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Orbitofrontal cortex abnormalities in schizophrenia 精神分裂症患者的眶额皮质异常
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001561
M. Bellani, S. Cerruti, P. Brambilla
Abstract The magnetic resonance imaging studies investigating the volumes of the orbitofrontal cortex in patients suffering from schizophrenia are here presented, trying to elucidate its role for the pathophysiology and for the cognition of the disease.
摘要磁共振成像研究了精神分裂症患者的眶额皮质体积,试图阐明其在病理生理学和疾病认知中的作用。
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引用次数: 29
Decrease in early adolescent illegal substance use in the Veneto region 威尼托地区青少年早期非法药物使用减少
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001639
Sonia Mazzardis, A. Vieno, M. Furegato, M. Santinello, M. Mirandola
Il consumo di sostanze psicotrope, oltre ad essere un importante fattore di rischio per lo stato di salute individuale, rappresenta un fenomeno con significative ricadute in ambito sociale (Santinello et al., 2006; Serpelloni et al., 2009). Come riportato nella Relazione annuale sullo stato delle Tossicodipendenze in Italia (2009), nel 2007 sono stati registrati, nella regione Veneto, circa 11 decessi ogni 100000 abitanti a seguito di incidenti stradali droga-correlati. In particolare, le fasce detà maggiormente interessate dal fenomeno sono risultate, per le femmine, quelle tra i 14 e i 24 anni e, per i maschi, quelle tra i 19 e i 24 anni.
精神药物的使用不仅是个人健康的一个主要危险因素,而且是一种具有重大社会影响的现象(Santinello et al., 2006;(Serpelloni et al., 2009)。正如《意大利毒品状况年度报告》(2009年)所述,2007年威尼托地区每10万居民中就有11人死于与毒品有关的道路交通事故。特别是,受影响最严重的年龄组是14至24岁的女孩和19至24岁的男孩。
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引用次数: 0
EPS Volume 19 issue 1 Back matter EPS第19卷第1期封底
Pub Date : 2010-03-01 DOI: 10.1017/s1121189x00001500
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引用次数: 0
The beliefs about drug treatments. The Italian version of the BMQ (The Beliefs about Medicines Questionnaire): its validity and applicability 对药物治疗的信念。意大利版BMQ(药物信念问卷):有效性和适用性
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001640
P. Argentero, Elisabetta Torchio, G. Tibaldi, R. Horne, J. Clatworthy, C. Munizza
L'adesione al trattamento è stata definita come la consonanza del comportamento di una persona alle indicazioni mediche (Fawcett, 1995; Myers & Nidence, 1998). Le revisioni della letteratura orientate ad analizzare questo argomento rilevano che, nei Paesi sviluppati, solo il 50% dei pazienti affetti da patologie croniche aderisce al trattamento, mentre nei Paesi in via di sviluppo si riscontrano tassi ancora più bassi. Per esempio, negli Stati Uniti, circa 50 milioni di adulti sono affetti da ipertensione, ma solo il 50% di essi sono stati diagnosticati e trattati adeguatamente; tra i pazienti trattati soltanto il 51% aderisce al trattamento. Analogamente, in Australia, solo il 43% dei pazienti affetti da asma assume i farmaci prescritti per l 'intera durata del trattamento e solo il 27.8% usa i farmaci prescritti come preventer (World Health Organization, 2001). Sul piano della frequenza, l 'analisi della letteratura indica che tra il 20% e il 90% dei pazienti affetti da disturbi psichici abbandona il trattamento, con un 'ampia variabilità di incidenza dovuta alle differenze nella definizione di mancata adesione e alla diversità dei campioni studiati.
对治疗的遵守被定义为一个人的行为符合医疗要求(Fawcett, 1995;(迈尔斯和尼登斯,1998)。面向这一主题的文献综述发现,在发达国家,只有50%的慢性病患者接受治疗,而在发展中国家,这一比例甚至更低。例如,在美国,大约有5000万成年人患有高血压,但只有50%的人得到了适当的诊断和治疗;在接受治疗的病人中,只有51%参加治疗。同样,在澳大利亚,只有43%的哮喘患者在整个治疗过程中服用处方药物,只有27.8%的人使用处方药物作为预防药物(世界卫生组织,2001)。在频率方面,文献分析显示,20%至90%的精神病患者放弃了治疗,由于缺乏依从性的定义和研究样本的多样性,发病率差异很大。
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引用次数: 19
Mortality among people with mental disorders 精神障碍患者的死亡率
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001512
F. Amaddeo, M. Tansella
Mortality among psychiatric patients has been found to be higher than the general population, not only in those long-term residents in old-fashioned psychiatric hospitals or attending hospital-based psychiatric services (Harris & Barraclough, 1998) but also in those treated in modern community-based systems of care (Amaddeo et al., 1995; Grigoletti et al., 2009).
精神病患者的死亡率已被发现高于一般人群,不仅是那些长期住在老式精神病院或在医院接受精神治疗的人(Harris & Barraclough, 1998),而且在现代社区护理系统中接受治疗的人(Amaddeo等人,1995;Grigoletti et al., 2009)。
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引用次数: 6
What can we do to reduce the burden of avoidable deaths in those with serious mental illness? 我们可以做些什么来减轻严重精神疾病患者可避免死亡的负担?
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001524
D. Crompton, Aaron Groves, J. McGrath
Abstract Individuals with schizophrenia have higher mortality rates compared to the general community. Apart from an increased risk of suicide, people with schizophrenia have an increased risk of death related to a wide range of comorbid physical conditions. There is evidence to suggest that much of this mortality is avoidable. The provision of assertive management of comorbid physical disorders has the potential to help close the differential mortality gap. While the primary data are robust, there is less empirical evidence to guide policy makers and service providers when dealing with these problems. Focused clinical programs aimed at reducing risk factors (e.g. smoking, obesity) and shared care between mental health teams and primary care providers can help reduce the burden of avoidable deaths. In light of recent evidence suggesting that the mortality gap has widened in recent decades, there is an urgent need to address the burden of avoidable deaths in those with serious mental illnesses.
与一般人群相比,精神分裂症患者的死亡率更高。除了自杀风险增加外,精神分裂症患者的死亡风险也会增加,这与多种共病的身体状况有关。有证据表明,这些死亡大多是可以避免的。提供对共病身体疾病的果断管理有可能帮助缩小死亡率差距。虽然原始数据是可靠的,但在处理这些问题时,指导政策制定者和服务提供者的经验证据较少。旨在减少风险因素(如吸烟、肥胖)和精神卫生团队与初级保健提供者之间共享护理的重点临床规划,有助于减轻可避免死亡的负担。鉴于最近有证据表明,近几十年来死亡率差距有所扩大,迫切需要解决严重精神疾病患者本可避免的死亡负担。
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引用次数: 18
Diagnosing psychotic disorders: validity, reliability and applications of the Diagnostic Interview for Psychosis (DIP). Italian version 精神障碍诊断:精神病诊断访谈(DIP)的效度、信度及应用。意大利版
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001585
A. Rossi, V. Morgan, F. Amaddeo, M. Sandri, L. Grigoletti, F. Maggioni, A. Ferro, Elena Rigon, V. Donisi, Valeria Vailati Venturi, F. Goria, I. Skre, M. Tansella, A. Jablensky
Aims – The Diagnostic Interview for Psychoses (DIP) is a comprehensive interview schedule for psychotic disorders, linked to the OPCRIT diagnostic algorithm, bridging the gap between fully structured, lay-administered schedules and semistructured, psychiatrist-administered interviews. Here we describe the validity, reliability and applications of the Italian version of the DIP. Methods – The interview was translated into Italian and its content validity tested by back translation. Sixty patients, drawn from among those who contacted the South-Verona Community Mental Health Service, were included in the study. Each patient was first assessed independently by two raters, one of whom conducted the interview, while the other assumed the role of observer. Subsequently (median: 89 days), 44 of these patients were re-interviewed by a third rater, who made an independent assessment. Diagnostic validity was assessed in 18 cases, interviewed with the DIP and using the SCAN as ‘gold standard. Results – The mean duration of the interview was 37 minutes for the inter-rater interviews and 39 minutes for the retest interviews. Good to excellent inter-rater reliability was demonstrated for both ICD-10 and DSM-IV diagnoses, while in the test-retest reliability pairwise agreement was high for half of the items. Diagnostic validity was good, with twelve out of the 18 DIP-OPCRIT diagnoses (67%) matching the SCAN diagnosis. Conclusions – Overall, the results support the reliability and validity of the Italian translation of the DIP. The Italian version will be useful both in routine practice to establish standard reference diagnoses of psychosis and in the research field, where it can be used by academic researchers in clinical trials and epidemiological studies.
目的:精神病诊断访谈(DIP)是一份针对精神疾病的综合访谈时间表,与OPCRIT诊断算法相关联,弥合了完全结构化、非专业人员管理的时间表与半结构化、精神科医生管理的访谈之间的差距。本文介绍了意大利版DIP的有效性、可靠性及其应用。方法:将访谈内容翻译成意大利语,采用反译法对访谈内容进行效度检验。从与南维罗纳社区精神卫生服务机构联系的人中选出60名患者参与了这项研究。每位患者首先由两名评分员独立评估,其中一人进行访谈,而另一人担任观察员的角色。随后(中位数:89天),其中44名患者再次接受第三方的访谈,并进行独立评估。对18例病例进行诊断有效性评估,采用DIP访谈并使用SCAN作为“金标准”。结果-内部面试的平均面试时间为37分钟,复试面试的平均面试时间为39分钟。在ICD-10和DSM-IV的诊断中,显示了良好到优异的量表间信度,而在测试-重测中,一半的项目的双信度一致性很高。诊断效度良好,18个DIP-OPCRIT诊断中有12个(67%)与SCAN诊断相匹配。结论-总体而言,结果支持DIP意大利语翻译的可靠性和有效性。意大利语版将有助于在日常实践中建立精神病的标准参考诊断,并在研究领域,它可以被学术研究人员用于临床试验和流行病学研究。
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引用次数: 5
Suicides in psychiatric in-patients: what are we doing wrong? 精神科住院病人的自杀:我们做错了什么?
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001536
D. de Leo, Jerneja Sveticic
Abstract Given the uncontested role of psychiatric illnesses in both fatal and non-fatal suicidal behaviours, efforts are continuously made in improving mental health care provision. In cases of severe mental disorder, when intensified treatment protocols and continuous supervision are required due to individual's impaired emotional, cognitive and social functioning (including danger to self and others), psychiatric hospitalisation is warranted. However, to date there is no convincing evidence that in-patient care prevents suicide. In fact, quite paradoxically, both admissions to a psychiatric ward and recent discharge from it have been found to increase risk for suicidal behaviours. What elements in the chain of well-intentioned approaches to treating psychiatric illness and suicidality fail to protect this vulnerable population is still unclear. The same holds true for the identifications of factors that may increase the risk for suicide. This editorial discusses current knowledge on this subject, proposing strategies that might improve prevention.
鉴于精神疾病在致死性和非致死性自杀行为中无可争议的作用,人们不断努力改善精神卫生保健服务。在严重精神障碍的情况下,由于个人的情感、认知和社会功能受损(包括对自己和他人的危险),需要加强治疗方案和持续监督,需要精神病住院治疗。然而,到目前为止,没有令人信服的证据表明住院治疗可以预防自杀。事实上,相当矛盾的是,精神病病房的入院和最近出院都被发现增加了自杀行为的风险。在治疗精神疾病和自杀的一系列善意方法中,哪些因素未能保护这一弱势群体,目前尚不清楚。这同样适用于识别可能增加自杀风险的因素。这篇社论讨论了关于这一主题的现有知识,提出了可能改善预防的战略。
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引用次数: 13
The methodological and conceptual aspects of mortality studies in psychiatry 精神病学死亡率研究的方法和概念方面
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001548
A. Biggeri, D. Catelan
Abstract An extensive literature documented a mortality differential for natural causes between psychiatric patients and the general population. Less clear is the pattern for cancer diseases. Methodological problems arise when trying to explain such mortality gap: selection bias and reverse causation; time-dependent confounders that are also intermediate variables; complex relationships within a life course have to be considered. We try to explain such problems in terms of causal graphs. Excess risk for causes of death which are not attributable to higher prevalence of risk factors or treatment side-effects and higher mortality rates for avoidable causes have been also documented. These findings underline the need for research on health promotion and preventive programs targeted to psychiatric patients.
大量文献记录了精神病人和普通人群之间自然原因的死亡率差异。癌症疾病的模式就不太清楚了。当试图解释这种死亡率差距时,方法学问题就出现了:选择偏差和反向因果关系;时间相关的混杂因素也是中间变量;必须考虑生命历程中的复杂关系。我们试图用因果图来解释这类问题。此外,还记录了不能归因于较高的风险因素流行率或治疗副作用的死亡原因的过度风险,以及可避免原因造成的较高死亡率。这些发现强调有必要研究针对精神病患者的健康促进和预防方案。
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引用次数: 2
In memoriam Leon Eisenberg and the essence of Medicine 纪念利昂·艾森伯格和医学的精髓
Pub Date : 2010-03-01 DOI: 10.1017/S1121189X00001652
L. Salvador-Carulla
I got in touch with Leon Eisenberg at the very end of his long and fulfilling professional life, or, to be precise, he got in touch with me. On December 12th, 2006 I received a sharp and hilarious comment on a paper I had written on the change of the name “mental retardation” to “intellectual disability” and its relation to stigma. In a friendly tone, it distilled joy of life and “bonheur”. The author recalled an old editorial at the American Journal of Psychiatry which explained that soldiers with neuropsychiatric problems were classified under a code known as ‘Section 8’ during the Second World War. “In no time at all, this classification number spread throughout the military community and became a term of derision. If you were thought to be a bit odd, you were called a ‘Section 8. Army psychiatrists concerned about the stigma changed the terminology from “Section 8” to “Simple Adult Maladjustment”. Not long after the change was made, the author of the editorial was in a base camp watching a film starring Jerry Lewis. He was astonished to hear members of the audience call out ‘Look at the ‘Sammy. After a moment he realized that “Sammy” stemmed from the initial letters “S.A.M.” of “Simple Adult Maladjustment”.
在利昂·艾森伯格漫长而充实的职业生涯即将结束时,我联系了他,或者更确切地说,是他联系了我。2006年12月12日,我写了一篇关于将“智力迟钝”改名为“智力残疾”及其与耻辱的关系的论文,我收到了一条尖锐而滑稽的评论。在友好的语气中,它浓缩了生活的乐趣和“bonheur”。提交人回忆起《美国精神病学杂志》上的一篇旧社论,其中解释说,在第二次世界大战期间,有神经精神问题的士兵被归类为“第8节”。很快,这个分类号就传遍了整个军界,成为一个嘲笑的词。如果你被认为有点奇怪,你就被称为“第8部分”。军队精神病医生担心这种耻辱,将术语从“第8节”改为“简单的成人适应不良”。改变后不久,这篇社论的作者在一个大本营看杰瑞·刘易斯主演的电影。他惊讶地听到一些观众喊道:“看那个萨米。”过了一会儿,他意识到“萨米”是由首字母“S.A.M.”演变而来的的“单纯成人适应不良”。
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引用次数: 0
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Epidemiologia e psichiatria sociale
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