W01 - 遗传精神医学 - Genetics in Psychiatry I
Chairs: Lingjiang Li, Chinese Mainland
KaiDa Jiang, Chinese Mainland

本工作坊邀 请复旦大学医学院、上海交通大学医学院精神医学专业的博士研究生介绍她们最新完成的博士课题中有关遗传学的研究内容 ， 主要包括精神分裂症易感基因研究、 ω -3 多不 饱和脂肪酸对慢性轻度应激抑郁症大鼠模型作用的基因芯片研究、抑郁症大鼠额叶皮层 5-HT2AR 和 SERT 基因表达、以及西 酞普兰对 SERT 转运功能影响的电生理学观察。内容涉及精神医学遗传学研究的多个方面 ， 每一项研究都有一定的创新性甚至处于国内领先水平。我们期待相关人士参与和讨论。

This workshop invited the psychiatric Drs of Fudan University and Shanghai Jiaotong University to introduce their newest genetic psychiatry studies, including the study of predisposing genes in schizophrenia, gene expression in hippocampus alteration induced by n-3 polyunsaturated fatty acids in chronic mild stress, expression of 5-HT2A Receptor and Serotonin Transporter Genes in the Frontal Cortex of Depression Rats, and the electrophysiological effects of Citalopram on the function of serotonin transporter. This workshop involved in several aspects of genetic psychiatry, and every study brings some new ideas even be leading level in internal. We expect your participation and discussion.

•  W01-1

酸性神 经酰胺酶 ASAH1 基因与精神分裂症易感性研究 - The Study of Genetic Susceptibility to ASAH1 Gene in Schizophrenia

DongHong Cui 1

1 Shanghai Mental Health Center , Shanghai , Chinese Mainland

目的 ： 探索酸性神 经酰胺酶基因 （ ASAH1 ） 与精神分裂症易感性 间的关系。

方法 ： 应用基因表达谱芯片对 6 例精神分裂症和 6 名健康 对照进行分析 ， 筛查易感基因。应用聚合酶链反应和限制性片段长度多态性技术对 254 个精神分裂症核心家系 ASAH1 基因的 3 个 SNPs （ rs3753118 、 rs3753116 和 rs7830490 ） 进行检测，计算 LD 、 TDT 及 单体型 TDT 。使用 PANSS 量表 评定 254 例精神分裂症患者疾病表型的数量性状，比 较在 3 个 SNPs 位点具有不同基因型、不同等位基因、不同 单体型的患者的 PANSS 量表 评分。

结果： 1. ASAH1 基因芯片研究：符合差异表达基因的有 31 条（数据此 处未报道），其中 ASAH1 基因表达水平在 6 例精神分裂症患者、 7 次 试验中均低于健康对照。 2. ASAH1 基因 传递不平衡分析：（ 1 ） rs3753116 － rs7830490 存在 强 LD （ D'=0.851 ， r2=0.369 ）， rs3753118 － rs3753116 存在中等 强度 LD （ D'=0.495 ， r2=0.165 ）， rs3753118 － rs7830490 存在弱 LD （ D'=0.196 ， r2=0.029 ）。（ 2 ） TDT 分析 显示 ASAH1 基因 rs3753118 、 rs3753116 和 rs7830490 与精神分裂症存在阳性 关联（ P<0.05 ）。（ 3 ） 单体型 rs3753118 － rs7830490 和 rs3753118 － rs3753116 － rs7830490 与精神分裂症存在阳性 关联（ Χ2=8.45 ， df=3 ，Ｐ <0.05 ； Χ2=15.86 ， df=7 ，Ｐ <0.05 ）， 单体型 rs3753118T － rs7830490A 和 rs3753118T － rs3753116G － rs7830490A 为精神分裂症的风险单体型 (P<0.05) 。 3. ASAH1 基因与精神分裂症数量性状的 关联分析：（ 1 ） rs3753118 位点 3 种基因型间患者的阳性症状分存在显著性差异 (P<0.05) ； rs3753116 位点 3 种基因型间患者的 PANSS 总分和阴性症状分存在显著性差异 (P<0.05) 。（ 2 ） rs3753118 Ｃ -rs3753116 Ｇ 单体型和 rs3753118 Ｃ -rs3753116 Ｇ -rs7830490 Ａ 单体型对应的 PANSS 总分和阴性量表分明显高于系统默认的 参照 单体型（Ｐ <0.05 ）。

结论： ASAH1 基因与精神分裂症 连锁， ASAH1 基因可能是中国 汉族人群精神分裂症的易感基因。 ASAH1 基因上可能存在着精神分裂症的症状数量性状位点。

Objective: To explore the genetic susceptibility of ASAH1 gene in schizophrenia.

Methods: Microarray analysis was used to detect gene expression profiles of leucocytes in six schizophrenic patients and six normal controls. Three SNPs (rs3753118, rs3753116 and rs7830490) of ASAH1 in 254 schizophrenia trios were genotyped by using PCR-RFLP, and the LD, TDT and haplotype TDT were analyzed by using EMLD, UNPHASED and TRANSMIT softwares. PANSS was used to quantify the phenotypes of schizophrenia. One-Way ANOVA and the QTPHASE of UNPHASED2.4 were used to compare the PANSS score between different genotypes, alleles and haplotypes.

Results: 1. Microarray analysis: 31 genes expression altered when the ratio of Cy5/Cy3 signal was more than 1.5 or less than 0.7 (we didn't report these dates here), and ASAH1 expression levels were significantly decreased in all patients compared to healthy controls. 2. TDT analysis: (1) Strong LD was found between rs3753116 and rs7830490 (D'=0.851, r2=0.369), mild LD was found between rs3753118 and rs3753116 (D'=0.495, r2=0.165), and weak LD between rs3753118 and rs7830490 (D'=0.196, r2=0.029). (2) SNP rs3753118, rs3753116, rs7830490 were observed to be associated with schizophrenia by TDT (P<0.05). (3) The haplotype rs3753118-rs7830490 and rs3753118-rs3753116-rs7830490 were associated with schizophrenia (P<0.05). 3.Association analysis between ASAH1 gene and symptom quantitative trait: (1) There were significant difference of the Positive score among patients grouped upon genotypes in rs3753118, and the total PANSS score and Negative score were significant different among patients grouped upon genotypes in rs3753116 (P<0.05). (2) The total PANSS score and the Negative score of patients with rs3753118C-rs3753116G haplotype, with rs3753118C-rs3753116G-rs7830490A haplotype, were higher than that of reference haplotype (P<0.05).

Conclusions: ASAH1 gene was linked with schizophrenia and might be a positional susceptibility gene of Chinese Han schizophrenia. There might be symptom quantitative trait locis of schizophrenia on ASAH1 gene.

•  W01-2

精神分裂症 8p 基因 NRG-1 的 关联研究及基因相互作用研究 - Association Study of NRG-1 and Gene-gene Interaction between NRG-1 and ASAH1 Indicate 8p Might be the Susceptibility Genetic Area of Schizophrenia

HuaiHui Zhang 1

1 Shanghai Mental Health Center , Shanghai , Chinese Mainland

目的 : 探索位于 8 号染色体短臂 （ 8p ） 的神 经胶质细胞生子因子 1 （ NRG-1 ） 基因与精神分裂症易感性之 间的关系 ； 探索同样位于 8p 的 NRG-1 与 ASAH1 基因 间的相互作用。

方法 : 应用 PCR-RFLP 检测 254 个精神分裂症核心家系 NRG-1 基因上的 2 个 标签 SNPs （ rs2439322 和 rs16879809 ）， 进行 LD 、 TDT 、 HHRR 及 单体型 TDT 分析。使用 PANSS 量表 评定 254 例精神分裂症患者疾病表型的数量性状，使用 单因素方差分析、 UNPHASED 软件的 QTPHASE 程序等比 较在 2 个 SNPs 位点具有不同基因型、等位基因、 单体型的患者的 PANSS 量表 评分。使用 MDR 软件对 NRG-1 基因的 2 个 SNPs （ rs2439322 、 rs16879809 ）和 ASAH1 基因的 3 个 SNPs （ rs3753118 、 rs3753116 和 rs7830490 ）基因分型数据， 进行基因相互作用分析。结果 :1. （ 1 ）位点 rs2439322 － rs16879809 之 间存在弱 LD （ D'=0.178 ， r2=0.024 ）。（ 2 ） TDT 和 HHRR 分析 显示： NRG-1 基因 SNPrs2439322 和 SNPrs16879809 与精神分裂症不存在阳性 关联（Ｐ >0.05 ）。（ 3 ） 单体型 TDT 分析 显示：单体型 rs2439322 － rs16879809 与精神分裂症存在阳性 关联（Ｐ <0.05 ），其中 单体型 rs2439322C － rs16879809T 为精神分裂症的风险单体型（Ｐ <0.01 ）。 2. NRG-1 基因与精神分裂症数量性状的 关联分析：研究 NGR-1 基因 2 个 SNPs 基因分型数据和 PANSS 评分间的关系，未有阳性发现（Ｐ >0.05 ）。 3. MDR 软件分析结果显示： 4 位点（ rs3753118 、 rs7830490 、 rs2439322 和 rs16879809 ）的模型有 统计学意义（ P<0.05 ）。 结论 :1. 研究 结果提示 NRG-1 基因 单体型 rs2439322 － rs16879809 与精神分裂症 关联， NRG-1 基因可能是中国 汉族人群精神分裂症的位置性易感基因。 2.NGR-1 基因 SNPrs2439322 和 SNPrs16879809 位点与精神分裂症的症状数量性状可能无 关联。 3.NRG-1 基因与 ASAH1 基因可能存在相互作用，并可能和精神分裂症的 发病风险关联。 4.8 号染色体短臂 较强的连锁信号可能和 NRG-1 与 ASAH1 基因的 联合作用有关。 8 号染色体短臂可能是精神分裂症的易感基因区域，可能含有多个精神分裂症候 选基因。

Objective ： To explore the genetic susceptibility of 8p gene NRG-1 in schizophrenia. To explore the gene-gene interaction between NRG-1 and ASAH1 who are all located in 8p.

Methods ： Two tag SNPs (rs2439322 and rs16879809) of NRG-1 in 254 schizophrenia trios were genotyped by using PCR-RFLP, and LD, TDT and HHRR were analyzed by using EMLD, UNPHASED and TRANSMIT softwares. PANSS was used to quantify the phenotypes of schizophrenia. One-Way ANOVA and the QTPHASE of UNPHASED2. 4 were used to compare the PANSS score between different genotypes, alleles and haplotypes. The gene-gene interaction between 2 SNPs (rs2439322 and rs16879809) of NRG-1 and 3 SNPs of ASAH1 (rs3753118, rs3753116 and rs7830490) were analyzed by using MDR software and the NRG-1 and ASAH1 genotyped datas of 254 trios.

Results: 1.(1) Weak LD was found between rs2439322 and rs16879809 (D'=0.178, r2=0.024). (2) Two SNPs were not observed to be associated with schizophrenia by TDT and HHRR (P>0.05). (3) Haplotype TDT analysis showed rs2439322 － rs16879809 was associated with schizophrenia (P<0.05), and identified a risk haplotype rs2439322C － rs16879809T (P<0.01). 2.There was no significant difference of the PANSS score among patients grouped upon different genotypes, alleles and haplotypes of NRG-1 SNPrs2439322 and SNPrs16879809. 3. MDR revealed that the pattern with 4 SNPs (rs3753118, rs7830490, rs2439322 and rs16879809) had statistical significance (P<0.05).

Conclusions: 1. The NRG-1 rs2439322 － rs16879809 haplotype was associated with schizophrenia, and indicated that NRG-1 might be a positional susceptibility gene of schizophrenia. 2. There might be no relationship between symptom quantitative trait of schizophrenia and NRG-1 gene. 3. There might exist gene-gene interaction between NRG-1 and ASAH1, and it could increase the risk for schizophrenia. 4. The strong linkage signal of 8p might be associated with gene-gene interaction of ASAH1 and NRG-1. 8p might be the susceptibility genetic area of schizophrenia and might exist a number of schizophrenia candidate genes.

•  W01-3

ω -3 多不 饱和脂肪酸对慢性轻度应激抑郁症大鼠模型作用的基因芯片研究 - Gene Expression in Hippocampus Alteration Induced by n-3 Polyunsaturated Fatty Acids in Chronic Mild Stress

XiaoYun Guo 1

1 Shanghai Mental Health Center , Shanghai , Chinese Mainland

Objective: The aim of the present study is to explore the antidepressant-like effect of n-3 polyunsaturated fatty acids in gene expression in hippocampus in CMS rats.

Methods: The whole experiment lasted for 8 weeks. Twelve male Sprague-Dawley rats were subjected to the CMS for 4 weeks, then subdivided into 3 groups, which were administered with venlafaxine （ 2.5 mg·kg-1·d-1 ） (3 rats), fish oil （ 0.72g·kg-1·d-1 ） (3 rats) and saline （ 4 mg·mg·kg-1·d-1 ） (6 rats) for 4weeks. And then all rats were killed by decapitation next day. The hippocampus were carefully dissected and stored at -80 ℃ . The total RNA was abstracted and then transcribed into cRNA. The cRNA were labeled with Cy5 and Cy3. The microarrays with more than 10,003 genes were hybridized against the cRNA probe mixture. The fluorescent signals were scanned.

Results: (1)n-3 polyunsaturated fatty acids regulated gene: ① 36 genes were regulated in fish oil treated stress groups when the ratio of Cy5/Cy3 signals was more than 2.0 or less than 0.5. Out of these 36 genes, 12 genes were up-regulated and 23 down-regulated. ② 202 genes were regulated in fish oil treated stress groups when the ratio of Cy5/Cy3 signals was more than 1.67 or less than 0.67. Out of these 202 genes, 71 genes were up-regulated and 131 down-regulated. Fish oil regulated genes included neuroimmune gene, signal pathway gene, neurotransmitter gene, neuropeptide related gene and others. (2)Venlafaxine regulated gene: ① 10 genes were up regulated in venlafaxine treated stress groups when the ratio of Cy5/Cy3 signals was more than 2.0 or less than 0.5. ② 80 genes were regulated in venlafaxine treated stress groups when the ratio of Cy5/Cy3 signals was more than 1.67 or less than 0.67. Out of these 80 genes, 54 genes were up-regulated and 26 down-regulated. Venlafaxine regulated genes included drug transporter gene, ion channel gene, neurodevelopment gene, neural plasticity gene and other genes. (3) 35 genes were co-regulated by n-3 polyunsaturated fatty acids and venlafaxine. ① 35 genes were regulated in venlafaxine treated stress groups when the ratio of Cy5/Cy3 signals was more than 1.67 or less than 0.67. Out of these 35 genes, 16 genes were up-regulated and 19 down regulated. ② No genes were regulated in venlafaxine treated stress groups when the ratio of Cy5/Cy3 signals was more than 1.67 or less than 0.67. N-3 polyunsaturated fatty acids and venlafaxine co-regulated gene include neuropeptide, neurotransmitter, GABA receptor, and mitochondria apoptosis, TNF related gene and other genes.

Conclusions: (1) The mechanism of antidepressant effect of N-3 polyunsaturated include the regulation of neuroimmune gene, signal pathway gene, neurotransmitter gene, neuropeptide related gene and other genes. (2) The mechanism of antidepressant effect of Venlafaxine includes the regulation of drug transporter gene, ion channel gene, neurodevelopment gene, neural plasticity gene and other genes. (3) N-3 polyunsaturated fatty acids and venlafaxine have co-regulated and solo-regulated genes.

W02 - The Happy Life: Voyages to Well-being
Chairs: Robert Cloninger, United States
Huanlin Wang, Chinese Mainland

W03 - In the Psychiatrists Chair - An Interview with a Patient Suffering Strange and Unusual Symptoms
Chairs: Raj Persaud , United Kingdom
Xueli Sun, Chinese Mainland

一名病人将由 Raj Persaud, Gresham 教授 进行访谈 ， 为了公众对于精神病学的了解 ， 来显示面临困境的医生对于极端情绪交替导致的难以管理行为的诊断和处理上的问题。经过 10 年以上 严重的症状问题 ， 这名病人的症状通过采用某些有趣的治疗策略后好转了。处理情绪交替发作的新方法将被讨论。

A patient will be interviewed by Professor Raj Persaud, Gresham Professor for Public Understanding of Psychiatry, to illustrates issues over diagnosis and management in the predicaent commonly faced by doctors of extreme mood swings leading to difficult behaviour. After over 10 years of extremely problematic symptoms this patient has been better after some interesting treatment strategies were implemented. Novel approaches to the Management of mood swings will be discussed.

W04 - 健康与心理疾病 – 药物模式的变化 ？Health and Mental Diseases - A Change of Paradigm in Medicine?
Chairs: Friedrich Zikes , Austria
Keqing Li, Chinese Mainland

a) 变化的模式意味着失去能力还是走向合作 ？

a1) 协调与不协调的平衡与不平衡与其效果

a2) 不平衡究竟存在于哪里 ？

a3) 解决症状 还是解决问题 ？

a4) 从疾病的 敌人到健康的朋友

a5) “ 简单预防 ” 可以 满足内科医生们吗 ？

b) 忍受与疼痛有意 义吗 ？

b1) 在 进展过程中的疾病与进步

b2) 庇 护到疾病

c) 心理 卫生与什么关于 ？

c1) 这个问题的意义与理解

c2) 对操作步骤有助的工具 helpful tools for handling processes

c2) 预防的有力工具

d) 移情 - 对痊愈过程有效的兴奋剂、

d1) 影响神 经突触 ， 细胞和新神经元习得机制

d2) 移情影响依从性 ， 治 疗效果和康复

e) 躯体与灵魂 - 对立还是统一 ？

e1) 治 疗考虑的重点

e2) 整体的两部分 还是不同问题 ？

e3) 各学科 间交流的优势

f) 依从性 - 低估和未被 发现

f2) 生物 积极的 “ 情感信号 领域 ” 的 应用

f3) 不同 领域互动的行为

g) 病人能力中的未 发现资源

g1) 病人的信仰内容作 为治疗潜能

g2) 应用信仰还是失去病人的信心

h) 各学科 间合作 – 会起作用 吗 ？

a1) 运用不同的渠道会 产生阻碍还是优势 ？

a2) 内科学的 ， 心理学的和 经济学的优势

a) changing paradigm means loosing competences or getting access to partnership?

a1) the (im)balance of harmony and disharmony and their effects

a2) where does imbalance actually exist?

a3) fighting symptoms or solving problems?

a4) from enemies of illness to friends of health

a5) will “simply prevention” may satisfy medical doctors?

b) May suffering and pain make sense?

b1) illness and progress in evolutionary processes

b2) refuge to sickness

c) What's about psycho-hygiene?

c1) meaning and understanding on that issue

c2) helpful tools for handling processes

c2) a mighty instrument of prevention

d) Empathy – an effective energizer in terms of recovery-processes

d1) influence to synapses, cytokines and novel neural learning

d2) empathy influences to compliance, treating-effects and recovery

e) Body and soul – contrast or unity?

e1) priorities concerning treatment

e2) two features of an entity or different issues?

e3) advantages of interdisciplinary accesses

f) Compliance - underrated and undiscovered

f2) the use of bio-energetic “emotional signature fields”

f3) behaviour on different fields in transaction

g) Undiscovered resources in patient's capacity

g1) patient's believe-contents as healing-potentials

g2) using the faith or loosing the confidence of patients

h) Interdisciplinary co-operation – does it work?

a1) will different accesses create obstacles or advantages?

a2) medical, psychological and economic advantages

W05 - 工作坊 ： 心理 动力学诊断 （ OPD ） 与治 疗 - Psychodynamic Diagnostics (OPD) and Therapy
Chairs: Gerhard Schuessler , Austria
Jianyin Qiu, Chinese Mainland

一 种被普遍接受的观点是诊断描述必须同治疗相适应。然而 DSM-IV 和 ICD-10 诊断系统并不能很好地满足这个需要，尤其是对心理治疗而言。操作性心理动力学诊断 (OPD) 是一 种描述不同人际关系与心理功能的工具，以此来伟不同治疗方法提供指导。本工作坊将重点强调人格结构诊断轴。并提供治疗指导。

There is a commonly shared view that diagnostic descriptions should be relevant for therapy. However DSM-IV and ICD-10 diagnoses do not fulfill this needs very well - especially for psychotherapy. The Operationalized Psychodynamic Diagnostics (OPD) are a tool to describe different interpersonal and mental functions in order to give guidelines for different therapeutic procedures. The axis personality structure will be especially stressed in this workshop. Therapeutic guidelines are presented.

W06 - 遗传精神医学 - Genetics in Psychiatry II
Chairs: KaiDa Jiang, Chinese Mainland
Lingjiang Li, Chinese Mainland

本工作坊邀 请复旦大学医学院、上海交通大学医学院精神医学专业的博士研究生介绍她们最新完成的博士课题中有关遗传学的研究内容 ， 主要包括精神分裂症易感基因研究、 ω -3 多不 饱和脂肪酸对慢性轻度应激抑郁症大鼠模型作用的基因芯片研究、抑郁症大鼠额叶皮层 5-HT2AR 和 SERT 基因表达、以及西 酞普兰对 SERT 转运功能影响的电生理学观察。内容涉及精神医学遗传学研究的多个方面 ， 每一项研究都有一定的创新性甚至处于国内领先水平。我们期待相关人士参与和讨论。

This workshop invited the psychiatric Drs of Fudan University and Shanghai Jiaotong University to introduce their newest genetic psychiatry studies, including the study of predisposing genes in schizophrenia, gene expression in hippocampus alteration induced by n-3 polyunsaturated fatty acids in chronic mild stress, expression of 5-HT2A Receptor and Serotonin Transporter Genes in the Frontal Cortex of Depression Rats, and the electrophysiological effects of Citalopram on the function of serotonin transporter. This workshop involved in several aspects of genetic psychiatry, and every study brings some new ideas even be leading level in internal. We expect your participation and discussion.

•  W06-1

抑郁症大鼠 额叶皮层 5-HT2AR 和 SERT 基因表达 - Expression of 5-HT2A Receptor and Serotonin Transporter Genes in the Frontal Cortex of Depression Rats
Ye Zhang 1
1 Shanghai Mental Health Center , Shanghai , Chinese Mainland

目的 ： 探 讨抑郁症大鼠额叶皮层中 5- 羟色胺 2A 受体和 5- 羟色胺转运体基因的表达 , 并考察西 酞普兰的影响。

方法 ： 采用 CUMS 方法在 SD 大鼠上建立抑郁症模型 ， 与 对照组相比 ， 抑郁症组表现出水平、垂直活动及糖水消耗量减少 ， 而西酞普兰则可以部分逆转这些征状。随后，采用定量 PCR 的方法 检测了各组动物额叶皮层内 5-HT2AR 和 SERT 基因的表达水平。

结果：

1) 与 对照组比较，抑郁症组大鼠额叶脑组织内 5-HT2A R 基因表达水平降低（ P=0.001 ）；西 酞普兰组与对照组相比较， 5-HT2A R 基因表达水平无 显著性差异（ P=0.348 ），与抑郁症 组相比显著升高（ P=0.014 ）；

2) 在雄性 动物中，抑郁症组和西酞普兰组动物脑组织内 5-HT2A R 基因表达水平 显著低于对照组（ P 值分别为 0.024 和 0.001 ）；在抑郁症 组和西酞普兰组动物之间该基因的表达水平无显著差异（ P=0.573 ）。雌性 动物中，抑郁症组动物脑组织 5-HT2A R 基因表达水平 显著低于对照组，（ P=0.002 ）；西 酞普兰组显著高于抑郁症组（ P=0.002 ）； 3) 在雄性 动物中，对照组、抑郁症组和西酞普兰组 SERT 基因表达无 显著性差异。雌性动物中，抑郁症组和西酞普兰组均明显低于对照组 . 结论：在慢性中等强度应激刺激下，大鼠左额叶脑区 5-HT2AR 基因表达减弱；西 酞普兰能 提高 5-HT2AR 基因表达水平， 这种效应具有性别依赖性，在雌性动物中更加显著。

Subject: To explore the possible alterations in 5-HT2A receptor and serotonin transporter (SERT) gene expression in the cortex in a rat model of depression and to observe the influence of Citalopram.

Methods: A rat model of depression was established by applying chronic unpredictable mild stress (CUMS). Compared with controls which were sham-stimulated, depression animals exhibited reduced motor activity and consumption of sweet water. Citalopram partially reversed these “signs” of depression. SYBSYBGreenI real-time PCR method was used to detect the expression levels of 5-HT2A receptor and SERT genes in the animals' frontal cortex:

Results:

1. Compared with controls (n=13), 5-HT2AR gene expression level was significantly lower in the depression group (n=25, P=0.001). Citalopram treatment seemed to enhance 5-HT2AR expression in that expression level in the treatment group (n=24) was not significantly different from the control group (P=0.348) and was markedly higher than in depression animals (P=0.014).

2. In male animals of depression (n=13) and Citalopram group (n=12), 5-HT2AR gene expression levels were both lower than that of the control male animals (P=0.001 and 0.028, respectively); but there was no significant difference in the expression levels between depression and Citalopram-treated males. In female animals, 5-HT2AR gene expression was significantly lower in depression group than in the controls （ P=0.002 ） . Citalopram-treated females had a significantly higher level of 5-HT2AR gene expression than in depression females （ P=0.002 ） and was not significantly different from that in control females （ P=0.839 ） .

3. SERT gene expression levels were not significantly different among the three groups. Taking the gender into account, we found that SERT gene expression levels in male animals were similar among the three groups. However, SERT gene expression levels in females animals of the depression group and Citalopram group were lower compared with that of control females (P=0.039 and 0.045, respectively). There was no notable difference between depression and Citalopram-treated females (P=0.690).

Conclusions: Chronic unpredictable mild stress-induced depression appeared to be associated with down-regulation of 5-HT2AR gene expression in the frontal cortex without overt alteration in SERT expression. Citalopram was able to enhance 5-HT2AR gene expression in depression animals. 5-HT2AR and SERT gene expression and the influence of Citalopram is gender-dependent.

•  W06-2

儿茶酚胺氧位甲基 转移酶基因多态性与迟发性运动障碍的关联研究 - Association Study between Catechol- 0-Methyltransferase Gene Polymorphism and Tardive Dyskinesia
Weihong Hu 1 , Kaida Jiang 1 , Dongxiang Wang 1
1 Hua Shan Hospital , Fudan University , Shanghai , Chinese Mainland

目的 ： 探 讨中国汉族人口中儿茶酚胺氧位甲基转移 酶 (COMT) 基因 Val108/158Met 多 态性与迟发性运动障碍 (TD) 的 关系。

方法 ： 以 124 例伴 TD 的精神分裂症患者 (TD 组 ) 、 112 例不伴 TD 的精神分裂症患者 ( 非 TD 组 ) 及 112 例正常健康 对照者 （ 正常对照组 ） 为研究对象 ， 并采用聚合酶链反应 - 限制性片段 长度多态性 (PCR-RFLP) 技 术检测 COMT 基因多 态性。

结果 ： (1) TD 组与非 TD 组及正常对照组比较 ， 等位基因及基因型频率均无统计学差异。 (2) 非 TD 组与正常对照组比较，非 TD 组的高活性 G 等位基因 频率（ 0.78 ） 显著高于正常对照组（ 0.70 ），低活性 A 等位基因 频率（ 0.22 ） 显著低于正常对照组（ 0.30 ）；非 TD 组低活性 A/A 基因型 频率（ 0.02 ） 显著低于正常对照组（ 0.07 ）。（ 3 ） COMT 基因型与 TD 严重程度具有显著相关性， A/A 基因型患者的 TD 严重程度评分显著高于 G/G 基因型。

结论： 本研究未 发现 COMT 基因与 TD 的 发生有关联。不伴 TD 的精神分裂症可能与 COMT 基因存在相 关性，高活性 G 等位基因可能增加了不伴 TD 的精神分裂症的 发生风险。 COMT 基因型与 TD 严重程度可能具有相关性，低活性 A/A 基因型患者可能 较高活性 G/G 基因型患者表 现更严重的 TD 。

关键词 : 儿茶酚胺氧位甲基 转移酶 多 态性（遗传） 迟发性运动障碍

Objective: To explore the relationship between catechol-O-methyltrans -ferase(COMT)gene Val108/158Met polymorphism and tardive dyskinesia(TD) in Chinese Han people ．

Methods: 124 schizophrenic patients with TD(TD group) ,112 schizophrenic patients without TD (non-TD group)and 112 normal controls (NC group)were studied using polymerase chain reaction(PCR)and restrictionfragment length polymorphism (RFLP)technique ．

Results: (1)Compared with non-TD group and NC group ,TD group hadn't statistical differences on the frequency of alleles and genotypes.(2)The frequency of allele G of non-TD group (0.78)was higher than that of NC group(0.70) ， and the frequency of allele A of non-TD group (0.22)was lower than that of NC group(0.30) ． The frequency of genotype A ／ A of non-TD group(0.02) was lower than that of NC group(0.07).(3)COMT genotypes were significantly associated with the severity of TD, and patients with genotype A ／ A had higher TD severity scores than those with genotype G ／ G.

Conclusion: The VallO8/158Met polymorphism of COMT gene isn't associated with TD in our studied sample, but it is associated with schizophrenia without TD. High activity allele G may increase the risk of schizophrenia without TD. COMT genotypes may be related to the severity of TD, and patients with low activity genotype A ／ A may have severer TD than those with high activity genotype G ／ G.

Key words: Catechol-O-methyltransferase ； Polymorphism(Genetics) ； Tardive dyskinesia

•  W06-3

西 酞普兰对 SERT 转运功能影响的电生理学观察 - The Electrophysiological Effects of Citalopram on the Function of Serotonin Transporter
Ye Zhang 1
1 Shanghai Mental Health Center , Shanghai , Chinese Mainland

目的 ： 探 讨西酞普兰对 SERT 功能的影响存在哪些特点。 方法 ： 采用 细胞内显微注射的方法将人类 SERT 基因 cRNA 注射到非洲爪蟾卵母 细胞内 ， 建立 hSERT 基因的异体表达系 统。随后采用双微电极电压钳技术观察西酞普兰对 SERT 介 导的 5-HT 转运电流的影响。

结果：

1) 将表达 hSERT 的非洲爪蟾卵母 细胞膜电位钳制在 -60 mV ，用含有 10 μΜ 5-HT 的任氏液灌流 细胞，可记录到 40-100 nA 的内向 5-HT 转运电流。

2) 西 酞普兰对 5-HT 转运电流具有阻断作用，这种阻断作用具有浓度依赖性（ IC50= 1.008 μM ）和 长时程效应。

3) 细胞内显微注射 cGMP 对 5-HT 转运电流有显著的抑制作用。 结论： 西 酞普兰能抑制 hSERT 对 5-HT 的 转运功能，并且这种抑制具有起效快、浓度依赖和长时程的效应。这可能是其抗抑郁作用的分子机制。

Subjects: To observed the effects of Citalopram on 5-HT transportation mediated by serotonin transporter.

Methods: Microinjection technique was used to structure the human SERT (hSERT) heterologious system. Then the effects of Citalopram on 5-HT transportation in Xenopus Oocytes heterologously expressing (hSERT) was observed using the two-electrode voltage clamp technique.

Results:

1. Oocytes were perfused with Ringers solution and voltage-clamped at –50 mV. When the extracellular solution was switched to Ringers containing 10 μ M 5-HT, an inward current ranging from 40 to 100 nA was registered in cells microinjected with hSERT genes but not in control cells pre-injected with vehicle. This current was blocked by the selective SERT blocker, Desipramine (10 μ M). Citalopram, like Desipramine, attenuated the 5-HT transporting current. The effect was of rapid onset, concentration-dependent and long-lasting. IC50 of Citalopram on 5-HT current was estimated to be 1.008 μ M.

2. We attempted to investigate the modulatory role of cGMP on hSERT by injecting cGMP intracellularly. There was evidence of cell injury after insertion of injection pippets in that the amplitude of 5-HT current declined gradually following injection of vehicle. However, following injection of cGMP, the decline in 5-HT current was greater compared with that following injection of vehicle

Conclusion: Citalopram was able to inhibit 5-HT uptake in Oocytes expressing hSERT and the effect was of rapid onset, concentration-dependent and long-lasting.

W07 - 双相障碍共病物 质滥用基于循证医学的处理 - Evidence-Based Management of Co-Morbid Bipolar and Substance Use Disorders
Chairs: Ihsan Salloum , United States
Wei Hao, Chinese Mainland

目的 ： 与其它精神疾病相比 ， 双相障碍合并酒精或其他物 质使用障碍的几率更高。针对此类人群的有效治疗干预手段依然十分有限。本工作坊将回顾针对该人群有实证依据的有效治疗方法。具体将讨论药物治疗与心理治疗。还将介绍新近完成的同时针对双相 障碍和酒精 / 物 质滥用的药物治疗与心理治疗的临床试验结果 ， 并且将就处理此类情况的可能治疗策略提出建议。

Objective: Bipolar disorder is associated with the highest frequency of alcoholism and other substance use disorder compared to any other major psychiatric disorders. Effective treatment interventions for this population are still limited. This workshop will review available, evidence based, treatment approaches for this population. Pharmacotherpeutic treatment and psychotherapeutic approaches will be discussed. Results from recently completed pharmacotherapy and psychotherapy clinical trials focusing on improving outcome for both, the bipolar disorder and the alcoholism/ substance abuse will be reviewed and potential treatment algorithm for the management of these conditions will be suggested.

W08 - 灵性在精神 卫生保健中的作用 - The Role of Spirituality in Mental Health Care
Chairs: Edgard Belfort , Venezuela
Pedro Ruiz, United States
Xin Ma, Chinese Mainland

内容 ： 在最近 20-30 年 间 ， 相对于所有类型的精神障碍和 / 或心理状 态而言 ， “ 灵性 ” 做 为一种有益的干预措施得到了越来越多的认可。尽管世界上许多地区对灵性的认识和应用已有几百年的历史，直到近来这种干预方法才在一些工业化国家中被大量的研究。当然全球化在 其中起到一定的作用。 如今 许多来自发展中国家的移民抱着改善其社会经济状况的目的移民至工业化国家的同时带来了他们的宗教信仰和宗教活动。同样的，精舍卫生专家对发展中国家的频繁访问使得他们对其他文化有了越来越多的了解。 在本工作坊内 ， 来自世界上不同地区的演 讲者将以其当前处境和当初受教养的经历 ， 呈现和交流他们将灵性做为其提供精神卫生保健服务的部分手段的感受、经验和应用方法。我们希望经验和专业知识的交流将使得与会精神卫生专业人员拓宽其对于精神卫生服务供给的视角

During the last 2-3 decades, there has been an increased recognition of "spirituality" as a beneficial mode of intervention vis-a-vis all types of psychiatric disorders and/or mental conditions. While this recognition and use of spirituality in many regions of the world for centuries, it was not until recently that this method of intervention has been observed quite frequently among industrialized nations. Certainly, the role of globalization has been a factor in this regard.

Nowadays, many migrants from evolving nations bring with them their religious beliefs and practices when they migrate to industrialized nations for the purpose to improve their socioeconomic conditions. Likewise, mental health professionals' frequent visits to evolving nations have permitted them to become more familiar with other cultures beside their own.

In this workshop, the presenters, who are from different parts of the world in terms of current location and original upbringing, will present and discuss their perception, experiences and utilization of spirituality as part of their approaches to mental health care delivery. Hopefully, this exchange of experiences and expertise will permit the mental health professionals who attend this workshop to enhance their views vis-a-vis mental health services provision.

•  W08-1

宗教和女性精神健康的冲突 - Tensions between Religion and Women's Mental Health
Nada L. Stotland 1
1 American Psychiatric Association, President-Elect, Chicago , Illinois , United States

灵性和宗教在女性精神健康中起到核心作用。然而一些主要宗教的教 义可能压迫或要求妇女处于利益受损的境地。精神科医生的责任在于探讨宗教教义以明确法律 是否在家庭或公众中被 误解 ， 这里将用一个临床实例来呈现这种情形。宗教教义使得某患者难以意识到自己处于受虐待的境地，而这种境地严重威胁了她的精神健康。该患者可能具有自杀倾向，却相信如果自己离开了其家庭关系将会下地狱。宗教神圣的背景下一个更为严峻的考验是如何使得患者在拯救自己和她的子女免受虐待的同时仍然保持其精神力量。

Spirituality and religion are central to women's mental health. However, the tenets of some major religions may pressure or require women to remain in situations detrimental to their well-being. It is the responsibility of the treating psychiatrist to explore the teachings of the religion in question to determine whether its laws are being misinterpreted in the family or congregation. Such a situation will be illustrated by a clinical case example. Religious dogma made it difficult for a patient to realize that she was in an abusive situation gravely threatening to her mental health. She was suicidal, but convinced that she would go to hell if she left the relationship. A more rigorous examination of the sacred texts enabled the patient to maintain her spiritual strength while rescuing herself and her children from the abuse.

•  W08-2

The Role of Spirituality in Mental Health

Edmond H.T. Pi 1

1 USC School of Medicine, Department of Psychiatry, Los Angeles , California , United States

据 报道灵性同精神病理学、心理社会功能和治疗结局的改善有关。这种改善可以解释为灵性构成了洞察力、意义、目的、幸福、福利、希望和对于环境是有意义的信仰。 DSM-IV 中的文化 标准大纲提出灵性 / 宗教 应被做为病史收集、评估和治疗计划的一部分。本位将复习和讨论灵性在精神科评估工作中的临床意义；寻找在治疗过程中起到一定作用（正面或负面）的灵性因素；将灵性观点同其他治疗方法进行整合；将患者的灵性信仰合并进精神科治疗中以求达到最佳疗效；对精神健康中灵性的跨文化观点进行描述，特别是对于具有不同文化背景的群体的治疗。

Spirituality has been reported to correlate with improvement in psychopathology, psychosocial functioning and treatment outcome. This improvement has been explained based on that spirituality constitutes insight, meaning, purpose, happiness, well-being, hope, and beliefs that circumstances are not meaningless or in vain. The Outline for Cultural Formulation in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision published by the American Psychiatric Association recommends that spirituality/religion should be included as part of history taking, assessment, and treatment planning. This presentation will review and discuss the clinical significance of spirituality that arises in psychiatric assessment; identify spiritual issues that play a role (positive vs. negative) in the course of therapeutic process; integrate spiritual considerations with other therapeutic approaches; incorporate patients' own spiritual beliefs into psychiatric treatment to maximize the therapeutic benefits; and delineate a crosscultural perspective of spirituality in mental health, particularly in treating culturally diverse populations.

•  W08-3

福利的科学 — 在 临床实践中发展灵性价值观和福利的需要的证据 - The Science of Well-being - The Evidence of the Need to Foster Spiritual Values and Well-being in Clinical Practice

Russell D'Souza 1

1 Indo Australasian Psychiatric Association, Melbourne , Australia

精神 卫生专业人员和他们的病人越来越多的意识到人类的基本需要做为一种意义来源比个体本身更为重要。专业人员致力于降低精神障碍致残率的实践目标和 by the heart felt wishes of the suffering for their therapists to recognize of the need for self transcendence 推 动了这种认识的提高。这些都导致精神卫生专业人员和普通公众越来越多的认识到在临床实践中培养灵性和福利的需要。我们现在可以看到这样一种趋势，即专业工作的培训聚焦于发展 健康和幸福度，而非 单纯的同疾病做斗争。 本文将 讨论减少残疾的现实必要性以及对于福利科学的理解，后者包括对通向福利之路的自我意识阶段。并且以群体神经生物学的观点对福利进行讨论。最后讨论源自治疗的福利的发展情况，诸如 Cloninger 的 “ 通往福利的幸福生活之航 ” 和 D'Souza 的 “ 从灵性角度促 进福利治疗的疗效 ”…… 。我将 强 调任何人都必须敢于质疑权威并且注重自我努力以便从自己那里得到答案。这将使得我们去关注建立在源于同情和包容的心理 — 生物学原 则之上的灵性，而不是拘泥于源自恐惧和不宽容之上的教条式判断。因此，只有以 一 种科学和客观的态度去对待灵性，我们才能够

Mental health professionals and their patients are increasingly aware of the basic need of all human beings for a source of meaning that is greater than one's self. This growth in awareness is driven by the professional's practical goal of reducing disability from mental disorders and by the heart felt wishes of the suffering for their therapists to recognize of the need for self transcendence. This has resulted in mental health professionals and the general public's growing awareness of the need to foster spirituality and well-being in clinical practice. We now see a groundswell of professional work to focus on the development of health and happiness, rather than merely to fight disease and distress.

This presentation will consider the practical necessity to reduce disability, and understanding the science of well-being including the stages of self-awareness on the path to well-being. Considering the interpersonal neurobiology view of well-being. Ultimately discussing the developing of well-being through therapies such as Cloninger's “The happy life- Voyages to well-being” and D'Souza's The Spiritually Augmented Well-being therapy.. I would emphasize that each person must question all authorities and focus on providing private exercises by which they can obtain answers for themselves. This allows attention to spirituality based on principles of psychobiology with roots in compassion and tolerance, rather than on the basis of dogmatic judgments that are rooted in fear and intolerance. Thus only by addressing spirituality in a scientific and non judgmental manner can we make psychology and psychiatry into a science of well-being that is able to reduce stigma and disability of psychological disorders.

W09 - 精神分裂症的自由基代 谢障碍 - Free Radicals Metabolism Abnormabilities in Schizophrenia

Chairs: Dongfeng Zhou, Chinese Mainland
Yizhuang Zou, Chinese Mainland and

W09-1

抗精神病 药对精神分裂症患者抗氧化物酶、脂质过氧化物、脑源性神经营养因子的影响 - Antioxidant Enzymes, Lipid Peroxidation and Brain-Derived Neurotrophic Factor in Different Forms of Schizophrenia Treated with Typical and Atypical Antipsychotics

Yunlong Tan 1

1 Beijing Huilongguan Hospital , Beijing , Chinese Mainland

目的 : 探 讨精神分裂症患者血浆超氧化物歧化酶 （ SOD ） 、 过氧化氢酶 （ CAT ） 、谷胱苷 肽过氧化物酶 （ GSH-PX ） 活性及血清丙二 醛 （ MDA ） 、 脑源性神经营养因子 （ BDNF ） 水平的相互作用及与精神病理症状、抗精神病 药治疗间的关系。

方法 : 分 别采用分光光度法和酶联免疫法对 92 例服抗精神病 药的慢性精神分裂症患 者 （ 偏 执型 34 例、未定型 18 例、残留型 40 例 ） 及 50 例正常 对照组的血浆 SOD 、 CAT 、 GSH-PX 活性、 MDA 水平和 BDNF 浓度进行测定 ， 疾病组与正常对照组在性别、年龄、吸烟史及药物滥用史方面相匹配 ， 分析这些指标与抗精神病药及精神病理症状之间的关系。

结果 : （ 1 ） 疾病 组和正常对照组之间 MDA 水平 ， SOD 、 GSH-PX 活性有 显著差异 ， CAT 活性无 显著性差异 ， 男女性患者间三个酶的活性均无显著性差异 （ P>0.05 ）， 但 MDA[ 男 ：（ 6.0±5.3 ） nmol/ml ； 女 ：（ 11.9±8.3 ） nmol/ml] 水平差异 显著 ； 疾病组 BDNF 水平 [ （ 7.3±2.6 ） ng/ml] 显著低于正常组 [ （ 9.9±4.3 ） ng/ml] （ 2 ） 疾病 组中服用氯氮平 （ 44 例 ） 、利培 酮 （ 20 例 ） 、第一代抗精神病 药 （ 28 例 ） 之 间 MDA 水平 ， SOD 、 GSH-PX 、 CAT 活性 ； BDNF 水平 氯氮平组 [ （ 7.8±2.7 ） ng/ml] 显著高于利培酮 [ （ 5.1±1.7 ） ng/ml] 和典型抗精神病 药组 [ （ 6.9±2.4 ） ng/ml] ， 利培 酮与典型抗精神病药间无显著差别 ；（ 3 ） 疾病 组 SOD 与 GSH-PX 、 SOD 与 MDA 、 BDNF 与 SOD 显著正相关性、 BDNF 与 MDA 显著负相关 ， 正常组抗氧化物酶和 MDA 之 间、 BDNF 与抗氧化 酶及 MDA 间无显著相关。（ 4 ） SOD 与阳性症状、 阴性症状和 PANSS 总分显著正相关， CAT 与 阴性症状、一般性精神病理分和 PANSS 总分有显著的负相关性， GSH-PX 活性、 MDA 与 临床精神病学之间无显著相关； BDNF 浓度与 PANSS 阴性症状分显著负相关，与抗精神病药物剂量。

结论 : （ 1 ）神 经保护因素、自由基代谢间的相互作用可能是精神分裂症疾病发生、发展的重要因素；（ 2 ）抗精神病 药可能通过该体系影响疾病的进程。

Objectives: To investigate the relationship among the serum BDNF concentrations, the plasma malondialdehyde (MDA) levels, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT) activities and psychopathlogical symptoms and neuroleptic medications respectively.

Methods: The serum BDNF concentrations, the plasma MDA levels, SOD, GSH-Px and CAT activities were analyzed using established procedures in 92 medicated schizophrenia as well as in control subjects (n =50). Psychopathlogical symptoms were assessed by using the positive and negative symptoms scale (PANSS). To analyze the relationship between the biochemical measures and subscores in the PANSS and antipsychotic medications.

Results: (1) The results showed that activities of SOD and GSH-Px were decreased but levels of MDA were elevated in patients with a chronic form of schizophrenia as compared with normal controls. SOD and GSH-Px activities were found to be significantly decreased in disorganized and residual subgroups compared to the control group. However, there was no significant difference in CAT levels among all the groups. The serum BDNF of schizophrenic patients （ 7.3±2.6 ng/mL ） was significantly lower than those of the normal controls （ 9.9±4.3 ng/mL.

(2) There were no significant differences in any free radicals metabolism parameters measured among all three subgroups treated with clozapine (n =44), risperidone (n =20) and typical antipsychotics (n =28). Significant difference were found in the serum BDNF levels among the groups of patients treated with various antipsychotics ， those of the patients with clozapine treatment were significantly lower than of the patients with risperidone treatment.

(3) A significant, positive correlation was observed between SOD and GSH-Px or between SOD and CAT in the patient group. There was no significant correlation between antioxidant enzymes and MDA in normal controls. The relative coefficient of the level of BDNF and the activities of SOD, Gpx were 0.288 and 0.265, and with the level of MDA was –0.219. (4) There was a significant and positive correlation between SOD and positive subscore, negative subscore or PANSS total score. A significant and negative correlation was noted between CAT and negative subscore, general psychopathology subscore or PANSS total score. There was no significant correlation between GSH-Px or MDA and clinical psychopathology. The relative coefficient of the serum BDNF levels and the PANSS negative sub-score in chronic schizophrenics was -0.307.

Conclusions: (1) Interaction between neurotrophic factors and oxidative stress may be implicated in the pathophysiology of schizophrenia.

(2) Treatments with typical and atypical antipsychotics may produce effects on the antioxidant enzymes, lipid peroxidation and Brain-derived neurotrophic.

•  W09-2

吸烟 对精神分裂症男性患者临床症状、氧化应激、认知功能影响的研究 - Cigarette Smoking, Symptoms, Oxidative Stress and Cognitive Performance in Male Patients with Schizophrenia

Zhiren Wang 1

1 Institute of Mental Health, Peking University , Beijing , Chinese Mainland

目的 : 探 讨吸烟对精神分裂症患者临床症状 、氧化 应激、认知功能的影响 ， 从氧化应激角度探索精神分裂症高吸烟率的原因。

方法 : 收集慢性精神分裂症男性吸烟和非吸烟患者共 746 例。 对所有患者进行阳性和阴性症状量表 （ PANSS ） 、 锥体外系副反应量表 （ RSESE ） 、异常不自主运 动量表 （ AIMS ） 进行评定 ； 使用成套神经心理测验 （ RBANS ） 对部分患者进行认知功能评定 ； 严格按照试剂盒提供的方法 , 进行比色法测定吸光度 , 再按公式 换算 ， 检测部分患者血浆超氧化物岐化酶 （ SOD ） 、谷胱甘 肽过氧化物酶 （ GSH-Px ） 、 过氧化氢酶 （ CAT ） 活性以及丙二 醛 （ MDA ） 浓度。

结 果 : 吸烟 组 PANSS 阴性症状量表得分 (22.8±7.8) 明 显低于非吸烟组 （ 24.8±9.1) （ p=0.008 ） 。 RSESE 总分和 AIMS 总分在两组间分布无差异。由于两组年龄分布存在差异（ p=0.044 ） , 以年 龄为协变量作进一步分析，发现吸烟组 PANSS 阴性症状量表得分仍显著低于非吸烟组（ p=0.001 ），另外 还发现吸烟组 PANSS 总分（ p=0.020 ）和 RSESE 总分（ p=0.015 ）明 显低于非吸烟组。吸烟患者平均每天的吸烟量与 PANSS 阴性量表得分（ r ＝ -0.171 ， p=0.000 ）、 PANSS 总分（ r=-0.135,p=0.002 ）、 BPRS 总分（ r=-0.136,p=0.002 ）、 RSESE 总分（ r=-0.141,p=0.001 ）呈 负相关。 RBANS 的五个分量得分和 总分两组间无差异。吸烟组 CAT 活性明 显高于非吸烟组 (2.9±0.3 vs 1.6 ±0.2 U/ml) (F=4.39, df =1,91, p=0.04) 。 CAT 活性与 SOD(r=0.23, p=0.04) 和 GSH-Px (r=0.24, p=0.02) 存在正相 关， SOD 活性与吸烟数量存在正相 关 (r=0.24, p=0.04) 。吸烟 组 MDA 浓度显著低于非吸烟组 (9.2±0.7 vs 14.4 ±1.7 nmol/ml) (F=7.03, df =1,95, p=0.01) 。

结论 : 吸烟（通 过尼古丁）可能激活中枢尼古丁乙酰胆碱受体升高伏膈核和前额皮层多巴胺水平或减轻吸烟患者的氧化应激以自我治疗。

Objective: To explore the relationships between cigarette smoking, symptoms, oxidative stress and cognitive performance in schizophrenics, it is attempted to explain the reasons of higher rates of smoking behavior in schizophrenia through the way of oxidative stress.

Methods: 746 male chronic schizophrenic patients were collected. All patients were assessed with the Positive and Negative Syndrome Scale (PANSS), A Rating Scale for Extra pyramidal Side effects (RSESE ） and Abnormal Involuntary Movement Scale (AIMS).The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was adminstered as a measure of cognitive performance in some of these subjects.Furthermore, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) activities were also measured in plasma in partial patients.

Results: The negative PANSS symptoms were significantly lower in smokers than non-smokers (22.8±7.8 vs. 24.8±9.1, p=0.008). The RSESE and AIMS showed no differences. Due to significant difference in age between two groups (p=0.044), age was treated as a covariate, further analyses showed PANSS symptom associations remained significant, furthermore, the PANSS total scores and the RSESE total scores of smoking group were lower than non-smoking group(p=0.020;p=0.015,respectively). A greater number of cigarettes smoked per day was significantly associated with fewer negative PANSS scores (r ＝ -0.171,p=0.000), PANSS total scores （ r= -0.135,p=0.002 ） ,BPRS total scores （ r= -0.136,p=0.002 ） and RSESE total scores （ r= -0.141,p=0.001 ） .The RBANS total scores and its five index scores showed no differences between smokers and non-smokers. The CAT activity was significantly higher in smokers than non-smokers (2.9±0.3 vs 1.6 ±0.2 U/ml) (F=4.39, df =1,91, p=0.04). The CAT activity was correlated with both SOD and GSH-Px activities (r=0.23, p=0.04;r=0.24, p=0.02,respectively). Greater SOD activity correlated more cigarettes smoked (r= 0.24,p=0.04). MDA was significantly lower in smokers than non-smokers (9.2±0.7 vs 14.4 ±1.7 nmol/ml) (F=7.03, df =1,95, p=0.01).

Conclusions: Nicotine (cigarette smoking) might reduce oxidative stress of smokers with schizophrenia or raise dopamine levels in the nucleus accumbens and prefrontal cortex by activateing neural nicotinic cholinergic receptors, which might be a form of self-medication to alleviate negative symptoms and the side effects of antipsychotic medications.

W09-3

迟发性运动障碍的临床特征 - The Clinical Features in Patients with Tardive

Wufang Zhang 1

1 Beijing Huilongguan Hospital , Beijing , Chinese Mainland

Abstract text has not been submitted

W10 - 分离性精神障碍的治 疗 - Treatment of Dissociative Disorders

Chairs: Benjamin Keyes, United States
Heqin Yan, Chinese Mainland

推荐者将描述 对于分离性精神障碍进行心理治疗的原理、技术和具体病例分析回顾。以最多见的分离性身份障碍 （ DID ） 为例 ， 在对文献中预期治疗成果进行回顾后 ， 作者将阐述既往对于分离性身份障碍的一些误解 ， 然后具体描述其治疗典型模式 ， 创伤后应激障碍 ， 强迫性神经症以及其它以思维插入、感知觉、冲动、幻听为主的表现及其他当事者的精神体验。特殊治疗技术包括与内心的声音交谈、将分离的人格与现在的躯体整合在一起、战胜机体防御、建立一个治疗联盟、应对防御后的人格等。治疗包括按顺序进行对典型的创伤后恢复治疗 , 其中 强 调基础、渐进、稳定性和牵制政策。推荐者还将讨论关于在治疗中保持中立 ， 划清界限以及道德相关问题。报告最后将留出时间进行提问和回答。

The presenters will describe the psychotherapy of dissociative disorders by reviewing general principles, specific techniques and case examples. They will focus on dissciative identity disorder (DID), the most chronic and complex of the dissociative disorders. After a review of the prospective treatment outcome data in the literature, the authors will address a number of misconceptions about DID and then will describe a treatment model that applies to DID, posttraumatic stress disorder, psychoses, obsessive-compulsive disorder and other conditions characterized by intrusions of thoughts, feelings, impulses, auditory hallucinations and other psychic content into the executive self. Specific treatment techniques such as talking through to the voices, orienting alter personalities to the body and the present, overcoming host resistance, and forming a treatment alliance with the alter personalities will be covered. The therapy involves the sequenced stages of recovery typical of all trauma therapies, and includes an emphasis on grounding, pacing, stabilization and containment. The presenters will also discuss therapeutic neutrality and the need for good boundaries and ethics. Time will be left for questions and discussions.

•  W10-1

本杰明 ?B? 凯斯 - Contribution I to the Workshop "Treatment of Dissociative Disorders"

Benjamin Keyes 1

1 Ross Institute, Richardson , Texas , United States

凯斯博士将在洛斯博士介绍的基础上继续深入探讨。他将进一步描述分离性身份障碍的心理治疗的一般原理 ， 然后引用具体病例重点介绍特 殊治 疗技术。包括 : 与内心的声音交 谈 , 将分离的人格与 现在的躯体整合在一起，战胜机体防御，建立应对分离人格的治疗联盟，举例说明对于 DID 的具体心理治 疗技术。报告最后将留出时间进行提问和回答。

Dr. Keyes will follow up on the introduction to the topic by Dr. Ross. He will describe further general principles of the psychotherapy of dissociative identity disorder (DID) and then will focus on specific techniques through discussion and case examples. These will include: talking through to the voices; orienting alter personalities to the body and the present; overcoming host resistance; and forming a treatment alliance with alter personalities. The psychotherapy of DID illustrates the principles of treatment for other dissociative disorders as well. Time will be left for questions and discussion.

•  W10-2

科林 ?A? 洛斯 - Contribution II to the workshop "Treatment of Dissociative Disorders"

Colin Ross 1

1 Ross Institute, Richardson , Texas , United States

洛斯博士将描述一个用于心理治 疗的关于分离性精神障碍的结构模型。同样应用于创伤后应激障碍、强迫性神经症以及其它以思维插入、感知觉、冲动、幻听及其他当事者的精神体验。作者将说明既往对于分离性身份障碍的一些误解，然后具体描述其治疗的典型模式，包括治疗者应处于中立，要渐进式地进行，注意 容 纳性和稳定性，并且有好的伦理学和界限。

Dr. Ross will describe a dissociative structural model of the psyche that can be used in the psychotherapy of dissociative identity disorder (DID), posttraumatic stress disorder, psychoses, obsessive-compulsive disorder and other conditions characterized by intrusions of thoughts, feelings, impulses, auditory hallucinations and other psychic content into the executive self. He will address a number of misconceptions about DID and then will describe general principles of the therapy of DID including therapeutic neutrality; pacing, containment and stabilization; and the need for good boundaries and ethics.

W11 - 精神 强化健康的 认知治疗 - Spiritually Augmented Well-being Cognitive Behaviour Therapy

Chairs: Pedro Ruiz, United States
XuDong Zhao, Chinese Mainland

寻求意义是所有的人类的基本需求 ， 对这一点的认识日益增强 ， 远远超出了 个人的范畴。推 动这种认识增强的是我们想要减轻精神障碍病人的残疾、改善他们功能的现实目标，以及内心治疗师能够认识到受病痛折磨的患者对自我卓越的需求的愿望。最新的证据提示无论是使用精神药物还是各种心理治疗，对于提高普通人群生活满意度平均水平并无太大帮助。最近对健康的研究显示在那些健康人群以及部分精神障碍的人群中提高健康，减轻残疾是完全可能的。这种有实证支持的干预手段关注健康与快乐的发展，而不是仅仅同疾病和不幸作斗争。

目 标： 1. 描述精神 强化 认知治疗的演变。 2. 了解健康（ well-being ）科学与神 经生 物学基 础。 3. 了解精神 强化 认知治疗与健康精神医学的构成。 4. 学 习已有的随机对照研究。 5. 提供 应用精神强化认知治疗的基本框架。

The increasing awareness of the basic need of all human beings for a source of meaning that is greater than one's self. This growth in this awareness is driven by our practical goal of reducing disability and improved function from mental disorders and by the heart felt wishes of the suffering patients, for their therapists to recognize the need for self transcendence. (2) The evidence currently suggest there has been no improvement whatsoever in the average levels of life satisfaction in the general population as a result of the introduction of psychotropic drugs or manulaised forms of psychotherapy to the present time. (5) Recent work on well being has shown that it is possible to improve well being and reducing disability in general population as well as in most if not all mental disorders. (1, 4) This evidence based intervention focus on the development of health and happiness, rather than merely to fight disease and distress.

•  W11-1

如何 应用精神强化健康认知治疗的交互工作坊 - Workshop and Interactive Session on the Use of the Spiritually Augmented Well-being Cognitive Behavior Therapy

Russell D'Souza 1

1 Monash University Australia , Melbourne , Australia

SAWCBT 以 寻求健康为目标 ， 这超越了传统 CBT 的原 则 ， 这使得气质个性访谈中的心理自主管理特质部分的培养和锻炼同健康联系起来。通过增加存在主义的、精神的资源和正性情绪等重要维度来锻炼自我先验的个性特质，由此带来的积极结果是强化健康与功能。它是一种半定式的二重取向治疗。目标是赋予能力和自我治疗， 因此治 疗师在开始可以作为场上队长，但在过程中应该逐步变为教练。关键认知领域关注自我接纳、希望、寻求意义以及寻找目标，必要时还有宽恕。行为成分包括冥想和融合个体恰当的信念体系，包括宗教仪式与祈祷。这些都通过使用冥想和定期仪式性监测联系融入治疗中。还每周 7 天使用 7 级健康练习模式的接触反应序列来指导人们走向健康之路。 SAWCBT 在 纵向上合并了物理学与哲学、事件与精神、古老的东方智慧和前沿的有动力性结果证明的西方科学。 本工作坊将 涉及 灵性、虔 诚、道德的终结、以及针对灵活构建应对和再活化这一重要维度的重要性的研究证据。 健康的科学与神 经生物学 还将讨论以谨慎的方式审视精神历史的，以满足伦理的需求。 介 绍 CBT 的原 则与应用。内容涉及接纳、希望（激发并灌输希望）、最大化地综合使经验、创造性和态度来帮助他人跨过疾病与重重阻碍寻找新的意义和目的 , 治 疗师的工作是促使疾病与重重阻碍将会离开从而获得最大程度的重建，面对死亡成功地走上有意义 和目的的旅程。 还要考虑药物以及使用药物的问题。工作坊还将涉及有针对结局的科学证据支持的祈祷现象以及各种形式的祈祷以及仪式，采用监测表、支持性治疗和终止治疗。 随后将 讨论小组活动、工作坊、应用的 SACBT 随机 对照研究，今后的方向。

The SAWCBT in seeking its objectives of well being goes beyond the conventional principles of Cognitive behavior Therapy that enables the fostering and exercising the branches of mental self governance measured as character traits in the Temperament and Character Inventory that are associated with well-being.(6) The particular exercising of the self transcendental character trait by adding the important dimension of existential, spiritual resources and positive emotions brings significant positive outcomes to demoralization enhancing well being and function. This therapy is a semi structured bi directional therapy. Empowerment and self-therapy are the goals thus the therapist might start as the captain but during the course there is a sideward move of the therapist moving to the position of a coach. The key cognitive areas focus on Self Acceptance, Hope, Finding meaning and seeking purpose and when necessary traversing the dimensions of forgiveness. The behavioral components include meditation and incorporating the individual's appropriate belief system including rituals and prayers. These are incorporated into the treatment with the use of the meditation and ritual daily and weekly monitoring exercises. It further involves the use of a catalytic sequence of 7 well-being exercise modules for each day of the week to guide a person along the path to well-being. The SAWCBT incorporates the longitudinal blend of physics and philosophy, the practical and the spiritual, venerable Eastern Wisdom and the cutting edge western science with the evidence of dynamic results.

This workshop will cover the concepts of spirituality, religiosity, Demoralization and evidence from studies on the importance of this dimension in resilience building coping and remoralisation. The science and neurobiology of well-being The suggested format of taking a spiritual history, (3) which fulfils the ethical requirements and is done with sensitivity, will be discussed.

There will be an introduction to the Principles of Cognitive behavior therapy and its application. The Catalogue components of Acceptance, the dimensions of hope with principals of invoking and instilling hope, use of the meaning matrix together with the use of experiential values creative values and attitudinal values in helping one find new meaning and purpose beyond the catastrophic aspects of illness and set back, with in the constrains that illness and set backs might leave one in order that maximization of the reintegration on the journey that transcends successfully the task of facing mortality with success- a meaning anf purposeful journey. The issues around meditation and practice of meditation will also be considered. The phenomology of prayer and the various forms of prayer and rituals with available scientific evidence of outcomes together with the use of the monitoring forms, scheduling of booster sessions and termination sessions are part of the workshop. Group activity, workshoping, the presentation of Randomized controlled studies using the SACBT, future directions and readings will see the completion of the program for the day.

References:

1. D'Souza R Rich D, Diamond I Godfery K, An open randomised control study using a spiritually augmented cognitive behaviour therapy for demoralisation and treatment adherence in patients with schizophrenia. Australian New Zealand Journal of Psychiatry 2002; 36:A9

2. Russell D'Souza, Kuruvilla George, Religion Spirituality and Psychiatry: Its application to Australian clinical practice; Australasian Psychiatry Volume 14 Issue 4 Page 408 - December 2006

3.D'Souza R., Do Patients Expect Psychiatrists to be interested in Spiritual Issues? Australasian Psychiatry 2002; 10:09-22.

4. D'Souza R. incorporating a spiritual history into a psychiatric assessment. Australasian Psychiatry. 2003; 11.

5. D'Souza RF, Rodrigo A, Spiritually Augmented cognitive behavioral therapy. Australasian Psychiatry 2004; 12(2):148-152

6. Myers DG, Diener E. The pursuit of happiness. Science America 1996;274(5):70-72

Educational Objectives:

1. To describe the evolution of the spiritually Augmented Cognitive Behavior Therapy.

2. To understand the science and neurobiology of well-being

3. To understand the components of the SACBT and well being psychiatry

4. To study the randomized controlled studies that have been conducted

5. To provide a framework for the utilization of the SACBT well being Concept.

W12 - 国 际合作在促进精神卫生改革中的作用 - Role of International Collaboration in Facilitating Mental Health System Change

Chairs: Chee Ng, Australia
Yanling He, Chinese Mainland

中国北京大学精神 卫生研究所 （ 中国疾病预防控制中心精神卫生中心 NCMH ） 和 卫生部与亚澳精神卫生中心 （ AAMH ） 联手合作进行全国精神卫生服务体系改革。两国精神卫生工作方面长久的合作关系为此奠定了基础。一个 主要的 项目就是建立 “686” 以社区 为基础的精神卫生服务体系，包括要在全国的城市和农村建立 60 个服 务机构。目前这些地区各种各样的社区精神卫生服务体系正在建立。通过大量的交互访问、培训研讨、学习和评估以及国际咨询部的参与，我国地方和全国的社区保健和卫生改革都得到了很大的提高。目前考虑的就是要适当加强社区精神卫生保健和康复服务的工作人员的储备。在 NCMH 和 AAMH 联手下，一项三阶段的培训项目已经启动。香港中文大学负责高水平专业技能工作人员的全面培训。这些骨干工作人员经过在中国大陆、香港、墨尔本三地的培训后，将帮助 完成全国的培 训任务，促进精神卫生改革。接下去将要讨论改革中一些主要的经验教训与原理、以及国际合作产生的影响，为的是改革要有系统地进行，并且与我国的文化相符。

The Institute of Mental Health Peking University (National Centre of Mental Health in China CDC, NCMH) and the Ministry of Health, China has been working to support a program of mental health reform nationally with Asia-Australia Mental Health (AAMH) ( University of Melbourne and St Vincent 's Health). This has been based a long term collaborative relationship in mental health between both countries. A key program has been the establishment of the “686” community-based mental health service program involving 60 sites in both urban and provincial areas throughout China where various aspects of community mental health service delivery are being developed. Supported by numerous exchange visits, training seminars, an international advisory board, study programs and evaluation programs, the practice of community care and sustained reform have been enhanced at the local and national level. The current priority is to build workforce capacity to deliver appropriate community mental health care and rehabilitation. A tripartite training program has been conducted between NCMH, University of Melbourne (AAMH), and the Chinese University of Hong Kong to provide a comprehensive training program for groups of multi-skilled case workers. This core group of case workers with appropriate expertise trained in three locations in China , Hong Kong and Melbourne , will help to implement training and support the mental health strategy nationally. Key lessons, elements and impact of international collaboration in developing mental health system change that is both culturally and systematically appropriate will be discussed.

W13 - 中挪精神 卫生立法、伦理与人权合作项目 （ 工作坊 ） - Sino-Norwegian Cooperative Program on Mental Health Legislation, Ethical Dilemmas and Human Rights in Psychiatry

Chairs: Bin Xie, Chinese Mainland
Bjeon Oscar, Chinese Mainland

该工作坊的目的是为来自各地的年轻精神科医师提供机会讨论他们在日常精神卫生相关工作中出现的伦理与法律问题。其间将以圆桌会议的形式就一些典型案例进行逐步的讨论 ， 以此帮助与会者思考在现实情景的中法律规定和伦理困境。还将比较中国与挪威等其他国家在该领域的差异。在工作坊结束后将就在精神卫生法规和保护人权的要求下开展精神卫生服务的标准化和指导工作达成一些共识。

The aims of this workshop is to provide an opportunity for young psychiatrists come from local and regional area in discussing ethical and legal issues in their daily mental health relevant practice. Some typical cases will be presented during this workshop, and it will be followed by roundtable discussion step by step in order to let the participants thinking about legislation provisions and ethical dilemmas in the real situation. Comparison between China and other countries like Norway in this field will be made as well. Some mutual senses or opinions will be gained at the end of this workshop for the purpose of developing standards or guidance on psychiatric services practice under the requirement of mental health legislation and human rights protection.

W14 - 电休克治疗中的伦理学问题 - The Ethics of Practicing Electroconvulsive Therapy

Chairs: Tarek Okasha , Egypt
GaoHua Wang, Chinese Mainland

今年将迎来 电休克治疗 (ECT) 诞生 67 周年的 纪念 ， 是唯一一个经受住了时间考验的精神科治疗手段。在过去的 67 年中， ECT 用在了各 类精神疾病如精神分裂症，抑郁症，躁狂症及其他精神障碍的治疗中。在本工作坊中，我们将回顾 ECT 的 发展历史， ECT 治 疗中的管理技术，在躯体和大脑内的生理学效应。我们也将讨论最近有关 ECT 治 疗的工作模式以及关于不同的 ECT 机器和病人知情同意等 伦理学问题下的治疗禁忌症问题。由于超过 2/3 的精神障碍患者来自 发展中国家，因此在此将讨论发展中国家 ECT 的使用 问题。同时，新的联合治疗措施如快速经颅磁刺激 (r-TMS) ，迷走神 经刺激 (VNS) 及深度大 脑刺激 (DBS) 等与 ECT 的 关系也将被展开讨论。教学目标： 1) 了解有 关电治疗的起源； 2) 了解 ECT 的作用机制及其 对机体的生理作用； 3) 回 顾 ECT 治 疗中的监护管理技能； 4) 探 讨新的 ECT 联合治疗措施。

This year the world celebrates 67 years of electroconvulsive therapy (ECT), which is the only line of treatment in psychiatry that withstood the test of time. During the last 67 years, ECT was used for the treatment of psychosis including; schizophrenia, depression, mania and other psychotic disorders. In this workshop we will look at the historical development of ECT, the art of administration of ECT, with its physiological effects on the body and brain. We will also discuss the recent views regarding the mode of action of ECT, the contraindications if any, different ECT machines and the problems of ethics and patient consent. The use of ECT in developing countries will also be discussed since more than two thirds of the world's mental patients come from developing countries. Also, new allied treatments as rapid trans-cranial magnetic stimulation (r-TMS), vagal nerve stimulation (VNS) and deep brain stimulation (DBS) will be discussed with their relationship to ECT.

Educational Objectives:

1) Learn about the origin of treatment with electrical therapy

2) Understand the different mechanisms of action of ECT and it's physiological effects on the body.

3) Review the state of the art administration of ECT

4) Discuss new allied therapies to ECT.

W15 - 中国分离性精神障碍 调查资料研究 - Research Data on Dissociative Disorders in China

Chairs: Colin Ross, United States
Myron Belfer, Switzerland  

作者在上海精神 卫生中心进行了两项关于未确诊的分离性精神障碍的流行病学调查研究 ， 分别使用了中文版分离体验量表 （ DES ）， 分离性障碍 访问进度表 (DDIS) 和分裂症多 维目录 (MID). 。在第一 项研究中，抽取上海精神卫生中心的 1345 名住院病人和 门诊病人以及一个非临床的样本，使用 DES 和 DDIS 。在第二 项研究中，分别给予 50 名住院病人和 临床确诊的受访者 DES 、 DDIS 和 MID ， 测试的结果向被调查者保密。两项研究均证明，中国的临床病人中存在慢性复合型分离障碍患者，而这类障碍尚无法通过施加暗示和影响的方式来解决，因为受访者没有人知道自己罹患分离性精神障碍，没有人明确地给予他们分离性障碍的诊断和治疗，在中国传统文化中目前还没有相关的描述；并且分离性精神障碍还没有出现在 CCMD-3 中，也没有 应用于临床诊断中。在上海精神卫生中心门诊病人的 DDIS 调查中发现，有童年性虐待和身体受虐经历的患病率与加拿大温尼伯湖地区报告的数据十分相近，两个样本所报告的分离性精神障碍的水平也相近。这项资料支持了一个假设，即心理创伤后发生分离性精神障碍在多种文化中均可以有所体现。作者详细阐述具体调查资料，并对中国和北美分离性症状的不同表现作出比较。他们要求在中国以至全亚洲的其它人口中对此进行深入调查研究。基于深入的研究， CCMD 也会考 虑作出包含分离性精神障碍诊断的相应修订。

The authors have conducted two studies on the prevalence of undiagnosed dissociative disorders at Shanghai Mental Health Center , using Chinese versions of the Dissociative Experiences Scale (DES), the Dissociative Disorders Interview Schedule (DDIS) and the Multidimensional Inventory of Dissociation (MID). In the first study, the DES and DDIS were administered to 1345 participants, including inpatients and outpatients from Shanghai Mental Health Center and a non-clinical sample. In the second study, the DES, DDIS and MID were administered to a sample of inpatients and clinical diagnostic interviews were conducted with 50 participants: the interviewers were blind to the results of the DES, DDIS and MID. Both studies demonstrated that chronic, complex dissociative disorders exist in China and can be detected in clinical populations. The disorders cannot be accounted for by suggestion or contamination because none of the participants claimed to have a dissociative disorder; none had received a dissociative disorder diagnosis or treatment; dissociative disorders are not represented in the popular culture in China ; and they are not diagnosed in clinical pratice and do not appear in the Chinese diagnostic manual (CCMD-3). The outpatients at Shanghai Mental Health Center reported rates of childhood sexual and physical abuse on the DDIS similar to those reported by general population respondents in Winnipeg , Canada : both samples reported similar levels of dissociative disorders. These data support the hypothesis that dissociative disorders occur in a variety of cultures in response to psychological trauma. The authors will present the data in detail, and will discuss the differences between dissociative symptoms reported in China and North America . They will call for further study in other populations in China and elsewhere in Asia . Depending on the outcome of further research, consideration should be given to including dissociative disorders in future editions of the CCMD.

•  W15-1

科林 ?A? 洛斯 - Contribution I to the Workshop "Research Data on Dissociative Disorders in China"

Colin Ross 1

1 Ross Institute, Richardson , Texas , United States

科林博士将回 顾在上海精神卫生中心所做的两项研究资料。在第一项调查中 ， 1345 名受 访者完成 DES 和 DDIS ， 包括住院病人、 门诊病人和非临床病人样本。在第二项调查中， 50 名已确 诊的住院病人和受访者完成了 DES 、 DDIS 和 MID ， 测试结果对受访者保密。调查结果表明：在中国存在慢性复合型分离性精神障碍患者，且此类障碍尚无法通过施加暗示和影响的方式来解决。洛斯博士将进一步阐述如何 在 亚洲其它地区进行深入调查研究，并且力求将分离性精神障碍的诊断纳入 CCMD 。

Dr. Ross will review data on two studies conducted at Shanghai Mental Health Center . In the first study, 1345 participants completed the Dissociative Experiences Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS): this included inpatients, outpatients and a non-clinical sample. In the second study, the DES, DDIS and Multidimensional Inventory of Dissociation (MID) were administered to a sample of inpatients and clinical diagnostic interviews were conducted on 50 participants: the clinical interviewers were blind to the DES, DDIS and MID results. The data show that complex, chronic dissociative disorders exist in China , and cannot be accointed for by contamination or suggestion. Dr. Ross will discuss future research that could be conducted elsewhere in Asia, and the possibility of including dissociative disorders in future editions of the Chinese diagnostic manual (CCMD).

•  W15-2

本杰明 ?B? 凯斯 - Contribution II to the Workshop "Research Data on Dissociative Disorders in China"

Benjamin Keyes 1

1 Ross Institute, Richardson , Texas , United States

凯斯博士将提供在上海精神卫生站中心所做的第二项调查研究中关于分离性精神障碍的临床病例 ， 病例样本完成了 DES 、 DDIS 和 MID 。 调查组分别挑选出阳性和阴性的分离性障碍患者供访问，科林博士和凯斯博士由翻译组陪同在一周内对 50 名受 访者进行了调查研究，他们对临床发现进行了细致的描述，并且对中国和北美患者的表现异同进行了比较。

Dr. Keyes will provide clinical case examples from the second study on prevalence of dissociative disorders conducted at Shanghai Mental Health Center (SMHC). In the second study, a sample of inpatients completed the Dissociative Experiences Scale (DES), the Dissociative Disorders Interview Schedule (DDIS) and the Multidimensional Inventory of Dissociation (MID). The research team at SMHC then selected inpatients positive and negative for dissociative disorders for Dr. Keyes and Dr. Ross to interview: 50 interviews were conducted over a period of a week, with team members acting as translators. The clinical findings will be described and Dr. Keyes will discuss similarities and differences between dissociative disorders in China and North America .

W16 - 双相障碍的 处理 （ 聚焦于难治性病例和诊断的复杂性 ） - Management of Bipolar Disorder (With a Focus on Treatment-refractory Illness and Diagnostic Complexities)

Chairs: Philip Mitchell, Australia
Qijie Shen, Chinese Mainland

本工作坊将 讲述双相障碍处理的实践 ， 着重于难治性和诊断的复杂性。本工作坊将讲述针对这些病例的药物治疗和心理治疗。我们回顾了最近的一些着重于双相抑郁处理的研究。我们将展示许多个案研究的情况，并讲述将来在治疗上的潜在发展。参考 ： 1: Mitchell PB, Malhi GS. Emerging drugs for bipolar disorder. Expert Opin Emerg Drugs.2006 Nov;11(4):621-34. 2: Ball JR, Mitchell PB, Corry JC, Skillecorn A, Smith M, Malhi GS. A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change .J Clin Psychiatry.2006 3: Mitchell PB, Malhi GS. Treatment of bipolar depression: focus on pharmacologic therapies. Expert Rev Neurother.2005 Jan;5(1):69-78. 4: Mitchell PB, Malhi GS. Bipolar depression: phenomenological overview and clinical characteristics. Bipolar Disord.2004 Dec;6(6):530-9. 5: Mitchell PB, Malhi GS. The expanding pharmacopoeia for bipolar disorder. Annu Rev Med.2002;53: 173-88.

This workshop will address practical issues in the management of bipolar disorder, focusing on treatment-refractory illness and diagnostic complexities. The workshop will address both pharmacological and psychological treatments for this illness. Recent studies will be reviewed, with a particular focus on the management of bipolar depression. A number of case studies will be presented. Potential future developments in treatment will be addressed.
References: 1: Mitchell PB, Malhi GS. Emerging drugs for bipolar disorder.Expert Opin Emerg Drugs. 2006 Nov;11(4):621-34. 2: Ball JR, Mitchell PB, Corry JC, Skillecorn A, Smith M, Malhi GS. A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change. J Clin Psychiatry. 2006 3: Mitchell PB, Malhi GS. Treatment of bipolar depression: focus on pharmacologic therapies. Expert Rev Neurother. 2005 Jan;5(1):69-78. 4: Mitchell PB, Malhi GS. Bipolar depression: phenomenological overview and clinical characteristics. Bipolar Disord. 2004 Dec;6(6):530-9. 5: Mitchell PB, Malhi GS. The expanding pharmacopoeia for bipolar disorder. Annu Rev Med. 2002;53:173-88.

W17 - 综合医院精神卫生工作坊 1 - Workshop of Mental Health In General Hospital 1

Chairs: Wei Hao, Chinese Mainland
Jing Wei, Chinese Mainland

•  W17-1

心身医学基本技能教 员培训项目 - 欧盟 Asia-Link 国 际合作项目介绍 - Psychosomatic Postgraduate Training Program-Introduction on EU Aid “Asia-Link” Project

Wenyuan Wu 1 , Yuan Shen 1 , Chunbo Li 1

1 Dept. of Psychosomatic Medicine, Tongji Hospital, Tongji University, Dept. of Medical Psychology & Psychiatry, Tongji University Medical School, Tongji, Chinese Mainland

上海同 济大学附属同济医院和德国弗莱堡大学心身医学科自 2003 年起共同 开展中德合作心身医学国家级继续教育项目。德国弗莱堡大学联合上海同济大学以及奥地利、 越南、老 挝等国于 2005 年 11 月向欧盟申 请了 “Asia － Link” 的国 际心身医学合作培训项目成功获得欧盟批准立项。项目旨在推动亚洲各国心身医学的普及和发展，提高专科及非专科医师对心理障碍的临床识别和治愈率、从而提高这些国家医疗卫生整体服务水平。

项目启动会于 2006 年 2 月在上海召 开，来自其他四国的 12 名代表出席了此次会 议。此后在中国、越南、老挝举行了四次国际性培训课程，主要由欧洲讲员授课。三个国家的 60 余名 专科和非专科医师作为未来的讲员（ Future Teacher ）参加了培 训，通过讲座、情景雕塑、现场医患访谈以及分组模拟等形式，掌握了有关抑郁障碍、躯体形式障碍等临床常见心身疾病的识别和处理的基本知识和技能。中国方面， 2006 年至 2007 年上半年，由同 济医院精神医学科组织，进行了五次培训。 15 名 Future Teacher 参加了全部培 训，熟练掌握了课程知识并熟悉了 Balint Group 、家庭塑像等方法，其中部分人 为 2007 年新加入的学 员授课。在亚洲的四个合作合作方中，中国是唯一按计划完成全部培训课程的国家。

同 时，原中华医学会精神科分会副主任委员吴文源教授、上海市行为医学会副主任委员李春波教授等作为中国方高级讲员， 2006 期 间分别三次赴越南胡志明市、顺化及老挝万象为当地医生授课。合作方胡志明市医药大学附属医院设有精神科，有专科医生两名，多收治重性精神病；合作方顺化大学医院具有相对较好的精神卫生服务基础，设有独立的精神科，有病床 30 余 张，也以收治重性精神病为主。受政治、经济、文化等因素所限，两地的非专科医师对心身医学的了解仍非常有限。老挝的经济发展相对落后，卫生服务体系尚不完善，医疗卫生资源十分有限。精神卫生服务才刚起步不到十年，目前全国仅有不到五名精神科专科医师，心身医学更是一片空白。因此，该项目的开展对当地 精神 卫生事业的发展无疑具有非常重大的意义。相比较而言，中国心身医学发展已经有了 10 余年 历史，像上海这样的大型城市，所有三级甲等综合性医院都设立了精神医学科，培养起了一批具有扎实的专业知识，接受国外先进理念教育的人才。相对越南和老挝，中国在这方面优势十分明显。

相信 这一高水平的国际合作项目将促进我国心身医学队伍的成熟，为我国心身医学的国际合作与交流带来巨大的潜力和契机，推动我国生物－心理－社会医学模式现实意义上的转换。

Tongji Hospital of Tongji University has started cooperative psychosomatic postgraduate training program with University Hospital Freiburg since 2003 with satisfactory results. Based on it, they applied Europe Union Aid ‘Asia-link' postgraduate training project combining with Austria , Vietnam as well as Laos , which was approved on Nov. 2005 by Europe Union. It aims to promote the quality of health care service in Asian countries in developing psychosomatic medicine.

The Kick-off Meeting has been held in Tongji Hospital , Shanghai in February 2006. 12 representatives from other four countries had attended this meeting. After that, four International training courses have been held in China , Vietnam and Laos , which were all delivered by European teachers. There are totally over 60 doctors from different specialties attended the training courses and they would be the future teachers in following two years. They got the feel of reorganization and management of common psychosomatic diseases such as depression and somatoform disorders in various forms including lecture, case live-interview, sculpture and Balint Group et al. In China , local future teachers have completed five self-training since than and some of them have taken the speaker for new participants.

Prof. Wu Wenyuan, the former vice president of Chinese Psychiatry Association and Prof. Li Chunbo, the vice president of Shanghai Behavior Medical Association both went to Hu Chi Ming City (HCMC), Hue in Vietnam and Vientiane in Laos to give co-teaching with European colleagues as Senior Teacher from China . University hospital of Medical & Pharmacy College HCMC has set Dept. of psychiatry with 2 psychiatrists. Most of patients are serious psychosis. Hue as the former capital of Vietnam has better health care basic. Another partner University Hospital Hue processes independent Dept. of Psychiatry with 30 beds. Limited by politic, economic and culture reasons, psychosomatic knowledge still very new to Vietnam physicians. Health care system in Laos remains far to be perfect and the medical resources are very limited under relatively backward economic development. Psychiatry as a spatiality of medicine just appeared for about 10 years. There are only less than 5 psychiatrists in the whole country, not to speak psychosomatic medicine which did not get any chance to develop at all. In such a situation, psychosomatic postgraduate training program as Asia-link (VNN0009) is undoubtedly of great significance on local health care service. We believe there exist great potentials in improving development of psychosomatic medicine in China and this international cooperative project will drive forward the transform of medical model into bio-psycho-social style in practical sense.

•  W17-2

重 归因模式在中国综合医院精神卫生培训中的应用和修正 - Adoption and Modification of the Reattribution Model for Mental Health Training in General Hospital in China

Hongyu Tang

Beijing Mental Health Institute, Beijing , Chinese Mainland

综合医院各科的临床医生在处理躯体形式障碍和躯体主诉突出的抑郁障碍时 ， 经常面临的问题是患者否认自己的躯体症状与心理社会因素的关系。患者对躯体检查的阴性结果和治疗效果不佳 ， 归咎于检查不深入或者医生水平不高 ， 而医生经常陷入无可奈何的境地 ， 其结果往往是患者的问题没有得到有效处理 ， 医生矛盾却由此产生了。

“ 重 归因模式 ” 由英国的 Goldberg 和 Gask 教授 1989 年提出 ， 并在 2001 年来中国培 训时讲授 ， 为我们打开了解决这一问题的大门。其基本步骤是：让患者感到被理解，按基本程序逐步深入，引导患者建立躯体症状和心理社会因 素的 联系，与患者协商治疗。 2001 年以来，我 们将其作为综合医院精神卫生培训的主要内容，反馈表明这一模式具有广泛适用性，同时在中国文化背景下运用时应当予以适当修正。

Physicians always find them being in a dilemma when they manage the somatoform disorders or depressive disorders with somatic symptoms. Patients deny the link between their presentations and the psycho-social factors, they pin the negative results of physical examination and poor outcome of medication on doctor's incapacity. On the other hand, doctors don't understand patient's complains and feelings just because they stand to the outdated model of organic approach.

Professor Goldberg and Gask of UK developed the Reattribution Model in 1989 and introduced it to us in 2001. Since then, this model has been national widely used for mental health trainings in general hospital. More and more physicians accept this model in routine work after saw its effects. The feedback both from doctors and patients indicated that there was a broad adaptation of this model, and meanwhile it needed to be modified correctly in Chinese culture background.

W18 - 自 杀患者的评估与管理 - Assessment and Management of Suicidal Patients

Chairs: David A. Jobes, United States
Konrad Michel , Switzerland

摘要 ： 在 传统的医学模式中 ， 自杀行为被认为是大多数精神疾病 （ 比如 ： 抑郁症 ） 的症状之一。很明显，自杀的人群都有一段私人的内心体验，他们的自杀是有目的的，因而，有必要对他们的精神状况做出评估和诊断。要对自杀做出恰当的评估鉴定需要一种能对其定性的方法，这种方法能够促进临床医生对自杀患者有更好的理解。在这样的背景下， David A. Jobes 提出了 CAMS(1) ( 自 杀率的协同评估和管理， Collaborative Assessment and Management of Suicidality) ， Konrad Michel 提出了 “ 叙事行 为理论方法 ” （ Narrative Action Theoretical Approach ）。他 们两位是国际工作组授权专攻这个课题 (www.aeschiconference.unibe.ch) 的成 员，国际工作组已经出版了临床医生指南，并组织了专家进行会议讨论。临床面对面治疗的方法不但是经验性的，而且已经证明能够增强联合治疗（自杀病人治疗的关键起点）的疗效。在这个工作坊，这两位专家将为协作性定性方法提供理论和实践的证据，通过录像记录的临床案例将会更进一步的演示证明这种方法。

In the traditional medical model, suicidal behaviour is understood as a symptom of a major psychiatric illness (e.g., depression). While a proper psychiatric assessment and diagnosis remains uncontested, it is clear that suicide as a behaviour is carried out by individuals who have their own very personal inner experiences and motives. Adequate clinical assessment treatment of suicidal risk therefore requires a patient-oriented approach, in which the clinician is the facilitator of a shared understanding of the patient's suicidality. In this context, David A. Jobes has developed the “Collaborative Assessment and Management of Suicidality” (CAMS)(1) and Konrad Michel has developed the “Narrative Action Theoretical Approach.” The authors are charter members of an international working group focused on this topic, (www.aeschiconference.unibe.ch), which has published guidelines for clinicians, and organizes regular professional meetings. Both clinical interviewing approaches have empirical support and have proven to be useful in enhancing therapeutic alliance—the critical starting point of any treatment of a suicidal person. In this workshop, the authors will present theoretical and empirical bases for collaborative and patient-oriented approaches; practical clinical application of these approaches will be further demonstrated with excerpts of video-recorded interviews.
(1) Jobes D.A. Managing Suicidal Risk. A Collaborative Approach. The Guilford Press, New York 2006

•  W18-1

叙事行 为理论方法 （ The Narrative Action Theoretical Approach ） - The Narrative Action Theoretical Approach

Konrad Michel 1

1 University Psychiatric Services Bern , Outpatient Psychiatric Department, Bern , Switzerland

摘要 ： 在 传统的医学模式中 ， 健康专家会问患者一些问题或者对其进行体检。然而，自杀不是一种疾病而是一种行为。观测者总是趋于寻找原因来解释这种行为，然而，自杀人群则关心的是他们自己的内心。实际上，在自杀的背后隐藏了很多的真相：在每个个案里都有一个特别的故事。考虑到个人经历和自杀企图背后的故事，病人应该更了解自己，在这方面可以称得上是专家。这就需要医生改变角色：尽可能多的倾听患者的心声， 与患者敞 开心扉，最终能够真实的感受患者的体验。解释自杀行为并了解自杀背后隐藏的真相，不但能够正确的处理自杀危机，而且是自杀病人重获自控感觉迈出的第一步。

In the traditional illness model the health professional asks the questions and the patient is the object of his or her examination. However, suicide is not an illness but an action. In explaining actions, observers tend to look for causal explanations, while the individuals concerned usually give intrapsychic explanations. In fact, there is more behind a suicidal act: in each case there is a – very individual - story behind it. Regarding the individual experience and the story behind a suicide attempt, the patient is the expert. This requires a change in the health professional's role vis-à-vis the patient: the ability to truly listen, be open for the patient's experience, and, for a moment, to become the co-author of the patient's story. Explaining an action, and making understood to another person what is behind this action puts the suicidal crisis into perspective and is the first step towards re-establishing the individual's sense of mastery – of becoming a real person again.

•  W18-2

CAMS （ 自 杀率的协作评估与管理 ） - The Collaborative Assessment and Management of Suicidality (CAMS)

David A. Jobes 1

1 Catholic University of America , Department of Psychology, Washington , D.C. , United States

摘要 ： CAMS 是一 种使医生和自杀患者在开始治疗关系时就能够相互理解的方法。临床医生最好能够与患者协作处理问题 ， 这样更容易处理这种高危病人。 CAMS 将会被作 为一门哲学、一种方法 ( 包括 现在或将来的研究 ) 来 讨论。 SSF （ The Suicide Status Form ），是 CAMS 不可或缺的一部分，在此将会通 过临床案例被引入并应用。关于自杀危象、危象评估、治疗计划、随访及治疗结果之间的早期相关性的问题将会被提出来。 CAMS 能 够更快的了解这些，而且，无论何时出现自杀危象， CAMS 都可以很容易地 处理新的或正在发生的案例。

The model of Collaborative Assessment and Management of Suicidality (CAMS) is a clinical approach placing the shared understanding between clinician and patient of the patients' suicidality right at the beginning of any therapeutic relationship.

Clinical work with suicidal patients is best performed by collaboratively managing the issue with the patient; in turn, such an approach makes the whole challenge of working with the patient at risk much more manageable for the clinician. CAMS will be discussed as a philosophy and as a clinical approach, including current/future research. The Suicide Status Form (SSF), which is an integral part of CAMS will be introduced and its use described, with clinical examples. Issues addressed will be early identification of suicidal risk, risk assessment, treatment planning, tracking, and outcomes. CAMS can be quickly learned and readily used with new cases, or with ongoing cases, whenever suicidal risk is present.

W19 - 如何 开展临床研究计划 - How to Develop a Clinical Research Program

Chairs: Mark Rapaport, United States
Yueqin Huang, Chinese Mainland

本工作坊的目的旨在就如何 开展临床科研计划发起讨论 ， 尤其针对发展中国家的需要。我们将讨论在精神医学学术部门开展临床研究计划的潜在好处和面临的挑战。特别关注存在于有限的经费预算、临床医疗、教学和研究之间的动态张力。第二篇论文将对一些实用的临床实践指南进行综述，为了促进在新兴国家建立药物研究机构必须遵循这些指南，本文讨论的目的在于提供一个囊括某些关键因素的引子，这对于建立一个成功的精神药物科研机构来说是必不可少的。在第三篇论文中我们将讨论制订和执行一项整合的全球性发展计划的复杂性。在全球研究计划中通常存在一些复杂和相互 冲突的因素，包括 经费有限、时间紧迫，而且有时还还受到内外政治环境的限制。最后，听众将会对发展临床科研计划的挑战和必需要素有一个基本的理解 .

The goal of the workshop is to initiate a discussion about the development of a clinical research program particularly focused towards the needs of the developing world. This workshop will discuss the potential benefits as well as the challenges faced with developing a clinical research program in an academic department of psychiatry. A special emphasis will be placed on dynamic tension that exists between budgetary limitations, clinical care, teaching and research. The second presentation will review the good clinical practice guidelines that must be followed in order to facilitate the emergence of a pharmaceutical research facility in an emerging nation. The goal of this talk is to present a primer of the key components necessary for a successful psychopharmacology research site. In the third presentation we will discuss the complexity of conceptualizing and implementing a global development program for a compound. There are frequently a variety of complex and competing factors that go into the development of a global research program. These may include financial constraints, time constraints and at times both internal and external political constraints. By the end of this workshop the audience should have a rudimentary understanding of some of the challenges and some of the steps necessary for the development of a clinical research program.

•  W19-1

将 临床研究整合进精神医学学术部门 - The Integration of Clinical Research into an Academic Department of Psychiatry

Mark Hyman Rapaport

Cedars-Sinai Medical Center , Department of Psychiatry and Biobehavioral Sciences, Los Angeles , United States

如何将 临床研究整合进资源有限的多维学术环境中是学术机构面临的最大挑战之一。当前绝大多数学术机构都面临着经费不足的巨大压力。即使在一些富裕国家 ， 用于发展和维持临床研究计划的经费也严重不足。同时，全球绝大多数研究机构都面临着一系列组合的压力，包括经费预算不足、紧迫的临床需要和培养医学生、住院医生、心理学者及其他受训者的义务。在如此复杂的环境中进行临床研究一个可能的方法是将研究整合进其他部门的工作之中。本文将讨论如何在 Cedars-Sinai 医 疗中心的精神医学和行为神经科学部开创临床研究计划的过程，该部门之前从未开展过重大研究项目。这需要转变该部门的观念和执行一系列谨 慎的初始行 动，后者用以将标准化评估和和标准化结局整合进临床及教学计划。我们将讨论迄今为止这项工作的成功经验和面临的挑战。最后将向听众展示一个工作模型 ， 在此模型框架内 ， 临床研究最终被整合进该部门的临床和教学工作之中 ， 并同时增加了收入来源 .

One of the greatest challenges that academic institutions face is how to integrate clinical research into the framework of a resource-limited multi-faceted academic environment. At this time most academic institutions are under significant financial pressures. Even in the wealthiest of countries funds for the development and maintenance of clinical research programs are highly sought after. At the same time, most institutions worldwide are faced with a combination of budgetary constraints, pressing clinical needs and an obligation to educate medical students, residents, psychologists and other trainees. One potential approach to establish clinical research in such a complex environment is to integrate the research into the other missions of the department. In this presentation we will discuss how the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai has initiated the process of developing a clinical research program in the department that previously had not a significant research presence. This has required a change in the culture of the department as well as a series of carefully laid-out initiatives to integrate standardized assessments and outcomes into both the clinical and teaching programs. We will discuss both the challenges and the successes of this endeavor to date. At the end of this of this presentation the audience will have an example of a working model where clinical research is being finally integrated into the clinical and teaching missions of the department while enhancing the revenue stream of the department.

•  W19-2

在 发展中国家建立研发中心 - The Development of a Center of Research Excellence in the Developing World

Amin Kalali 1

1 Medical and Scientific Services, Quintiles CNS Therapeutics, San Diego , United States

目前 药物研发的临床试验已经发生了巨大的变化 ， 过去大部分试验都在美国或西欧进行。目前存在很多引领临床试验全球化的因素 ， 包括适应常规需求的大规模临床研究、费用维持、规律性的数据传递和从多民族人群获得数据。

因而非常需要一些可招募患者的研究中心 ， 这些中心能够很好的遵循临床试验指南 ， 按标准操作进程工作 ， 拥有评估疾 病的 专家。在发展中国家是急需的，因为这些国家缺乏有临床研究经验的医师。

报道将讨论什么是药物研发中心发展所需，而研发中心也将使患者得到最新的治疗和评估。

在 报道结束时 ， 听众将了解引领药物研究全球化的因素 ， 对新研究者的潜在需求和什么才是药物研究中心发展所需

There has been a recent dramatic change in where clinical trials in drug development programs are being conducted. Historically most trials were conducted in the US or Western Europe . However many factors have led to a relentless drive towards globalization of clinical trials. These include the need for far larger studies due to regulatory demands, the need to contain costs, the need for global regulatory submissions, and the desire to have data from multiple ethnic populations.

This has resulted in a great need for research centers with access to patients that are well trained in the rigorous Good Clinical Practice guidelines, are professionally run with standard operating procedures, and have the expertise in assessing the disease under study. This need is particularly acute in the developing world where less clinicians have had clinical research experience.

This presentation will discuss what qualities are necessary to develop a center of pharmaceutical research excellence, enabling patients access to the latest treatments being evaluated in drug development programs.

At the end of this presentation the audience will have learnt about the factors driving the globalization of clinical trials, and its implications for the need for new researchers, and what is required to develop a center of pharmaceutical research excellence.

W20 - 综合医院精神卫生工作坊 2 - Workshop of Mental Health in General Hospital 2

Chairs: Rong Fang, Chinese Mainland
Wenyuan Wu, Chinese Mainland

•  W20-1

《柳叶刀》与 医学人文精神 暨《柳叶刀》在中国 - The LANCET and Humanistic Spirit of Medicine & The LANCET in China

Kewei Ma 1

1 The Lancet, Shanghai , Chinese Mainland

《柳叶刀》 （ THE LANCET ） 是由英国柳叶刀出版集 团出版的国际综合性医学杂志 ， 现隶属于世界最大的学术出版机构 ——ELSEVIER 集 团。杂志自 1823 年 创刊以来，一直以其广博的视角 、 浓郁的人文精神对全球医学大事、热点进行深入报道。《柳叶刀》杂志关注跨学科的探索，寻求对生命特性的科学理解和对个体经验的人文理解的综合。精神病学作为最能体现人文精神的医学学科，我们认为该学科会起到推动医学发展的关键作用。近年来，随着中国经济的飞速发展，人们的各种压力逐渐增加，精神卫生问题日渐突出，已成为了严重的社会问题。《柳叶刀》对此密切关注，并连续发表了数篇关于中国自杀研究的文章。 2004 年 2 月，由世界 图书出版西安公司引进出版了《柳叶刀中文版》，除为方便包括精神科医生在内的同道们获取医学新知外，我们还希望 能促 进跨学科跨国界的教育与研究，同时成为培养高素质医生的重要平台和快速通道。本文将对《柳叶刀》的人文精神和在中国的未来发展目标以及与精神病学学科之间的合作前景作一概述。

The LANCET is a comprehensive international medical journal published by Lancet Publishing Group Company in Great Britain . Now it is affiliated to ELSEVIER, the largest academic publishing corporation in the world. Since its first publication in 1823, it has been devoted to the in-depth covering of medical events all over the world and well-concerned issues. It features an encyclopedic vision and a strong sense of humanistic spirit. Psychiatry is a branch of medicine that fully demonstrates the spirit of humanity and play a key role in pushing the medicine forward. Therefore, it has received special attention of The LANCET. In recent years together with the economic boom of China , people have suffered more pressures of various kinds and the problem of mental health is becoming more and more serious. Actually it is now a serious social problem that has called the attention of the whole society. The LANCET is a world-class medical journal and it has paid close attention to this problem. It has continuously carried a few articles about the research of suicide in China . In Feb. 2004, Xi'an World Publishing Corporation introduced and published The Chinese Edition of The LANCET. This has provided an easy access to new knowledge of medicine for the psychiatrists and other medical staff. The multi-discipline or transnational eduction and research will be promoted by its publishing.This article intends to cover the main ideas of The LANCET together with its Chinese Edition and its importance for mental health.

•  W20-2

精神科医生的自我心理保健 - How to Keep Psychiatrists own Mental Health

Denghua Tang

Institute of Mental Health of Peking University , Beijing , Chinese Mainland

精神科医生在 临床工作中通常要将自己作为治疗工具来帮助患者 ， 因此自我心理健康尤其重要 ， 而由于职业及工作的特点又使得其要面临更多的心理健康的危险因素 ， 我们将从医患沟通 （ 及人际沟通 ） 、情绪管理、团队及同行资源的利用等诸方面来探讨精神科医生的自我心理保健。

In clinical work, psychiatrists usually use themselves as treatment instruments to treat patients, so their own mental health is particularly important. As psychiatrists, because of their career and work character, they have to face much more risk factors which are bad for mental health. We will discuss how to keep psychiatrists' own mental health on several parts, such as doctor-patient communication, emotion management, utilization of source from groups and workmates.