were conducted by BIS and BAS only when they were recruited. Results ①The intemet addiction group had significantly higher scores on the BIS and BAS total scores than the control group at the first week ( BIS score 99.3 ±15. 1vs 75.0 ± 15.4, t=8.47, P＜0. 01; BAS score 78.3 ±24.4 vs 54.8 ± 17.7, t=5.87 , P＜0. 01 ). IAD group had lower scores on the total scores of BIS-Ⅱ and BAS after intergration interview than before, but the subscales and total scores were higher than those in the control group ( BIS score 86.3 ± 16.6 vs 75.0 ± 15.4, t =4.98, P ＜ 0.01 ;BAS score 66.2 ± 22.6 vs 54.8 ± 17.7, t = 3.65, P ＜ 0. 01 ). ②Total score of SCL-90 in IAD group were significantly correlated with the BAS total score ( r=0. 376, P＜0. 01 ) ,and the decreased SCL-90 total score was also related with the decreased BAS score ( r= 0.508, P＜ 0. 01 ). Conclusion This study suggests that IAD group exhibit more impulsivity and aggressivity than those in the control group. After interview, their impulsivity and aggressivity are significantly decreased, but are still higher than those in the normal control group.
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Objective To approach potential abnormalities of neuro-chemical compounds in cerebrum of obsessive-compulsive disorder and to analyze the relationship among the abnormalities with duration of illness and symptom severity. Methods 19 patients with obsessive-compulsive disorder and 22 comparison subjects were scanned by 1H magnetic resonance spectroscopy to exam bilateral prefrontal lobe, temporal lobe, parietal lobe, occipital lobe, anterior cingutate and caudate nucleus, hippocampus as well as splenium and genu of corpus callosum,thalamus. The ratios of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) were respectively recorded.The severities of obsessive-compulsive symptoms were assessed by Yale-Brown Obsessive-Compulsive Scale. Results ( 1 ) The ratios of NAA/Cr in right caudate nucleus and left hippocampus were higher than those in normal controls (1.23 ±0.37 vs 1.0 ±0.33, t=2.14, P=0.039;1.34 ±0.25 vs 1. 10 ±0.45, t=2.41, P=0.021 ), but NAA/Cr ratios in genu of corpus callosum were lower(0. 97 ±0.30 vs 1.19 ± 0. 26, t = -2.47, P= 0.018 ).(2) The Cho/Cr ratios in right caudate nucleus and left temporal lobe were higher than those in control groups (1.09±0.51 vs0. 67±0.21,t=3.32, P=0.003;2.58±0.62vs0.84±0.17, t=2.21,P=0.03). (3) The duration of illness was negatively correlated with the Cho/Cr ratios of right prefrontal lobe ( r = - 0. 507, P =0. 027 ). (4) The NAA/Cr ratios of genu of corpus callosum as well as the Cho/Cr ratios of left temporal lobe were negatively correlated with YBOCS score ( r 1 = - 0.457, P = 0.049; r 2 = - 0. 585, P = 0.009 ). Conclusion Neuronal functions increase in right caudate nucleus and left hippocampus which are opposite in genu of corpus callosum. These abnormalities may play an important role in pathogenesis of OCD.
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Objective To investigate the efficacy of escitalopram combined with psychoanalysis in the treatment of refractory depression. Methods A total of 63 patients were randomly divided into escitalopram group ( n = 32) and escitalopram combined with psychoanalysis group( n = 31 ). All patients were evaluated with Hamilton depression Rating Scale(HAMD). Results After treatment,the scores of HAMD in two groups were both significantly lower than those before treatment. In the 8th ( ( HAMD ( 17.35 ± 2.98 ) ), 12th ( ( HAMD (9. 26 ±3.46) )weekend of treatment, the scores of HAMD in study group were significanlly lower than those in control group(8 th:21.97 ± 3.26; 12 th: 15.28 ± 3. 18 ). There were no significant differences in side effects between study group and control group. Conclusion Escitalopram angumented with psychoanalysis takes effects better than escitalopram single and doesn't increase side effects in the treatment of refractory depression.
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Objective To investigate the characteristics of the cognitive impairment about attentional network among amphetamine-induced psychiatric disorders. Methods Amphetamine-induced psychiatric disorders ( n = 100) and normal controls ( n = 100) were assessed with Attentional Network Test(ANT) in the first week and the fourth week. Results Compared with the control group, the first ANT's response time was significantly increased, and the correct rate, orienting and executive control network were significantly reduced in Amphetamineinduced psychiatric disorders( eg:response time ( 867. 37 ± 272.24 ) ms vs ( 668.56 ± 136. 20 ) ms, correct rate (0.88 ±0.06 ) ms vs (0.88 ±0.06) ms ,orienting( - 217.86 ± 198.00 ) ms vs ( -59.67 ± 85.07 ) ms and executive control network ( 184.74 ± 66.61 ) ms vs ( 74.71 ± 50.77 ) ms, P ＜ 0.01 ), but the alerting network was higher ( ( 151.17 ± 198.27 ) ms vs (50.60 ± 67.47 ) ms). In the second ANT results, there was no significant difference between two groups. Compared with the first ANT results of amphetamine-induced psychiatric disorders, the second ANT had shorten response time ,that the correct rate, orienting and executive control network were significantly increased(P ＜ 0.01 ). Conclusion These results suggest that amphetamine-induced psychiatric disorders have impairment in cognitive function, but these impairment can be recovered within one month.
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Objective: To understand the use patterns, initial abuse age, initial abuse reasons and the demographic characteristic of opiates abusers at six areas in Hunan Province. Methods: Combined stratified cluster-sampling, household and cue investigation, 370 opiate abusers from 68 192 community residents aged between 15 and 50 years were interviewed. Results:About 95% opiate abuses reported that they had abused heroin in their life time, and the other had abused dolantin and/or methadone. Inhalation and Injection were the first two ways of administration (81.4% and 38.6%). The average initial abuse age was 27?6 years, 90.2% abuses reported that they had abused illicit drug before 35 years. Curiosity, peer pressures and exciting seeking were the first three main reasons of initial abuse (75.1%, 72.7% and 56.5%, respectively). Opiates abusers tended to be male (87.3%), young people aged below 35 years (71.1%), and 78.7% of the abusers got only junior school or below education. Subjects with unstable occupation and marital status had higher use rate than those with stable ones.Conclusion:Heroin was the major opiates abused, the main administration was inhalation and injection in Hunan Province. Young and middle aged male with low educational level or without stable occupation or marital status were the majority of opiates abusers.