RÉSUMÉ
Objective To find out whether obsessive-compulsive (OCD) and schizophrenia (SCH) subjects show distinguishable cognitive performance profiles and to determine the magnitude of cognitive deficits in both groups.Methods Thirty patients with OCD and 30 patients with SCH,admitted to our hospital from August 2011 to February 2012,and 30 healthy control subjects (HCS) were assessed by using a battery of neuropsychological tests,which included trail making test (TMT),Stroop test (ST),Wechsler memory scale (WMS),improved Wisconsin card sorting test (WCST); the data were compared with statistical methods.Results In TMT,the patients with OCD showed significantly worse performance in TMT-B using time and TMT B-A (s) than subjects with HCS (P＜0.05),and the patients with OCD showed significantly better performance than the patients with SCH in all aspects (P＜0.05),except the TMT-B errors; the patients with SCH showed significantly worse indexes in all aspects of TMT as compared with subjects with HCS (P＜0.05).In ST,the patients with OCD showed worse performance in St-cw errors and St-cw times than subjects with HCS,and showed better performance in ST-W errors and ST-W using times than the patients with SCH (P＜0.05); the patients with SCH showed significantly worse performance in all aspects as compared with subjects with HCS (P＜ 0.05).In WMS,the patients with OCD showed worse performance in picture recall,recognition,associative learning,short memory and memory quotient than subjects with HCS (P＜0.05),and were better performance than the patients with SCH in all aspects ofWMS (P＜0.05),except in long memory,recognition,associative learning and tactile memory; the patients with SCH showed significantly worse performance in all aspects of WMS than subjects with HCS (P＜0.05).The patients with OCD and SCH showed worse performance in all aspects of WCST,except random error number,than subjects with HCS (P＜0.05); the patients with OCD had better performance than the patients with SCH in all aspects of WCST (P＜0.05).Conclusion The cognitive defects in patients with OCD primarily occur on narrowing attention,conversion difficulties,short-term memory and visual space memory disorders,while patients with SCH have comprehensive neurocognitive impairment; the overall level of cognitive function in patients with OCD is higher than that in patients with schizophrenia.
RÉSUMÉ
Objective To test the efficacy of cognitive behavioral self-help therapy (CBTI-SH) on patients with chronic insomnia vs.a zolpidem control condition.Methods A total of 60 adults with chronic insomnia and common comorbidities were recruited from our hospital from July 2011 to October 2012.Participants were randomly assigned to either intervention group (n=30),consisting of sleep hygiene plus four-week CBTI-SH with printed material and 2 telephone instruction-calls,or control group (n=30),consisting of sleep hygiene plus a four-week supervised zolpidem tapering therapy.The CBTI-SH included cognitive restruction,stimulus control therapy,sleep restriction therapy and relaxation therapy.The primary outcome was self-report symptom,based on sleep diaries (including Sleep Latency-SL,Total Sleep Time-TST,Time In Bed-TIB,Sleep Efficiency-SE,Wake after Sleep Onset-WASO),Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleeping Scale (ESS) which were evaluated at baseline and at the end of the 2th,4th,6th week treatment.Continuous variables were evaluated by repeated-measures multivariate analyses of variance (MANOVA).At the end of every two weeks,each participant was asked to assess treatment adherence to the six core recommendations of CBTI-SH or sleep hygiene.Results The multivariate analysis of variance showed a significant treatment group plus time interaction,and time main effects for PSQI,ESS,SL,SE,TST,TIB and WASO in the two groups (P＜0.05).The patients in the intervention group had significantly better outcomes than those in control group.Effect sizes (Cohen d)were 1.93,0.04,1.00,0.98,0.11,0.57 and 0.43,respectively.The intervention group reported higher average adherence scores in "use of the bed only for sleeping,not worrying in bed",and lower average scores in "adherence to TIB prescription,getting out of bed when unable to sleep",compared with those in the control group.Conclusion CBTI-SH is effective for treating chronic insomnia and daytime sleepiness as compared with supervised zolpidem tapering therapy,but the treatment adherence needs to be improved.
RÉSUMÉ
Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter and lenticular nucleus in patients with bipolar Ⅱ disorders.Methods Thirty patients with bipolar Ⅱ disorders and 20 healthy controls,collected in our hospital from September 2012 to April 2013,were evaluated with Multi-Voxel 1H-MRS scans on prefrontal white matter and lenticular nucleus to assess the levels of N-acetyl aspartate (NAA),choline compound (Cho),creatine (Cr) and myo-inositol (mI),and then,the ratios of NAA/Cr,Cho/Cr,mI/Cr,NAA/Cho and NAA/Cho+Cr were calculated.Results Levels ofNAA,NAA/Cr,Cho and mI in the right prefrontal white matter were significantly lower in patient group than those in the normal controls (P＜0.05); NAA level,and ratios of NAA/Cr,NAA/Cho,NAA/Cho+Cr in the left prefrontal white matter were obviously lower in patient group than those in the normal controls (P＜0.05); NAA and Cho in right lenticular nucleus were lower as compared with those in the healthy control subjects (P＜0.05).Conclusion Prefrontal white matter fiber damage and glial cell disfunction occur in patients with bipolar Ⅱ disorder; besides,neuronal loss and disfunction in the right lenticular nucleus exist.