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Objective To observe the efficacy and safety of citalopram in the treatment of behav-ioural and psychological symptoms of dementia(BPSD)and cognitive function of Alzheimer's disease(AD) patients.Methods From April 2015 to February 2016,80 cases of moderate Alzheimer's disease(according to the clinical dementia rating scale,CDR)with symptoms of BPSD in Qingdao Mental Health Center were collected and randomly divided into treatment group and control group.Treatment group was given citalopram (10 to 30 mg/d),the control group was given the same dose of placebo,and the patients in both group were given memantine(10 mg/bid)for 12 weeks.Simple mental state examination(MMSE)was used to measure cognitive function.Neural psychiatric questionnaire(NPI)measurement was used to evaluate BPSD and the TESS was used to assess adverse effects.Results Decreased scores of MMSE between the treatment group and the control group were respectively(0.67±0.77)and(0.26±0.68)after 12 weeks of treatment.There was significant difference in decreased scores of MMSE between the two groups(t=2.49,P=0.02).The scores of NPI in agitation/attack(t=2.986,P=0.04),apathy(t=3.144,P=0.002),indifference/dysthymia (t=6.094,P=0.000)and anxiety(t=6.496,P=0.000)showed statistically significant differences between the two groups.There were no significant difference in TESS scores(P>0.05).The most frequently adverse e-vents in the study included dizziness,headache,fatigue and nausea.QTc interval prolongation were found in participants treated with 30 mg citalopram per day in the study group.Conclusion Citalopram is an effec-tive and safe drug in the treatment of BPSD and cognitive function associated with moderate AD.
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Objective To study the correlation of personality characteristics and plasma cortisol levels in the patients with generalized anxiety disorder.Methods According to Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ), 38 patients with generalized anxiety disorder and 39 normal controls were assessed with Hamilton anxiety scale (HAMA) , generalized anxiety disorder scale (GAD-7) , penn state worry questionnaire (PSWQ) , symptom checklist-90(SCL-90) and eysenck personality questionnaire (EPQ).Electrochemiluminescence was used to test plasma cortisol concentration.Results The EPQ-N score in the patients was significantly higher than that in normal controls(t=14.307, P＜0.01).Furthermore,N score in the patients showed a significantly positive correlation with HAMA total score, SCL-90 total score, somatization score, interpersonal sensitivity score, depression score and anxiety score (r=0.492-0.977, P＜0.01).Plasma cortisol levels in patients with generalized anxiety disorder((668.50±60.22) nmol/L) were significantly higher than those ((345.35±58.91) nmol/L) in normal controls (t=23.802, P＜0.01).Plasma cortisol concentrations displayed a significantly positive correlation with N score, GAD-7, PSWQ, HAMA total score, SCL-90 total score, somatization score, interpersonal sensitivity score, depression score, and anxiety score (r =0.501-0.995, P＜ 0.01).Conclusion Plasma cortisol levels in the patients with generalized anxiety disorder are higher than those in normal controls.Plasma cortisol levels are related to the mental health.Patients with generalized anxiety disorder tend to be neuroticism.
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Objective To study the alexithymia and personality characteristics in patients with somatoform disorders.Methods Totally 60 patients with somatoform disorders and 60 normal controls were tested with Toronto alexithymia scale (TAS) and Minnesota Multiphasic Personality Inventory (MMPI).Results The patients with somatization disorders showed alexithymia and personality base.The total and factor scores of TAS of study group((86.20 ± 11.15),(21.12 ± 3.28),(26.08 ± 3.86),(18.21 ± 4.69),(23.44 ±5.60)) were higher than controlled group((65.00 ± 10.12),(12.43 ±5.18),(15.64 ±5.57),(15.56 ±3.16),(18.71 ±4.30)) with significant difference (t =2.11-6.22,P =0.000-0.042).The MMPI scale scores of Hs (hypochondriasis),D (depression),Hy(hysteria),Men-Nancy(Mf),paranoid(Pa),psychotic(Pt) were higher in patients with somatoform disorders ((72.79 ± 10.50),(68.46 ± 13.63),(79.03 ± 12.12),(51.72 ± 7.74),(57.98 ± 10.60),(54.98 ±8.83)) than those in normal controls ((51.66 ± 10.11),(47.96 ±9.42),(51.47± 11.90),(43.66 ±8.77),(47.67 ± 6.69),(47.48 ±8.67)) with significant difference (t =2.56-6.86,P =0.000-0.015),especially the scale scores of Hy and Hs were the most significantly among those (T ＞ 70).There was close correlation between personality traits and alexithymia.Factor Ⅰ was positively related to depression,paranoid and psychotic,the relevancy was 0.454(P =0.023),0.405 (P=0.044),0.477 (P=0.016) respectively,besides Factor Ⅱ was also positively related to depression,and the relevancy was 0.437(P=0.029).Conclusion Patients with somatoform disorders have the alexithymia and the personality characteristics,and there are close relationship between them.
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Refractory ulcer is a commonly seen disease clinically. We believe the therapeutic strategies for refractory ulcer should include changing life style, standardizing medication, tracing observation, and rechecking in regularity. Traditional Chinese medicine combined with western medicine can be used for the treatment. When the therapeutic effect is not good, diagnosis and therapeutic methods need to be re-judged.Local therapy and operation can be performed if necessary.