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P001
Trauma and Dissociation in China
Bo Ji 1
1 SMHC, Shanghai, China
Objective: In order to determine whether pathological dissociation occurs in China, the authors conducted a survey among psychiatric inpatients, outpatients, and the general population in Shanghai, China. There is virtually no popular or professional knowledge of dissociative identity disorder in China , and therefore professional and popular contamination cannot exist.
Method: Chinese versions of the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule were administered to 423 inpatients, 304 outpatients, and 618 factory workers in Shanghai by Chinese psychiatrists working at the Shanghai Mental Health Center .
Results: Dissociative disorders were diagnosed in 24 respondents by structured interview, and 15 respondents fell into the dissociative taxon on the Dissociative Experiences Scale. The outpatients reported the highest rates of childhood physical and/or sexual abuse and of pathological dissociation.
Conclusions: Pathological dissociation can be detected readily among psychiatric outpatients in China but is much less common in the general population. Pathological dissociation is more frequent in more traumatized subsamples of the Chinese population. The findings are not consistent with the sociocognitive, contamination, or iatrogenic models of dissociative identity disorder.
P002
乙肝患者及配偶心理健康状况及社会支持相 关研 - Psychological Health and Social Support of Hepatitis B Patients and their Spouse
跃庆 丁 1
1 江西省九江市第五人民医院 , 江西 . 九江 , Chinese Mainland
目的 ： 探 讨慢性乙肝患者及其配偶心理健康状况及社会支持相关性。
方法 ： 以 Beck 抑郁自 评量表 （ BDI ） 及社会支持量表 （ SSRS ） 对 126 例住院慢性乙肝患者及其配偶 进行问卷调查及相关因素综合评估。
结果 ： 乙肝患者 / 配偶 轻度以上抑郁情绪发生率达 80.95%/60.30% 。其中 轻度占 53.40%/38.89% ， 中度 19.05%/14.29% ， 重度 7.94%/7.14% 。乙肝患者 BDI 总分与总社会支持（ SST ）及表 现支持（ SSS ）呈非常 显著负相关（ r=-0.493 ， r=-0.527p<0.001 ）与年 龄呈正相关 (r=0.263 p<0.05) ；与从事 职业呈负相关（ r=-0.189 p<0.05 ）。其配偶 BDI 总分与主观支持呈显著负相关（ r=-0.381 p<0.001 ）；与年 龄呈负相关（ r=-0.257 ）乙肝患者及其配偶的客 观支持与主观支持之间呈显著差异（ P<0.05 ）。
结论： 慢性乙肝患者及其配偶大部分存在不同程度的抑郁情 绪，二者中度以上抑郁达到或超过普通内科住院患者；乙肝患者的社会总支持越低及从事职业条件越差其抑郁情绪越高，且年龄越大，抑郁情绪越重。二者的客观支持低于主观支持 ； 乙肝患者的配偶主观支持越低及年龄越小 ， 抑郁情绪越重。
基金 项目 : 九江市科技局指 导性项目 ( 编号 2004.47 号 ) * ： 九江市第三人民医院肝炎科
关键词 ： 慢性乙肝 心理健康 社会支持 抑郁
P003
The Correlation between Mental Health Status and Social Support in Patients with Chronic Hepatitis and in their Partners
Yue Qing Ding 1 , 跃庆 丁 2
1 The Fifth People's Hospital of Jiujiang, Jiujiang, Chinese Mainland, 2 江西省九江市第五人民医院 , 江西 . 九江 , Chinese Mainland
Objective: To examine the mental health status in patients with chronic hepatitis and in their partners, and investigate the effect of social supports 。
Methods: BDI and SSRS were administrated to 126 patients/their partners 。
Results: The rate of depressive in the patients were 80.95% 。 and their partners were60.30% 。 The mild depressive were 53.40%/38.09% 。 The moderate depressive were 19.05%/14.29% 。 The severe depressive were 7.94%/7.14% 。 The are positive come/at ion between the patients' scores in BDI and sst ， sss 。 (r=-0.493,r=-0.527,p ＜ 0.05) ， are positive come/at ion with the ages (r=0.263 p ＜ 0.05) 。 And negatively correlation with the josh (r=-0.169 p ＜ 0.05) 。 There are significantly negatively correlation between the partners' scores in BDI and subjective supports (r=-0.321, p ＜ 0.001) ， are negatively correlation with the ages (r=-0.257) 。 There are remarkable difference between subjective support and objective support (p ＜ 0.05) 。
Conduction: Most of the patients with chronic hepatitis and their partners have depressive 。 The rate is higher than other patients 。 The low social ， bad job conditions and old age is correlated with the depressive 。 But in the partners 。 The low subjective support and young age is cumulated with the depressive 。
Key words: patients with chronic hepatitis ， Mental health ， social supports ， Depression
P004
西 肽普兰治疗老年脑卒中后抑郁临床对照研究 - Clinical Control Study of Citalopram in the Treatment of Senile Post-stroke Depression
继承 董 1
1 青 岛市精神卫生中心 , 山 东省青岛市 , Chinese Mainland
目的 ： 探 讨西肽普兰治疗老年脑卒中后抑郁的疗效和安全性。
方法 ： 将 40 例老年 脑卒中后抑郁病人随机分为两组 ， 分别给予西肽普兰和阿米替林治疗 ， 共 6 周 ， 采用 汉密尔顿抑郁量表 （ HAMD ） 、副反 应量表 （ TESS ） 于治 疗前和治疗 1 、 2 、 4 、 6 周末分 别评定疗效及不良反应。结果：西肽普兰和阿米替林治疗老年脑卒中后抑郁的疗效相似，但西肽普兰比阿米替林起效快，不良反应轻，疗效指数优于阿米替林（ P<0.05 ）
结论： 西 肽普兰可作为治疗老年脑卒中后抑郁的首选药物。
关键词 : 西 肽普兰 阿米替林 老年 脑卒中后抑郁 中 图分类号 ： R749.4 文献 标识码 ： A
Objective: To compare the efficacy and security of citalopram in the treatment of senile post-stroke depression.
Method: 40 patients with senile post-stroke depression were divided into two groups which were received citalopram or amitriptyline for 6 weeks respectively. And the curative effect and side reaction were evaluated with Hamilton depressive scale (HAMD) and treatment emergent symptom scale (TESS) respectively before and after the treatment in 1st, 2nd, 4th, 6th weekend.
Results: The efficacy of both drugs were same, citalopram had a more rapid onset of action and less side effects than amitriptyline. The score of efficacy index in citalopram group was significantly greater than that in amitriptyline group (P<0.05) 。
Conclusion: citalopram could be the first choice for senile post-stroke depression.
Key words: citalopram; amitriptyline; senile post-stroke depression
P005
米氮平治 疗广泛焦虑障碍对照研究 - Mirtazapine in the Treatment of General Anxiety Disorder: A Control Study
传福 宋 1 , 仲 夏 2 , A01
1 芜湖市第四人民医院 , 芜湖市 , Chinese Mainland, 2 芜湖市第四人民医院 , 芜湖 , ?land Islands
目的 : 验证米氮平与阿普唑仑治疗广泛性焦虑症的临床疗效及副反应。
方法 : 采用随机分 组的方法 , 对符合 CCMD - 3 诊断标准的 66 例广泛性焦 虑症分为米氮平组 (33 例 ) , 阿普 唑仑组 (33 例 ), 疗程 6 周 , 用焦 虑自评量表 (SAS) 、 Hamilton 焦 虑量表 (HAMA) 和副反 应量表 (TESS) 评定疗效和副反应。
结果 : 米氮平与阿普 唑仑疗效相当 , 副反 应研究组较对照组少且轻。结论 : 米氮平治 疗广泛性焦虑症安全、有效 ， 且副反应轻微。
Objective: To study the clinical effects and side effects of Mirtazapine in the treatment of generalized anxiety disorder.
Methods: 66 patients who met the criteria of CCMD - 3 for generalized anxiety disorder were randomly assigned to Mirtazapine (33 patients) and Alprazolam (33 patients) treatment for 6 weeks.The clinical effects and side effects were tested with HAMD, SAS and TESS.
Results: Mirtazapine was similar to Alprazolam in clinical effect, but side effects were fewer and milder in the research than in the control group.
Conclusion: Mirtazapine is an effective and safe anxiolytic agent in patient with generalized anxiety disorder.
P006
抑郁性障碍患者的躯体症状研究 - Somatic Symptoms in Patients with Depressive Disorder
万良 程 1 , 仲 夏 1
1 芜湖市第四人民医院 , 芜湖 , Chinese Mainland
目的 : 了解抑郁性障碍患者的躯体症状特征。 方法 采用自制的一般情况 调查表和自制的躯体症状调查表对符合 CCMD-3 抑郁 发作的 119 例 门诊及住院抑郁障碍患者进行调查。根据汉密尔顿抑郁量表 （ HAMD ） 的得分 ， 将 119 例患者分 为轻、重性抑郁障碍二组 ， 比较二组的一般资料及临床躯体症状。 结果 二 组的一般资料无明显差异 ， 而重性抑郁障碍组躯体症状与轻性抑郁障碍组有显著差异。结论 抑郁性障碍的躯体症状非常突出 ， 应引起临床的足够重视。
P007
曲 唑酮与马普替林治疗抑郁障碍的疗效对照研究 - Trazodone and Maprotiline in the Treatment of Depression: A Control Study
荣华 刘 1
1 四川省 绵阳市第三人民医院 , 心身疾病科 , 四川省 绵阳市 , Chinese Mainland
摘要 ： 目的 比 较与曲唑酮与马普替林治疗抑郁障碍的疗效和副反应。方法 67 例符合 ICD-10 诊断标准的抑郁障碍患者。随机分为两组，应用曲唑酮 36 例， 马普替林 31 例，治 疗 6 周。采用 汉米顿抑郁量表修订版（ HAMD-CR ）、 临床总体评定量表（ CGI-SI ）和副反 应量表（ TESS ） 评定疗效和副反应。结果 曲 唑酮与马普替林治疗抑郁障碍均有效，两者疗效相当（ P>0.05 ）。曲 唑酮副反应明显少于马普替林（ P<0.01 ）。 结论 曲 唑酮治疗抑郁障碍安全、有效。
关键词 ： 曲 唑酮 ； 马普替林 ； 抑郁障碍
Objective: To compare trazodone with maprotiline in the treatment of depressive disorders efficacy and side effects. ICD-10 67 cases with the standard method of diagnosis in patients with depressive disorders. Randomly divided into two groups, 36 cases of trazodone application, maprotiline 31 cases, 6 weeks. Huntington adopted revised version of Hamilton depression scale (HAMD-CR) Clinical Global Assessment Scale (CGI-SI) and Deputy Scale (TESS) to evaluate the efficacy and side effects.
Results: trazodone and maprotiline in the treatment of depressive disorders are valid for both efficacy (P> 0.05). Trazodone side effects less than maprotiline (P <0.01).
Conclusion: trazodone treatment of depression safe and effective.
Keywords: Trazodone; Maprotiline; Depression
P008
帕 罗西汀治疗脑中风后抑郁状态 27 例分析 - Paroxetine in the Treatment of 27 Post-stroke Depression Patients
宛平 朱 1 , 俊 许 2
1 安徽省 铜陵市第三人民医院 , 铜陵市 , Chinese Mainland, 2 安徽省 铜陵市第一人民医院 , 铜陵 , Chinese Mainland
目的 : 观察帕罗西汀对脑中风后抑郁状态的治疗效果
方法 : 收集 2003 年 6 月 —2006 年 6 月在我院神 经内科确诊为脑中风后抑郁状态 27 例 . 其中男性 16 例 , 女性 11 例 . 平均年 龄 63.5±3.3 岁 . 脑出血 11 例 . 脑梗塞 16 例 . （ 经头颅 CT 或 MRI 证实 ） . 脑中风发病至入组治疗时间平均 26.5±3.2 天 . 患者入 组标准 ⑴ 符合 CCMD—3 脑器质精神障碍抑郁状态的诊断标准 ; ⑵ 按 汉密尔顿抑郁量表 （ HAMD ） 评定总分 ≥17 分 ; ⑶ 入 组前检查血 , 尿常 规及肝 , 肾功能 . 心 电图正常 ; ⑷ 既往无精神病及 癫痫病史 , 无 药物过敏史 ; ⑸ 近 2 周内未用 过精神病药物及抗抑郁药物 . 所有的病人从 开始入组起 , 每日服用一次 盐酸帕罗西汀 （ 浙江华海药业股份有限公司生产 . 商品名 乐友 . 每片 20mg ） , 一周后如无明 显不适可将剂量加至 20mg 剂量 —40mg ／ 日 . 其中 22 例的 剂量为 20mg/ 日。 4 例 为 30mg/ 日 ,1 例 为 40mg/ 日 . 治 疗时程为 6 周。治 疗前后分别检查血 , 尿常 规及肝 , 肾功能 . 心 电图。应用 HAMD 用 药进行评定。分别在用药前，用药后 3 周末及 6 周末各 测评一次，量表评定疗效按 HAMD 减分率 标准：减分率 ≥90 ％ 为痊愈，减分率 ≥60 ％ 为显效，减分率 ≥30 ％ 为好转， <30 ％ 为无效。为了更好地进行疗效分析，同时对 HAMD 量表的 4 个因子 进行针对性分析。用随机配对 T 检验对结果进行分析。
结果： 应用盐酸帕罗西汀 3 周后，患者的 HAMD 量表的 总评分降低了 48.7 ％，治 疗后第 3 周及第 6 周 较疗前显著降低 (P<0.05 或 P<0.01) 。其中焦 虑／躯体化平均分数在服药后 3 周降低 约 49.2 ％， 6 周后降低 75.4 ％， 迟滞平均分数在服药后 3 周降低 41.1 ％， 6 周后降低 71.2 ％。本 组 27 例患者无中断治 疗，在治疗的整个过程中没有出现严重的药物副反应。仅有 5 例出 现恶心，出汗，口干，，打瞌睡等现象需对症处理。治疗中 3 周及 6 周末 复查肝功能，肾功能，及血 , 尿常 规，心电图均正常。
结论： 帕 罗西汀对脑中风后抑郁状态有较好的疗效。副反应 小，耐受性好。 值得肯定。
P009
13 例 轻躁狂病人误诊酒精滥用及其社会功能损害的探讨 - 13 Cases of Hypomania Misdiagnosed as Alchohol Abuse: A Approach on their Social Function
张天祥 张 1 , 黄 庆艳 黄 2
1 河南 鹤壁市第一人民医院精神科 , 河南 鹤壁市第一人民医院精神科 , Chinese Mainland, 2 河南 鹤壁市第一人民医院精神科 , 河南 鹤壁市 , Chinese Mainland
目的： 探 讨轻躁狂病人的酒精滥用及社会功能的损害问题。
方法：近一年来到我院戒酒、同 时符合轻躁狂诊断的病人及轻躁狂病人因严重酗酒问题到我院求治者。
结果： 13 例病人均 为男性，符合 CCMD—III 轻躁狂的诊断。其中 11 例以戒酒 为理由住院。诊断；酒精中毒性幻觉 2 例， 单纯性醉酒 6 例。通 过详细询问病史，仔细观察病情，发现有明显社会功能损害者 9 人，占 75% 。 长期家庭不和，矛盾冲突 10 例，占 77% 。离婚 6 例，离婚率 46% 。 饮酒方式：均以结交朋友，交流感情为目地，聚众豪饮，并拒绝他人付账。饮酒量；平均 4 两 / 次。
结论： 轻躁狂病人以结交朋友，聚众豪饮的行为方式来宣泻旺盛的精力，表达高涨的情感，以致造成家庭矛盾及社会功能损害。本组病例误诊率较高，占 85% 。考 虑是因为患者精神症状较轻微，未直接造成对社会功能的影响，故重视不够。患者主要的精神症状为活动过度，热情，大方，而无明显易激惹的症状表现。其次受家属的误导，将社会功能的损害归因于 “ 酒精 滥用 ” 。
第三： 患者 饮酒方式惹人关注，常为聚众豪饮，并且拒绝他人付款，掩盖了精神症状。
关键词 : 轻躁狂，酗酒，社会功能损害，易激惹，活动过度。
P010
The Investigation of Risk Factors for Suicidal Idea of Depression and the Effect of Antidepressants on Suicidal Idea
Zuowei Wang 1 , Shoping Zhang 1 , Yindi Chen 1
1 Hongkou Mental Health Center of Shanghai, Shanghai, Chinese Mainland
Objective: To explore the effect of antidepressants on suicidal idea of depression patients, and to investigate the risk factors for suicidal idea.
Methods: 58 outpatients of depression were included. Trait Coping Style Questionnaire (TCSQ), Pittsburgh Sleep Quality Index (PSQI), Self-rating Idea of Suicide Scale (SIOSS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were applied to evaluate coping style, sleep quality, suicidal idea, depressive and anxious symptoms of patients.
Results: After three months with treatment of antidepressants the scores of HAMD, HAMA , PSQI, SIOSS were improved very significantly （ P<0.001 ） . Multi factors regression analysis showed that divorce or bereft of spouse, better educated, physical diseases, higher score of negative coping and lower score of positive coping, and more severe insomnia are risk factors for suicidal idea （ P<0.05 ） before treatment. While after treatment, suicidal idea of female, married and first-onset patients without physical diseases, with lower score of positive coping and more severe insomnia before treatment, have been improved more significant, and also the improvement of suicidal idea was consistent with remission of depressive, anxious and insomnia.
Conclusion: The risk factors for suicidal idea of depression were various, and could be effectively prevented through antidepressants and other measurements.
Key words: depression; antidepressants; suicidal idea; suicide risk factors
P011
产后抑郁情绪及其交感神经皮肤反应研究 - A Control Study on Depression and Sympathetic Skin Response with Postnatal Women
振芬 寇 1
1 河南省精神病医院 , 新 乡市 , Chinese Mainland
目的 : 探 讨产后妇女的抑郁情绪及自主神经状况。方法 对 50 例初 产后妇女和 48 例健康 妇女分别进行了交感神经皮肤反应（ SSR ） 测定和抑郁量表评定，并将两组结果加以比较。结果 产后妇女与对照组相比，异常率为 80% （ 40/50 ）， SSR 波潜伏期延 长和 P3 波幅降低，其差异具有 显著性意义（ p<0.01 ），抑郁量表 评定各因子分两组相比差异存在显著性意义（ p<0.01 ）。 结论 SSR 可作 为评价产后妇女的自主神经功能的客观指标，对产后妇女的全面康复有较高的临床 价 值。
关键词 : 产后妇女 抑郁 自主神 经功能 SSR
Objectives ： To explore the depression and autonomic nerve dysfunction with postnatal women.
Methods ： SSR test and SDS test were used for fifty postnatal women and forty-eight normal healthy women ， and the results were compared in the two groups 。
Results ： The abnormal rate of SSR with postnatal women group was 80% （ 40/50) ， The latency of SSR with postnatal women group were longer than those in control group ， The amplitude of SSR with postnatal women group was lower than that in the control group ， There was significantly difference between the two groups （ p<0.01 ）， There was significantly difference with the factor scores of SDS in the two groups （ p<0.01 ） 。
Conclusion ： SSR has remarkable clinical value as a objective index in apprasing autonomic nerve dysfunction with postnatal women ， in order to prompt overall rehabilitation with postnatal women.
Key words: Postnatal women ； Depression ； Autonomic nerve dysfunction, Sympathetic skin response
P012
情感性精神障碍与气象要素的相 关性 - Correlation between Affective Disorders and Meteorological Factors
晓云 张 1 , 志 颖 冯 2 , 金 华 李 2
1 天津市气象科学研究所 , 天津 , Chinese Mainland, 2 天津市安定医院 , 天津 , Chinese Mainland
目的 : 探 讨情感性精神障碍与气象要素的关系。
方法 : 用相 关系数检验法对天津市安定医院 1997 ～ 1999 年情感性精神障碍月入院量和同期气象 资料的相关性进行回顾性分析。结果 情感性精神障碍月入院量与同期日照和气 压有显著意义的相关性。
结论 : 日照和气 压可能是情感性精神障碍发病的主要气象因素。
关键词 : 情感性精神障碍 气象要素 抑郁 躁狂 日照
Objective: To study the relationship between affective disorders and meteorological factors.
Methods: It has been analyzed in review that characteristic of number of affective disorders and meteorological data in hospital from Tianjin AN DING Hospital with correlation coefficient method from January lst,1997 to December 31th,1999.
Results: The correlation has been proved between affective disorders and air pressure, sunshine-hour and wind speed.
Conclusion: The mainly meteorological factors of affective disorders may be Sunshine-hour and air pressure.
Key words: affective disorders; meteorological factors; major depression; mania; sunshine
P013
西 酞普兰合并曲唑酮治疗抑郁症的对照研究 - Combined Therapy with Citalopram and Trazodone in Deprssion: A Control Study
作佳 李 1 , 情感障碍
1 山 东省烟台市莱州荣军医院 , 莱州 , Chinese Mainland
目的 ： 比 较西酞普兰合并曲唑酮与单用西肽普兰治疗抑郁症的疗效与安全性。
方法 ： 将 60 里抑郁症患者随机分 为两组 ， 分别为合用组 （ 30 例 ） 与 单用组 （ 30 例 ）， 疗程 6 周 ， 用 汉密尔顿抑郁量表 （ HAMD ） 及 汉密尔顿焦虑量表 （ HAMA ） 在治 疗前及治疗后 2 、 4 、 6 周 评定疗效 ， 用副反应量表 （ TESS ） 评定不良反应。
结果 ： 合用 组显效率 72.1% ， 有效率 87.2% ； 单用组显效率 68.3% ， 有效率 86.2% ， 两 组间差异无显著性 （ p ） 0.05 ） 。合用 组 HAMD 睡眠障碍因子份明 显低于单用组（ p 〈 0.05 〉。合用 组起效时间平均 8.61 天， 单用组平均起效时间 15.21 天，差异有 显著性（ p 〈 0.05 〉。不良反 应方面，合用组出现不良反应 12 例， 单用组 10 例，两 组差异无显著性（ p ） 0.05 ）。
结论： 西 肽普兰是治疗抑郁症较为安全有效的药物。西肽普兰合并曲唑酮治疗抑郁症的睡眠障碍较单用西肽普兰更为有效，且起效时间快。
关键词： 西 肽普兰 曲 唑酮 抑郁症
P014
偏 远农村和城市贫民区抑郁症病人结局对照研究 - Outcome of Depressive Patients from a Remote Rural Area versus those in a Dense City Slum Area
Asis Krishna Acharya 1
1 Calcutta Pavlov Hospital, Psychiatry, Kolkata, India
目的： 在抑郁症的恢 复中，支持，照顾和一个好的社区可能是有益的治疗环境。在全球化和城市化时代，城市环 境中好的社会 结构和联结已经消失。在偏远的乡村家庭功能仍然保持完好，总的社会功能还在那儿。研究随访观察了来自这二种环境的病人 1 年。
方法： 2004 年来自 Calcuta Pavlov 医院 门诊部的符合 DSM-IV 诊断标准 160 典型抑郁症病人（ major depressive disorder ）入 组。另外一组来自一个诊所，距离城市 126 公里，同 样是 160 个情况 类似的病人。两组的药物治疗是类似的。研究人员每两周评定他们的恢复和副反应情况。每 3 个月 进行汉密尔顿抑郁量表评定（ 24 分）。
结果： 两 组分别有 7 和 9 名病人 违约未 能完成研究。城市 组中男性有 60 名，女性有 90 名， 乡村组中有男性 58 名，女性 92 名。年 龄分布从 38-62 岁，中位数为 50 岁。城市组有 83 名病人 3 个月 时显示出显著进步，乡村组有 87 名病人有 显著进步。 1 年后城市 组 138 名病人症状完全消失， 乡村组 142 名病人完全 缓解。
结论： 两 组病人并无显著不同，全球化或城市化对病人的恢复程度并无显著影响。
Objectives: In depressive state recovery, support, care and a wellnit social community may be of some favourable therapeutic environment, it was thougt. In globalisation and urbanisation erra, that wellnit social stucture and bonding are missing in city scenario. In remote village community such an situation of stable family functioning and general good social functioning is still there. Depressive patient from both these community are taken here for a follow up study of 1 year to identify any difference in their outcome.
Methods: 160 patients suffering from major depressive disorder (MDD) as per diagnostic cliteria of DSM-4TR, of both sexes were recorded in Calcuta Pavlov Hospital o.p.d in 2004. In another disrict clinic 126 k.m away from city another 160 patients of similer background, who were diagnosed as suffering from MDD were taken, who comes from villages situated 1 k.m away from metalled road. Closely identical pharmacological therapy were institued for both the groups. They were clinically assesed fortnigtly for improvement, any side effects,or a remmision. At each 3 monhs interval they were administered Hamilton Rating Scale for Depression′ (24 point`s scale). Ham. Rating Scale shows significant improvement in majority of patients belonging to both the groups from the very first 3 months post treatment period They were assesed both clinicaly and applying HAM score on each successive3 months interval for another 9 monhs, totalling an one year follow up.
Results: 7and 9 pt`s in both the group could not complete the study due to defaultation. 150 in both groups satisfactorily completed the study. 90 females and 60 males remained in urban group. 92 female and 58 male constitued the village gr.
Age distribution were from 38 to62 years of age with a median distribution of 50 years.83 patients in ub.gr.shows maked improvement on 3 monts score. 87 pt`s in the vill. gr. shows that improvement. At the end of 1year no. of symptom free pt. in ur . gr.were138 and in other gr. it was 142.6 pt. in first gr. and 2 pt. in other gr. shows no improvement of significant degree.
Conclusions: In both the groups studied for brief one year there is no such significant difference in outcome. Globalisatoin or urban shifting in people may not have much impact on their recovery rate.
P015
A Comparative Study of Citalopram Combined with Trazodone and Citalopram in the Treatment of Depressive Disorders
Zuo-jia Li 1 , Yu-bin Han 1 , Chang-sheng Qu 1
1 Psychiatry Department of Laizhou VA Hospital, Yantai, Chinese Mainland
Objective: To compare the clinic effects and the safety of citalopram combined with trazodone and citalopram in the treatment of depressive disorders.
Methods: Sixty patients with deprestive disorders were randomly divided into combined group (30 patients) and single group (30 patients) for 6 weeks. Clinic effects and side effects were tested with HAMD, HAMA and TESS before treatment and 2, 4, 6 weeks after treatment respectively.
Results: After 6-week treatmen, the significant imiprovement rate and response rate was 72.1% and 87.2% in Combined group, 68.3% and 86.2% respectively in single group. There were no significant differences between two grous (p 〈 0.05. Citaloparam combined with trazodone has faster efficienty. 12 patients had side effects in combined group and 10 ones in single group. There were no significant differences between two grous (p 〈 0.05).
Conclusions: Citalopram combined with trazodong has better efficacy and faster efficienty.
Key words: Citalopram Trazodone Depressive disorders.
P016
文拉法辛治 疗抑郁症的临床研究 - Clinical Study of Venlafaxing in Treatment of the Patients with Depressive Disorder
Zu-song Liu 1 , Wu-gang Duan 1 , Bing-hua Wang 1 , Wei-dong Zhou 1 , 精神 药理学
1 The Second Hospital Affiliated to Xianning University, 咸宁市 , Chinese Mainland
目的 ： 评价文拉法辛治疗抑郁症的临床疗效和不良反应。方法：将 63 例抑郁症患者随机分 为研究组和对照组，研究组 32 例， 对照组 31 例。所有入 组患者均符合中国精神障碍分类与诊断标准第 3 版（ CCMD-3 ）有 关抑郁症诊断标准，汉密顿抑郁量表（ HAMD ） 17 项评分 ≥18 分，患者家属均知情同意。研究 组用文拉法辛治疗，起始剂量为 50mg/d ， 2 周内 渐加至 75—225mg/d ，平均（ 122.5±73.5 ） mg/d ； 对照组用阿替林治疗，起始剂量为 50mg/d ， 2 周内加至 100—300mg/d, 平均（ 155.5±75.5 ） mg/d ， 2 组均根据治疗反应酌情调整药物剂量，研究期间不合用其它抗抑郁药物或电休克等治疗，可酌情使用苯二氮卓类、抗组织胺类和抗胆碱能类等药物作对症处理，治疗观察时间 8 周。在治 疗前及治疗后第 1 、 2 、 4 、 6 、 8 周末，用 HAMD 评定临床疗效；在治疗后第 1 、 2 、 4 、 6 、 8 周末，用副反 应量表（ TESS ） 评定药物不良反应。临床疗效以 HAMD 总分减分率进行评定，减分率 ≥75% 为痊愈， 50—74% 为显效， 25—49% 为好转， <25% 为无效。采用 t 检验， χ2 检验进行统计分析。
结果： 治 疗 8 周后，研究 组痊愈 12 例， 显效 15 例，好 转 3 例，无效 2 例； 对照组分别为 10 、 14 、 4 和 3 例；研究 组显效率 84.38% ，有效率 93.75% ， 对照组分别为 77.42% 和 90.32% ，两 组差异无显著性意义（ P 均 >0.05 ）。 HAMD 评分，两组自第 2 周未 开始均较治疗前有显著性意义的下降（ P<0.05 ～ 0.01 ），两 组间同期比较，第 2 周末，研究 组显著低于对照组，其他时点两组间差异无显著性意义（ P >0.05 ）。研究 组不良反应主要有口干、乏力、头晕、视力模糊、食欲减退等，一般反应轻微，患者均可耐受，且随着治疗时间延长逐渐消失；对照组不良反应 主要有口干、便秘、 头晕、视力模糊、排尿困难和心电图改变等，治疗后第 2 、 4 、 6 、 8 周末 TESS 评分及不良反应总发生率研究组低于对照组，差异有显著性意义（ P <0.05 ～ 0.01 ）。
结论： 文拉法辛治 疗抑郁症起效较快，疗效好，不亚于阿米替林，但不良反应少，是一种疗效确定且使用安全的抗抑郁药物，可作为抗抑郁一线药物使用。
关键词 : 抑郁症 ； 文拉法辛 ； 阿米替林 ； 疗效 ； 安全性
Objective: To explore efficacy and safety of venlafaxing in treatment of the patients with depressive disorder.
Methods: All 63 patients with depressive disorder diagnosed according to CCMD-3 criteria were randomly assigned to study group (32 cases, treated with venlafaxing) and control group (31 cases, treated with amitriptyline) for 8 weeks. Hamilton Depressive Scale (HAMD) and Treatment Emergent Side effect Scale (TESS) were used to evaluate the efficacy and adverse effect respectively.
Results: After 8 weeks, The clinical efficacy and the scores of HAMD had no significant difference between two groups.But the scores of HAMD in two groups after treatment were significantly lower than those before. The incidence of adverse effect and the scores of TESS in study group were significantly lower than those in the control group.
Conclusion: venlafaxing is as effective as amitriptyline in treatment of the patients with depressive disorder. But it is much safer.
Key words: Depression Venlafaxing Amitriptyline Efficacy Safety
P017
护士家访对首发精神分裂症患者生活质量的影响 - Influence of Nurses′ Home Visiting on the Life Quality of the First Episode Schizophrenics
Gui-ying Gu 1 , De-zhi Zeng 1 , Gui-zhi Zheng 1 , Wei-dong Zhou 1 , 精神康 复
1 The Second Hospital Affiliated to Xianning University, 咸宁市 , Chinese Mainland
目的 ： 探 讨护士家访对首发精神分裂症患者生活质量的影响。
方法 ： 将 100 例符合中国精神障碍分 类与诊断标准第 3 版 （ CCMD-3 ） 精神分裂症 诊断标准的首发精神分裂症患者随机分为家访组与对照组 ， 每组 50 例 ， 患者家属均知情同意。 2 组患者均住院接受系统抗精神病治疗，病情充分缓解达到临床痊愈或显著进步标准时出院，出院后对照组按常规维持治疗，家访组在此基础上接受为期 1 年的 护士家访，出院后前半年内 1 次 /2 月，后半年 1 次 /3 月。家 访内容：了解患者病情和健康关照措施落实情况，协助解决存在和潜在的问题；讲授精神卫生相关知识，重点是维持治疗的意义、方法以及注意事项；结合患者及其家庭实际进行心理健康教育，有针对性地给予心理疏导，调解家庭关系，尤其是对家庭成员的高情感表达予以干预，营造和谐的家庭氛围；与患者及其家属共同商讨，修正健康关照方案，合理安排患者生活、工作、学习和社会活动，促使患者角色转换，并提供家庭护理和应对技巧；发放精神卫生宣传资料，填写家访调查表，每次家访时间不少于 2 h 。在患者出院 时和出院后 1 年末分 别用阳性和阴性综合征量表（ PANSS ）、治 疗中需处理的不良反应量表（ TESS ） 评定患者病情变化 和不良反 应，用世界卫生组织生活质量评定量表（ QOL-100 ） 评定患者生活质量的变化。统计学处理：计数资料用例数和百分比表示，采用 χ2 检验；计量资料用 ±s 表示，采用成 组和配对 t 检验。
结果： PANSS 量表 评分，出院时 2 组间无显著差异，出院后 1 年末，家 访组较出院时显著下降，对照组反而上升， 2 组间差异显著； TESS 评分 2 组较出院时显著下降，但 2 组间同期比较差异无显著性意义；再入院率研究组显著低于对照组； QOL-100 评分，出院时 2 组间差异无显著性意义，出院后 1 年末，除精神支柱因子外，其他各因子 积分研究组较出院时显著升高，而对照组却明显降低， 2 组间差异有统计学意义。
结论： 护士家访对提高首发精神分裂症患者生活质量有明显的促进作用，且简便易行，具有良好的社会学和经济学价值，值得在临床上推广应用。
关键词 : 护士家访 精神分裂症 生活 质量
Objective: To explore the influence of nurses' home visiting on the life quality of the first episode schizophrenics.
Methods: 100 first episode schizophrenics were randomly assigned into the study group and the control group. Each had 50 cases. The study group received nurses' home visiting for a year. The Positive and Negative Syndrome Scale(PANSS) and WHO Quality of Life-100(QOL-100)were used to evaluate the efficacy of the patients' life quality improving and rehabilitation. The Treatment Emergent Side effect Scale(TESS) was used to evaluate the adverse effect.
Results: In a year, the scores of PANSS and the rate of re-admission to the hospital in the study group were lower significantly than those in the control group. But the scores of QOL-100 in the study group were higher significantly than those in the control group in a year. The scores of TESS had no significant difference between the two groups.
Conclusion: Nurses'home visiting can significantly improve the life quality of the first episode schizophrenics.
Key words: Nurses'home visiting ;Schizophrenia; Quality of life
P018
抑郁症患者治 疗前后认知功能变化的分析 - An Analysis on the Cognitive Function in Depression Before and After Therapy
璐璐 张 1 , 洪波 郑 1 , 悦 邓 2 , 柱国 何 1 , 静山 马 1 , 娟花 黎 1
1 广州市精神病医院 , 广 东省广州市 , Chinese Mainland, 2 广州医学院第二附属医院 , 广 东省广州市 , Chinese Mainland
目的 : 研究抑郁症患者治 疗前后认知功能改变及相关因素。
方法 : 对 100 例符合 CCMD-3 的抑郁症患者 ， 给与单一抗抑郁药治疗 8 周。于治 疗基线和治疗末评定 HAMD24 、 WCST 、 WMS-RC 和 连线 A 、 B 测验 ， 并与 100 名健康志愿者 对照。
结果 : （ 1 ） 治 疗后患者组的 HAMD24 量表 总分和各因子分均显著降低 ， 神经心理学检测成绩均明显提高。 （ 2 ） 患者 组 WMS-RC 中的数字广度 （ 倒背 ） 改 变与睡眠障碍分改变呈负相关 ； 连线测验 B 的 测验时间与认识障碍分呈负相关 ， 提笔数与绝望感分呈正相关 ； WCST 中的分 类数与认识障碍分、焦虑 / 躯体化分呈 负相关。（ 3 ）痊愈 组和症状残留组的 WCST 及 WMS-RC 检测均低于对照组。 （ 4 ）重度抑郁 组的 WCST 及 WMS-RC 部分 检测低于中度抑郁组。
结论 : 抑郁症患者治 疗后认知功能明显提高，认知障碍改善与临床症状缓解存在相关性，但治疗后仍有部分认知功能未恢复到正常水平。不同程度抑郁症患者的认知功能障碍存在差异。
Objective: To analyse the cognitive function in depression and the related factors before and after therapy.
Methods: 100 patients with depression were given one antidepressive for 8 weeks, and 100 healthy people were involved as controls. They were all assessed with HAMD24 ﹑ WCST ﹑ WMS-RC and Connecting trial A ﹑ B.
Results: (1) the depressed patients made significant decrease in HAMD24, and improvement in the neuropsychological tests after treatment. (2) the improvement in neuropsychological tests had some correlation to depression symptoms. (3)compared with controls, the recovered patients and the patients with residual symptoms still have lower scores on the parameters of WCST and WMS-RC.(4)compared with moderate depression, the patients with severe depression have lower scores on some parameters of WCST and WMS-RC.
Conclusions: The cognitive function in patients with depression improves after drug treatment, with correlation to the depression symptoms remission. The cognitive function in patients with depression varies with the severity of the disease.
P019
抑郁症患者的家庭 负担和家庭功能评价 - An Evaluation of Family Burden and Family Function on Major Depression
Jin-guo Zhai 1 , Jing-ping Zhao 1 , Min Chen 1
1 Psychiatric Faculty, Jining City, Chinese Mainland
Objective: To study the family burden and family function of major depression.
Methods: 126 major depressive patients who met with DSM- Ⅳ criteria were enrolled randomly and investigated. with Family Burden Scale (FBS) and Family APGAR Index (APGAR), comparing to the control group in family burden and family function.
Results: Positive rate (the family proportion whose factor score no less the average score) in four factors of FBS such as family economic burden, family daily activities, family entertainment and mental health of family member were, more than 50 per cent, higher. In rural patients, the factor score of family economic burden was higher than that of urban patients (t=2.687, P ＜ 0.01), and the factor score of mental health of family member was lower (t=3.375 ， P ＜ 0.01). There was no significant difference in family dysfunction between premorbid of major depression and control group ( χ 2 ＝ 0.108, P ＞ 0.05). Significant differences were found in family dysfunction not only between premorbid and postmorbid ( χ 2 ＝ 70.045, P ＜ 0.001) but also between postmorbid and control group (P ＜ 0.001).The total scores and each factor score of APGAR in postmorbid were lower than premorbid (P ＜ 0.001).
Conclusion: The family burden and family dysfunction of major depression were serious, we must give effective intervention.
Key words: Major depression ， Burden of disease ， Family burden ， Family function
P020
首 发和复发重性抑郁症患者血清 S100B 水平的比 较 - Serum S100B Levels in First Episode and Recurrent Major Depression
Yang Kun 1 , Xie Guangrong 1
1 The Mental and Health Institute in Central Southern University, Psychiatry, Changsha, Chinese Mainland
目的 : 检测重性抑郁症患者血清 S100B 水平 ， 探 讨重性抑郁症患者 S100B 的 临床意义 ； 并探讨不同发病次数对抑郁症血清 S100B 的影响。
方法 : 应用 ELISA 法 对 54 例抑郁症患者和 35 名正常 对照进行血清 S100B 水平 检测。结果 抑郁症 组和正常对照组之间血清 S100B 水平具有 显著差异性 (P<0.05) ， 且抑郁症 组血清 S100B 水平 显著高于正常对照组 ； 首发和复发抑郁症以及复发抑郁症和正常对照组之间血清 S100B 水平有 显著差异性 (P<0.05) 。 结论 S100B 可能是抑郁症的 脑功能紊乱的指标之一； S100B 涉及抑郁症的病理生理 学机制； 发作次数不同，抑郁症的病理生理机制不同。
P021
重性抑郁症主 观和客观睡眠研究 - The Objective Sleep and Subjective Sleep in Major Depressive Disorder
Yang Kun 1 , Xie Guangrong 1
1 The Mental and Health Institute in Central Southern University, Psychiatry, Changsha, Chinese Mainland
目的： （ 1 ） 对抑郁症患者进行匹兹堡睡眠质量量表 (PSQI) 评估和多导睡眠脑电图检测（ PSG ），探 讨首发和多次发作抑郁症之间的睡眠脑电特征的异同，分析抑郁症患者主、客观睡眠特征。（ 2 ）利用 汉密尔顿抑郁量表 (HAMD) 、 汉密尔顿焦虑量表 (HAMA) 对抑郁症进行评估，探讨抑郁症患者 S100B 、多 导睡眠脑电图与 HAMA 、 HAMD 之 间的关系。
方法： 采用病例 对照研究的方法，应用一般情况调查表（自拟）、 HAMD 、 HAMA 、 PSQI 对 29 例抑郁症患者和 14 名正常 对照进行睡眠评估。应用多导睡眠脑电仪 (PSG) 对 29 例重性抑郁症患者中的和 14 名健康 对照进一步检测重性抑郁症患者客观睡眠指标。
结果： （ 1 ）抑郁症 组在睡眠潜伏期、睡后觉醒的次数、 RT% 、 REM 睡眠潜伏期、 REM 活 动度、 REM 强度、第一 个 REM 睡眠 时间、 FRT% 、 REM 睡眠次数方面与正常 对照组相比，有显著差异性 (P<0.05) ； 首次 发作抑郁症和多次发作抑郁症患者在 S1% ， REM 睡眠 时间， RT% ， REM 睡眠潜伏期， REM 密度， FRT% 有 显著性差异（ P<0.05 ）；（ 2 ）抑郁症男性和女性在 PSG 睡眠 变量方面（睡眠潜伏期、觉醒时间、睡眠效率、睡眠维持率、睡眠阶段 S2 、 REM 活 动度、 REM 强度、第一 个 REM 睡眠 时间、 REM 睡眠次数）存在 显著差异 (P<0.05); 抑郁症患者 PSQI 总分、睡眠效率和睡眠时间与 PSG 的 S2% 、 SWS 、 SWS （ % ）、 REM 活 动度等显著相关 (P<0.05) ；（ 3 ）客 观睡眠和主观睡眠在睡眠效率、实际睡眠时间、睡眠潜伏期显著性差异 (P<0.05), 且主 观睡眠的睡眠效率差于客观睡眠效率，主观睡眠实际睡眠时间少于客观睡眠的实际睡眠时间，主观睡眠 的睡眠潜伏期 长于客观睡眠的睡眠潜伏期。
结论： (1) 抑郁症患者存在 严重的睡眠紊乱； (2) 性 别、不同发作次数的抑郁症患者存在显著的多导睡眠变量差异； (3) 抑郁症患者主 观睡眠和客观睡眠存在显著差异，抑郁症患者负性认识恶化了主观睡眠：低估睡眠总时间，高估睡眠潜伏期。
P022
S100B 基因多 态性与抑郁症易感性的关联研究 - The Association of S100B Gene with Major Depressive Disorder
Yang Kun 1 , Xie Guangrong 1
1 The Mental and Health Institute in Central Southern University, Psychiatry, Changsha, Chinese Mainland
目的： 了解重性抑郁症患者神 经胶质源性蛋白 (S100B) 基因多 态性的分布情况，初步探讨 S100B 基因多 态性与重性抑郁症患者的关系，目的想推测出如下假设： S100B 是否是重性抑郁症患者的 遗传易感因素。
方法： （ 1 ）采用病例 对照研究的方法，应用一般情况调查表（自拟）、 HAMD 、 HAMA 等， 对 152 例重性抑郁症患者的 临床特征进行评定；并对 150 名健康 对照进行心理评估。（ 2 ）采用聚合 酶 链反应－限制性片断长度多态性（ PCR-RFLP ）技 术，检测 152 例重性抑郁症患者和 150 名健康 对照者的 S100B 基因多 态性。结果：抑郁症组和正常对照组之间 S100B 基因 rs9722C>T 和 rs11911834G>T 基因型 频率及等位基因频率无显著差异性 (P>0.05) ；首次 发作年龄和抑郁类型（首次发作或多次发作）在 rs9722C>T 三 种基因型之间具有显著差异性 (P<0.05) ；抑郁 类型（首次发作和多次发作）在 rs11911834G>T 三 种基 因型之 间具有显著差异性 (P<0.05) 。
结论： S100B 基因 rs9722C>T 和 rs11911834G>T 不与抑郁症 关联；发作次数在 S100B 基因的不同基因型中是有 显著差别的。
Objectives: To understand the distribution of glial-derive protein S100B gene polymorphism, to explore initially the relationship of S100B gene polymorphism and major depressive disorder. The purpose is to suppose presumption as following: whether S100B may be one of the genetic vulnerable factors in major depression.
Methods: （ 1 ） To adopt case control study, and 152 MDD were assessed with general health state of oneself － developing questionnaire ， HAMA ， HAMD, 150 healthy controls were assessed with HAMD; （ 2 ） To detect the S100B gene polymorphism in 152 MDD patients and 150 healthy controls by polymerase chain reaction--restriction fragment length polymorphism.
Results: There are not significant differences in the genotypic frequency and allele frequency of S100B gene rs9722C>T or rs11911834G>T polymorphism in depressed patients and normal controls （ P>0.05 ） . there are significant differences in onset age and the subgroup depression ( first-episode and recurrent depression) in three genotypes of S100B rs9722C>T in patients and controls （ P<0.05 ) . there are significant differences in the subgroup depression ( first-episode and recurrent depression ) in three genotypes of S100B rs11911834G>T in patients and controls （ P<0.05 ） .
Conclusions: S100B gene rs9722C>T or rs11911834G>T polymorphism are not significantly related with depression; there are certain differences in depressive episodes among different genotypes of S10B gene.
P023
大学生抑郁无望感 / 自尊理 论的结构方程模型 - The Structural Equation Modeling of Hopelessness/Self-esteem Theory for Depression in Graduates
纯 王 1 , 宁 张 2 , 亚林 张 3
1 湖南 长沙湘雅二医院精神卫生研究所 , 湖南 长沙 , Chinese Mainland, 2 南京医科大学附属南京 脑科医院 , 江 苏南京 , Chinese Mainland, 3 湘雅二医院精神 卫生研究所 , 湖南 长沙 , Chinese Mainland
目的 ： 探索抑郁与 归因方式、无望感、自尊和人格的关系。
方法 ： 本研究 对 185 名大学生 进行了 Beck 抑郁量表 （ BDI ） 、 归因方式问卷 （ ASQ ） 、自尊量表 （ SES ） 和卡特 尔 16 项人格问卷 （ 16-PF ） 的 测定。
结果 ： 验证了归因方式 ( 持 续归因和宿命归因 ) 、自尊以及人格的敏感性 对抑郁的直接关系 ， 归因方式和自尊在人格 （ 兴奋性和由紧张性、怀疑性和稳定性组成的神经质人格 ） 对抑郁的作用中具中介作用 ， 否定了二者对抑郁的交互作用。
结论 ： 本研究在中国大学生被 试中验证和澄清了抑郁的无望感 / 自尊理 论 ， 建立了该理论的结构方程模型。
Objective: To investigate the correlation of depression, attributional style and personality.
Method: 185 undergraduates were measured with Beck Depression Inventory （ BDI ） , Attributional Style Questionnaire （ ASQ ） , The self-Esteem Scale (SES) and Sixteen Personality Factor Questionnaire （ 16-PF ） .
Result: Results suggest that Self-esteem, attributional style （ stable attribution and fated attribution ） and sensitivity have direct effect on depression. Self-esteem and attributional style have significant modiating effect on the path of personality (liveliness and neuroticism including tension, suspiciousness and stability) to depression and there is no interaction in them to depression.
Conclusion: This research testified and clarified the integrated hopelessness/self-esteem theory for depression. And a structural equation modeling for this theory was established.
P024
抗抑郁 药物引发转相的前瞻性观察 - Prospective Observation of Switching Rate of Antidepressants in Management of Depressive Episode in 3 Months
卫东 金 1
1 浙江省精神 卫生中心 , 杭州 , Chinese Mainland
目的 ： 前瞻性探 讨抗抑郁药物在治疗抑郁发作过程中出现转相的几率。
方法 ： 对 190 例接受抗抑郁 药物治疗的抑郁发作的病人在 “ 最自然 ” 的抗抑郁治 疗情况下进行为期 3 个月的 观察 ， 评价转相几率。其中转相标准是 ：（ 1 ） 出 现躁狂或轻躁狂 ； 或者 （ 2 ） 原来的循 环加快 ； 或者 （ 3 ） 杨氏躁狂评定量表 ≥11 分或者其中的易激惹和破坏攻 击行为 ≥3 分 ；（ 4 ） 治 疗医师认为应该停用抗抑郁药物而使用抗精神病药物或心境稳定剂。
结果 ： （ 1 ） 190 例病人 3 个月的治 疗中 ， 转相 18 例 ， 转相率为 9.47% ，（ 2 ） 男性病人 61 例 ， 转相 4 例 ， 转相率为 6.56% ， 女性病人 129 例 ， 转相 14 率 为 10.85% ， 差异没有 显著性 （ X2=0.89 ， P>0.05 ） 。（ 3 ） 单相抑郁与双相抑郁分别为 170 例和 20 例，分 别有 10 例和 8 例病人出 现转相，转相率分别为 5.88% 和 40% ，差异有非常 显著性（ X2=24.29 ， P<0.01 ），（ 4 ） 应用心境稳定剂者 36 例， 转相 5 例， 转相率 13.8% ，没有 应用心境稳定剂者 154 例， 转相 13 例， 转相率 8.44% ，差异没有 显著性（ X2=1.47 ， P>0.05 ）。（ 5 ）服用 2 种或 2 种以上抗抑郁药 物者 54 例， 转相 7 例， 转相率 12.96% ， 仅服用一种抗抑郁药物者 136 例， 转相者 11 例， 转相率为 8.08%, ，差异没有 显著性（ X2=1.07 ， P>0.05) 。有心境障碍家族史者 38 例， 转相 7 例， 转相率 18.4% ，没有心境障碍家族史者 152 例， 转相 11 例， 转相率 7.23% ，差异有 显著性（ X2=4.43 ， P<0.05 ），
结论： 抗抑郁 药物在为期 3 个月的治 疗中可以出现转相，应该注意这种转相。
感 谢： 王秀珍（ 辽宁省沈阳市精神卫生中心）、谢守富（辽宁省大连市第七人民医院）、郗小明（辽宁鞍钢精神康复医院）、甘景梨、高存 友（全 军精神疾病防治中心）、徐乐平（解放军 102 医院）、王金 龙（浙江省嘉兴康慈医院）、钱建军（浙江省绍兴市第七人民医院）、赵俊雄（浙江省金华市第二人民医院）、施和勋（浙江省义乌市精神卫生中心）、祝云龙（浙江省衢州市第三人民医院），黄文武（浙江省温州康宁医院）。
Objective: to observe prospectively of switching rate of antidepressants in management of depressive episode.
Methods: 190 patients with depressive episode treated by antidepressants were observed for 3 months and switching rate were assessed under “best natural therapy”. And switching criteria was following: (1) manic or hypomanic episode; or(2) promoting rapid cycling; or (3) YMRS≥11 or irritability or aggravation in YMRS ≥3. (4) Psychiatrist think that the patients should be stopped to take antidepressants and should be placed by mood stabilizer or antipsychotics or their combination.
Results: (1)18 of 190 patients was found to switch in 3 month therapy. The switching rate was 9.47%. (2)4 of 61 males was found and 14 females was found to switch, their switching rate was not significant (6.56%,10.85%,X2=0.89 ， P>0.05).(3) 10 of 170 unipolar depression and 8 of bipolar depression was found to switch, their switching rate was very significant ( 5.88%,40%,X2=24.29 ， P<0.01). (4)5 of 36 patients token mood stabilizer and 13 patients not token mood stabilizer was found to switch, their switching rate was not significant (13.8% ， 8.44%,X2=1.47 ， P>0.05). (5)7 of 54 patients token more two antidepressants and 11 patients token single antidepressant was found to switch, their switching rate was not significant (12.96% ， 8.08%, X2=1.07 ， P>0.05). (6)7 of 38 patients with family history of mood disorder and 11 of patients without family history of mood disorder was found to switch, their switching rate was significant (18.4%, 7.23%,X2=4.43 ， P<0.05).
Conclusion: Some depressive patients may switch during treatment with antidepressant, it should be stressed on.
P025
世界 卫生组织生活质量量表 （ WHOQOL ） 应用于门诊精神分裂症患者中的信度、效度分析 - Analysis for WHOQOL applied in Outpatients credits and effections
仕友 孙 1
1 北京回 龙观医院 , 100096, Chinese Mainland
目的 ： 对世界卫生组织生活质量量表 （ 简版 ）（ WHOQOL-brief ） 应用于门诊精神分裂症病人的信度、效度分析。
方法 ： 收集 100 例 门诊病人 ， 符合 ICD － 10 精神分裂症的 诊断标准 ， 用简明精神症状量表 （ BPRS ） 评定精神症状 ， 用总体功能量表 （ GAF ） 评价社会功能 ， 用世界卫生组织生活质量量表 （ 简版 ）（ 26 项 ） 评价生活质量。
结果 ： 该量表的同质信度为克伦巴赫系数在 0.21-0.83; 分半信度 为 0.70 ， 不同性 别、年龄、文化、婚姻与生活质量无显著性相关。结论：世界卫生组织生活质量量表（简版）适应于门诊精神分裂症病人，信度、效度良好。
关键词 ： 生活 质量 精神分裂症 世界 卫生组织生活质量量表 （ 简版 ）
Objective: To investigate quality of life of outpatients with schizophrenia and its correlation with related factors.
Methods: 100 schizophrenic cases met the criteria of ICD-10 were recruited and evaluated by Positive and Negative Syndromes Scale (PANSS), General Assessment Functioning (GAF), and WHO Quality of Life (brief version).
Results: There were significant correlation between quality of life (QOL) and negative syndromes, rather than positive syndromes. QOL of patients with employment trend to be higher than that of unemployment. There was no significant relation between QOL of the patients with side-effect and without side-effects rated by themselves. There was no significant relation between QOL of the second-generation antipsychotics and first-generation antipsychotics. QOL of male patents was higher than that of female. There was no significant relation between QOL and marital states of the patients.
Conclusion: QOL of patients could be improved by ameliorating negative syndromes and employment.
Keywords: schizophrenia, quality of life
P026
Erectile Dysfunction and its Relation with Coping Style in Patients with Major Depression
福喜 吴 1
1 广州市精神病医院 , 广州 , Chinese Mainland
Objective: To investigate the erectile dysfunction(ED) and its relation with coping style in Chinese male adult patients with major depression (MD).
Methods: 60 patients with MD aged from 26 to 50 years were evaluated with International Index of Erectile Function (IIEF), Hamilon Depression Rating Scale (HAMD), Self-rating Depression Scale(SDS) and Trait Coping Style Questionnaire (TCSQ).
Results: ① In the patients with MD, the rate of comorbidity with ED was 61.7% and there were no significant difference between the rates of the first-onset patients and the recurrent patients. ② The scores of HAMD in the patients comorbidity with ED were higher than those of patients not comorbidity with ED ,but the scores of SDS and TCSQ had no significant difference between them. ③ In the recurrent patients, the scores of IIEF and positive coping of TCSQ were lower and the scores of HAMD were higher than those of the first-onset patients with MD. ④ The rate of comorbidity with ED in patients with treatment of SSRIs were 60% and mitrazapine 63.2%, there were no significant difference between them. ⑤ There was a negative correlation between the scores of HAMD and IIEF, and a positive correlation between the scores of HAMD and negative coping of TCSQ in the patients with MD. ⑥ The multiple stepwise regression analysis showed that the scores of HAMD, negative coping of TCSQ and Quetelet BMI were associated with the scores of IIEF in patients with MD.
Conclusion: The patients with MD have a high rate of comorbidity with ED and their coping style are negative no matter who has ED or not.
P027
抑郁症患者勃起功能障碍及其 应对方式分析 - Erectile Disfunction in Patient with Depression and Analysis of their Coping Style
福喜 吴 1
1 广州市精神病医院 , 广州 , Chinese Mainland
目的 : 探 讨男性抑郁症患者的勃起功能及其与应对方式的关系 ；
方法 : 对 60 例年 龄 26-50 岁的男性抑郁症患者采用国际勃起功能指数问卷 （ IIEF ） 、 汉米尔顿抑郁量表 （ HAMD ） 、自 评抑郁量表 （ SDS ） 、特 质应对方式问卷 （ TCSQ ） 等量表 进行评估 ， 同时对抑郁症与勃起功能障碍 （ ED ） 共病 组及非共病组、首发与复发抑郁症患者组 IIEF 、 HAMD 、 SDS 、 TCSQ 量表 评分进行比较 ， 并对影响抑郁症患者的勃起功能的因素进行多元回归分析。
结果 : 60 例抑郁症中 ， IIEF 评分 ≤21 分者 37 人 ， 即抑郁症与 ED 共病率 为 61.7% ， 其中首 发抑郁与 ED 共病率 为 51.7% ， 复发抑郁与 ED 共病率 为 71.0% ， 二者共病率比 较无显著性差异 ； 抑郁症与 ED 共病 组 HAMD 评分比非共病组高 ， SDS 、 TCSQ 评分二者无显著性差异 ； 复发抑郁症患者组 IIEF 、 TCSQ 积极应对分均比首发抑郁症患者组低 ， HAMD 评分比首发抑郁症患者组高 ， SDS 及 TCSQ 消极 应对分两组比较无显著性差异 ； 服用 SSRI 类药物及米氮平的抑郁症患者中 ， 抑郁症与 ED 共病率分 别为 60% 及 63.2% ， 两者比 较无显著性差异 ； 相关分析表明抑郁症患者 HAMD 与 IIEF 评分显著负相关 ， HAMD 及 SDS 评分均与 TCSQ 积极应对分显著负相关 ， HAMD 与 TCSQ 消极 应对分显著正相关。多元逐步回归分析表明影响抑郁症患者勃起功能的因素分别为 HAMD 评分、 TCSQ 消极 应对分与身高体重指数。
结论 : 抑郁症与 ED 的共病率高，且抑郁症病情越 严重，与 ED 共病率越高。抑郁症患者无 论是否与 ED 共病，其 应对方式均倾向于消极应对。
P028
NET 基因 G1287A 多 态性与社会心理因素在重性抑郁症中的 交互作用研究 - The Interaction of NET Gene Polymorphism G1287A and Social Psychic Factors in Major Depression
红 杨 1 , 晓红 崔 1 , 燕 任 1 , 克 让 张 1
1 山西医科大学第一医院 , 精神 卫生科 , 太原 , Chinese Mainland
目的： 1 ．分析 NET 基因 G1287A 多 态性与重性抑郁症（ MD ）的 关联性。 2 ．分析 NET 基因 G1287A 多 态性与社会心理因素交互作用与 MD 的 关联性。
方法： 采用病例 对照研究，选取病例组和对照组各 281 例，使用 HAMD 、 EPQ 、 LES 、 SSS 、 TCSQ 分 别对人格、生活事件、社会支持、应对方式等进行评估，运用 PCR 及基因 测序方法对 G1287A 多 态性进行检测。统计分析使用 SPSS11.5 进行，基因型分布比较用 χ2 检验，通过 logistic 回 归模型计算各基因型对抑郁症的相对危险度（ OR ），并利用 该模型对重性抑郁中的基因 - 社会心理因素交互作用 进行分析，通过单独环境暴露的 OR 值（ ORe ）、 单独遗传暴露的 OR 值（ ORg ）及两者共同作用的 OR 值（ OReg ）之 间的关系，并结合交互作用系数（ γ, γ ＝ βeg/βe ），判断交互作用存在与否及其作用性 质。
结果： 1 ． Hardy-Weinberg 遗传平衡检验：经拟合优度 χ2 检验分析，达到遗传平衡（ P>0.05 ）， 说明该样本具 有群体代表性。 2 ． NET 基因多 态性 G1287A 与 MD 的 关联分析： NET G1287A 在两 组中基因型、等位基因频率分布差异无显著性 (P ＞ 0.05) 。以 GG 基因型 为参照， GA 基因型的 OR 值为 1.033(0.730-1.461, P=0.855) , AA 基因型的 OR 值为 1.447(0.757-2.766, P=0.263) ；以 G 等位基因 为参照， A 等位基因的 OR 值为 1.122(0.864-1.457, P=0.427 ) 。
3. NET 基因多 态性 G1287A 与社会心理学因素交互作用与 MD 的 关联研究： G1287A AA 基因型与精神 质人格、内向型人格及较少采取积极应对方式可能存在超相乘模型交互作用， γ 分 别为 2.528 ， 1.878 ， 1.935 ；与神 经质人格可能存在正相加模型交互作用， γ 为 1.032 ；与生活事件可能存在夫相加模型交互作用， γ 为 0.791 ；与消极 应对方式、社会支持可能不存在交互作用。
结论： 在中国 汉族人群中：
1. 未 发现 NET 基因多 态性 G1287A 与重性抑郁症 发病有关联。
2. NET G1287A AA 基因型 对精神质人格、内向型人格、较少采取积极应对方式及神经质人格抑郁症患病风险可能有放大作用；对生活事 件抑郁症患病 风险有减弱作用。
Objective:
1. To analysis the association between NET gene polymorphism G1287A and MD.
2. To analysis the association between the interaction of G1287A-social psychic factors and MD.
Method: A case-control sample, including 281 cases and 281 controls, was recruited in our study with strict selected standards. HAMD, EPQ, LES, SSS and SCSQ were used to evaluate the Social-psychic factors, such as personality, life events, social supports and coping styles. Polymerase chain reaction (PCR) and DNA direct sequencing technique were used to detect the G1287A genetic polymorphism of the NET gene. All statistical analysis was performed using SPSS statistical software. The genotype and allele frequency distribution were compared with χ 2 analysis, and multivariate logistic regression were used to screening Social-psychic factors and analysis the interaction between NET gene polymorphism and Social-psychic factors in MD.
Results: 1 ． The Hardy-Weinberg equilibrium test ： We found there was no statistical difference between observed number and expected number by the goodness-of-fit χ 2 test (P ＞ 0.05). 2 ． There was no significant difference of genotype frequency and allele frequency of NETG1287A between cases and controls (P ＞ 0.05). Referring to G/G genotype, the OR value of G/A genotype and A/A genotype were respectively 1.033(0.730-1.461, P=0.855), 1.447(0.757-2.766, P=0.263). Referring to G allele, the OR value of A allele was 1.122(0.864-1.457, P=0.427). 3. There were significant multipliable interaction among genotype A/A and Psychoticism, Introverts, low- Positive coping style, the γ value were respectively 2.528 ， 1.878 ， 1.935; There were positive additive interaction between genotype A/A and Neuroticism, the γ value was 1.032; There were negative additive interaction between genotype A/A and LES, the γ value was 0.791; There were no significant interaction among genotype A/A and Negative coping style, low-social support.
Conclusion: In Chinese Han population ：
1. The NETG1287A gene polymorphism was probably not associated with MD.
2. There were significant interaction among genotype A/A and Psychoticism, Introverts, Neuroticism, LES, low-Positive coping style. There was no significant interaction between genotype A/A and Negative coping style, and low-Social support.
Key words: Major Depression, NETG1287A, Social psychic factor, Interaction
P029
NET 基因 T-182C 多 态性与社会心理因素在重性抑郁症中的 交互作用研究 - The Interaction of NET Gene Polymorphism T182C and Social Psychic Factors in Major Depression
晓红 崔 1 , 红 杨 2 , 忻蓉 李 2 , 克 让 张 2
1 山西医科大学第一医院 , 精神 卫生科 , 030001, Chinese Mainland, 2 山西医科大学第一医院 , 精神 卫生科 , 太原 , Chinese Mainland
目的 ： 1 ． 分析 NET 基因 T-182C 多 态性与重性抑郁症 （ MD ） 的 关联性。 2 ． 分析 NET 基因 T-182C 多 态性与社会心理因素交互作用与 MD 的 关联性。
方法 ： 采用病例 对照研究 ， 选取病例组和对照组各 281 例 ， 使用 HAMD 、 EPQ 、 LES 、 SSS 、 TCSQ 分 别对人格、生活事件、社会支持、应对方式进行评估 ， 运用 PCR 及基因 测序方法对 T-182C 多 态性进行检测。统计分析使用 SPSS11.5 进行，基因型分布比较用 χ2 检验，通过 logistic 回 归模型计算各基因型的相对危险度（ OR ），并利用 该模型对重性抑郁中的基因 - 社会心理因素交互作用 进行分析，通过单独环境暴露的 OR 值（ ORe ）、 单独遗传暴露的 OR 值（ ORg ）及两者共同作用的 OR 值（ OReg ）之 间的关系，并结合交互作用系数（ γ, γ ＝ βeg/βe ），判断交互作用存在与否及其作用性 质。
结果： 1 ． Hardy-Weinberg 遗传平衡检验：经拟合优度 χ2 检验分析，达到遗传平衡（ P>0.05 ）， 说明该样本 具有群体代表性。
2 ． NET T-182C 在两 组中基因型、等位基因频率分布差异无显著性 (P ＞ 0.05) 。以 TT 基因型 为参照， TC 基因型的 OR 值为 1.058(0.746-1.499, P=0.753), CC 基因型的 OR 值为 1.844(1.010-3.365, P=0.046) ；以 T 等位基因 为参照， C 等位基因的 OR 值为 1.233(0.956-1.589, P=0.116 ) 。 3. NET T-182C 与社会心理学因素交互作用与 MD 的 关联研究： T-182C C/C 基因型与精神 质人格、生活事件、较少采取积极应对方 式及低社会支持可能存在超相乘模型交互作用， γ 分 别为 2.592 ， 1.619 ， 1.565 ， 2.376 ；与神 经质人格、消极应对方式可能存在正相加模型交互作用， γ 分 别为 1.154 ， 1.152 ；未 发现 T-182C C/C 基因型与内向型人格之 间存在交互作用。
结论： 在中国 汉族人群中： 1. NET 基因多 态性 T-182C 可能与重性抑郁症 发病有关联， CC 基因型可能增加抑郁症 发病风险。 2. NET T-182C CC 基因型 对精神质人格、经历较多生活事件、较少采取积极应对方式、低社会支持、神经质人格及消极应对方式抑郁症患病风险可 能有放大作用。即 该基因型与上述社会心理因素其中之一同时存在时 ， 会增加抑郁症患病风险。
Objective:
1. To analysis the association between NET gene polymorphism T182C and MD.
2. To analysis the association between the interaction of T182C- social psychic factors and MD.
Method: A case-control sample, including 281 cases and 281 controls, was recruited in our study with strict selected standards. HAMD, EPQ, LES, SSS and SCSQ were used to evaluate the Social-psychic factors, such as personality, life events, social supports and coping styles. Polymerase chain reaction (PCR) and DNA direct sequencing technique were used to detect the T182C genetic polymorphism of the NET gene. All statistical analysis was performed using SPSS statistical software. The genotype and allele frequency distribution were compared with χ 2 analysis, and multivariate logistic regression were used to screening Social-psychic factors and analysis the interaction between NET gene polymorphism and Social-psychic factors in MD.
Results: 1 ． The Hardy-Weinberg equilibrium test ： We found there was no statistical difference between observed number and expected number by the goodness-of-fit χ 2 test(P ＞ 0.05). 2 ． There was no significant difference of genotype frequency of NETT182C between cases and controls (P=0.128). Referring to T/T genotype, the OR value of C/C genotype and T/C genotype were respectively 1.844(1.010-3.365, P=0.046), 1.058(0.746-1.499, P=0.753). Referring to T allele, the OR value of C allele was 1.233(0.956-1.589, P=0.116 ). 3.There were significant multipliable interaction among genotype C/C and Psychoticism, LES, low-Positive coping style and low-social support, the γ value were respectively 2.592 ， 1.619 ， 1.565 ， 2.376; There were significant additive interaction among genotype C/C and Neuroticism, Negative coping style, the γ value were respectively 1.154 ， 1.152; There were no significant interaction between genotype C/C and introverts .
Conclusion: In Chinese Han population ：
1. The C/C genotype of NETT182C polymorphism was probably related to MD.
2. The C/C genotype of NETT182C polymorphism could probably amplify the effects of Psychoticism, Neuroticism, LES, Negative coping style, low-Positive coping style and low-social support to MD.
Key words: Major Depression, NETT182C, Social psychic factor, Interaction
P030
精神分裂症患者凶 杀案的作案特征与责任能力比较研究 - Comparative Study on Characters and Responsibility of Murder by Patients with Schizophrenia
孙 付 根 1 , 寇 振 芬 2 , 董 瑞 兰 2
1 河南省新 乡医学院二附院 （ 河南省精神病医院 ） , 早期干 预一科 , 新 乡市 , Chinese Mainland, 2 新 乡医学院第二附属医院 , 河南新 乡 , Chinese Mainland
目的 ： 探 讨精神分裂症患者凶杀案的作案特征与刑事责任能力评定。
方法 ： 采用 对照研究方法 ， 对精神分裂症患者与非精神病人的案例资料统计分析。
结果 ： 精神分裂症患者 杀人具有突发、公开性、不自主性、残忍性 ； 多在病理动机下单独作案 ， 受害人多为熟人或亲人 ， 案中、案后缺乏自我保护能力 ， 检验能力部分或全部丧失 ； 妄想、幻听、认知障碍是导致杀人的直接因素。
结论 ： 作案特征与作案 动机及检验能力是评定刑事责任能力的主要因素。
关键词 : 精神分裂症 ； 凶 杀 ； 司法精神病学 ； 作案特征 ； 刑事责任能力
Objective: To explore the assessments of characters and responsibility of murder by patients with schizophrenia.
Methods: Case's data of patients with Murder; Forensic psychiatry; Characters of murder; Criminal responsibility were statistically analyzed. Results Characters of murder by patients with Murder; Forensic psychiatry; Characters of murder; Criminal responsibilitywere outburst, open, non-autonomic and bloody; the most was caused pathological motivation, victims were mainly acquaintances or relatives, self-safeguard was lack during and after committing murder,and capacities for checkup were partially or entirely lost; the direct reasons were delusion,hallucination, congnitive-disorder 。
Conclusions: the characters, activity and capacities for checkup are the main factor of assessments of responsibility of murder by patients.
Key words: Schizophrenia ； Murder ； Forensic psychiatry ； Characters of murder ； Criminal responsibility
P031
No Association between the Combind Effect of the Serotonin and Norepinephrine Transporter Gene in Major Depressive Disorder
Shan Wang 1 , Ning Sun 2 , Jinli Liu 2 , Zhifen Liu 2 , Yong Xu 2 , Juyi Peng 2 , Kerang Zhang 2
1 the First Hospital of Shanxi Medical University, Department of Mental Health, Taiyuam, Chinese Mainland, 2 the First Hospital of Shanxi Medical University, Department of Mental Health, Taiyuan, Chinese Mainland
Objective: Recent studies suggest that major depressive disorder (MDD) may be influenced by polymorphisms in the serotonin and norepinephrine transporter gene, and these two transporters are the important target for antidepressant. Therefore, the purpose of the present study was to replicate the association between the serotonin transporter gene(5-HTT), norepinephrine transporter gene (NET) and MDD and to analyze the combind effect between the 5-HTT and NET gene.
Methods: We analyzed an insertion/deletion polymorphism in the promoter region of 5-HTT gene (5-HTTLPR), T128C polymorphism in the promoter region of NET gene and another silent polymorohism G1287A in exon nine of the NET gene. Our study included 304 subjects affected MDD (according to DSM-IV) and 366 volunteers. Genotypes were ascertained at 5-HTTLPR by agorose gel electrophoresis of PCR products and at T128C and G1287A by PCR products direct sequencing. Cocaphase was used for statistical analysis.
Results: No statistical significant differences between patients and controls were found for the three analyzed polymorphisms, either in the genotype distribution or in the allele frequencies. Similarly, the combind effect of 5-HTT and NET gene was not found between patients and controls.
Conclusion: This study suggests that the investigated polymorphisms in the 5-HTT and NET gene are not major risk factors in increasing susceptibility to MDD in a Han Chinese population and the combination function of these two genes are not associated with major depressive disorder. Hower, larger replication studies with different ethnic samples are needed.
P032
5-HTTVNTR 与 环境因素的交互作用与重性抑郁症的关联研究 - The Relationship of Major Depression with the Interaction Effect between Serotonin Transporter Gene STin2 Polymorphisms and Environment
克 让 张 1 , 忻蓉 李 1 , 宁 孙 1 , 晓红 崔 1 , 勇 徐 1 , 菊意 彭 1
1 山西医科大学第一医院精神 卫生科 , 太原 , Chinese Mainland
目的 ： 探 讨 5-HTT 基因第二内含子区由 17bp 核心序列形成的可 变数目串联重复序列 （ VNTR ） 简称 STin2 和社会心理因素的交互作用与重性抑郁症 （ MD ） 的 关联性。
方法 ： 采用病例 对照研究 ， MD 人群来源于山西医科大学第一医院精神 卫生科共 239 例 ， 汉族 ， 年龄在 18~58 岁之间 ， 平均年龄 29.6±8.4 岁 ， 其中男性 122 人 ， 女性 117 人。以 遗传学研究用诊断检查（ DIGS ）作 为筛查工具， DSM-IV 作 为诊断标准， HAMD （ 17 项）评分大于 17 分。无其他 遗传性疾病及严重躯体性疾病，无其他精神障碍。健康人群来源于山西太原健康志愿者，共 239 例， 汉族，年龄在 18~60 岁之间，平均年龄 30.1±9.8 。其中男性 108 人，女性 131 人。研究 对象无明显精神、躯体疾病及阳性精神疾病家族史，个体间无亲缘关系。使用艾森克个性问卷（ EPQ ）、生活事件量表（ LES ）、特 质应对方式问卷 （ TCSQ ）、社会支持量表（ SSS ） 进行社会心理因素评估， 采用聚合 酶 链反应（ PCR ） 对 STin2 多 态性进行检测。 5-HTT 基因和社会心理因素的交互作用用多元 Logistic 回 归实现。结果： ① STin2 和人格的交互作用与 MD 的 关联分析： STin2 的 Stin2.12/12 基因型与精神 质人格之间存在交互作用，符合超相乘模型。交互作用系数 γ 为 1.38 。 STin2 与内外向的交互作用符合 负相加模型，交互作用系数 γ 为 0.85 。 STin2 与神 经质之间的交互作用不明显。 ② STin2 和生活事件的交互作用与 MD 的 关联分析： STin2 与生活事件的交互作用系数 γ 接近 1 ，提示 SS 基因型与 较多生活事件的交互作用不明显。 ③ STin2 和 应对方式的交互作用与 MD 的 关联分析： STin2 与 积极应对方式及消极应对方式之间均不存在明显交互作用。 ④ STin2 和社会支持的交互作用与 MD 的 关联分析： STin2 与低社会支持存在交互作用，符合超相乘模型。交互作用系数 γ 为 1.28 。
结论： 在中国 汉族人群中， STin2 Stin2.12/12 基因型与精神 质人格、低社会支持存在协同交互作用，提示该基因和上述社会心理因素同时存在时可以增加 MD 发病的风险。而 Stin2.12/12 基因型与内向型人格 则存在拮抗交互作用。
Objective: To investigate the influence of interaction effect between STin2 gene polymorphism and social psychic factors on MD.
Methods: A case-control sample, including 239 patients and 239 controls, was recruited in our study with strict selected standards. EPQ, LES, SSS and TCSQ were used to evaluate the social psychic factors, such as personality, life events, social supports and coping styles. PCR was used to detect the polymorphism of STin2. Multivariate logistic regression was used to select social psychic factors and complete interaction.
Results: There were significant interaction between STin2.12/12 and psychotics personality, low social supports, γ were 1.38 and 1.28 showed they could increase MD morbility. There were also significant interaction between STin2.12/12and introverts, γ was 0.85 showed they could decrease MD morbility.
Conclusions: In Chinese Han population, STin2 gene have cooperative influence on psychotics personality, low social supports and MD morbility. While the genotype have antagonistic influence on introverts and MD morbility.
P033
上海市某城区人群抑郁障碍患病率流行病学 调查 - Epidemiologieal Survey of Depression Prevalence among Residents in a Community of Shanghai
Shaoping Zhang 1 , Fang Fang 1 , Yindi Chen 1 , Zuowei Wang 1 , Zhiqiang Xue 1
1 上海市虹口区精神 卫生中心 Hongkou District Mental Health Center, Shanghai, Chinese Mainland
Objective: To examine the prevalence and the relevant factors of senile depressive disorders in an urban community residents sample.
Methods: This study was conducted among residents aged 12 years or above among community residents. They were selected by stratified random sampling from 1 of 10 streets of Hongkou district in Shanghai , China . The study design consisted of a screening stage followed by a clinical interview stage with structured clinical interview instrument for DSM-III-R (SCID-P). The cut-off point in screening was CES-D(Center for Epidemiological Studies of Depression)≥16. 5038 subjects were examined among 5512 residents.
Results: The incidence of depressive symptoms (CES-D≥16) was 4.53 %. The overall prevalence of depression was 1.02 %. The prevalence of dysthymia, depressive state related to physical disease and major depression were 0.18 % , 0.14 % and 0.70 % respectively. The depressive symptoms correlated to age, female gender, low income, low educational level, jobless, introversion, lack of hobby, physical diseases, previous depressive episodes and positive family history of psychosis. And compared with the people just having depressive symptoms, the people with depressive disorder have significant higher score on LES total score, negative score and family problem score, and significant lower PSSS total score.
Conclusions: Depression is a psychotic disorder with high prevalence, which is correlated to some socio-demographic factors, life events and social supports ． These high-risk people should be paid more attention on.
P034
重性抑郁症患者急性期症状 对所测人格的影响 - The Study of Personality in Acute Stage of Major Depression
亮 牛 1 , 杨红 任燕 崔 晓红 廖雪梅 詹海明 彭菊意
1 山西医科大学 , 太原 , Chinese Mainland
目的 ： 分析重性抑郁症患者急性期所 测艾森克人格特点 ， 探讨急性期症状对所测人格的影响。
方法 ： 严格按照纳入、排除标准 ， 以遗传学研究用诊断检查 （ DIGS ） 作 为筛查工具 ， DSM-IV 作 为诊断标准 ， 收集 2004 年 5 月至 2006 年 12 月山西医科大学第一医院精神 卫生科门诊就诊的 120 例首 发重性抑郁症 （ MD ） 患者。收集一般人口学 资料包括性别、年龄、教育水平、职业等；采用艾森克人格问卷 (EPQ) 测量 MD 急性期精神 质（ P ）、内外向（ E ）、神 经质（ N ）三个人格 维度，用 HAMD (17 项 ) 评定抑郁症状严重程度， HAMA （ 14 项）评定焦虑症状严重程度。统计分析用 t 检验、 χ2 检验及相关分析等。
结果： 1.MD 抑郁 严重程度与急性期人格的相关分析： MD 患者 HAMD 总分与急性期神经质人格呈正相关（ r=0.188, P=0.04 ），与精神 质人格、内外向人格无明显相关（ P>0.05 ）。
2.MD 焦 虑严重程度与急性期人格的相关分析： MD 患者 HAMA 总分与急性期神经质、精神质、内外向人格无关联（ P>0.05 ）。
结论： 1.MD 患者抑郁症状与急性期神 经质人格呈正相关，与其它人格可能无相关；焦虑症状与急性期人格可能无相关。 2.MD 患者急性期症状 对所测人格有影响。
Objective: To assess the influence of the symptoms to the measured personality by investing the Eysenck Personality Questionnaire (EPQ) personality of patients in acute stage of MD.
Methods: Collected 120 MD patients who visited the Psychiatry Department in the first Hospital of Shanxi Medical University from 2004.5 to 2006.12. To collect the demography data including gender, age, educational level, occupation. Three personality dimensions (Neuroticism, Extraversion and Psychoticism) were assessed with EPQ, MD symptom severity were assessed with HAMD, the anxiety symptom severity were assessed with HAMA . The t-test, chi-square-test and correlation analysis were used for statistical methods.
Results:
1. Association study between EPQ personality and depression symptom severity in acute stage of MD patients: There were positive correlation between HAMD and MD patients neurotic personality in acute stage(r=0.188, P =0.04), and there were no correlation between the P.E personality and MD patients HAMD scores (P>0.05).
2. Association study between EPQ personality and anxiety symptom severity in acute stage of MD patients: There were no correlation between HAMA and EPQ personality (P>0.05).
Conclusions:
1. There were positive correlation between HAMD and MD patients neurotic personality in acute stage. There were no correlation between the P.E personality and MD patients HAMD scores.
2. MD symptom in acute stage may effect the personality measurement .
P035
重性抑郁症患者 缓解期人格特征研究 - The Study of Personality in Catabasis of Major Depression
红 杨 1 , 牛亮 任燕 崔 晓红 樊珍 黄 润虎
1 山西医科大学 , 太原 , Chinese Mainland
目的 ： 研究重性抑郁症患者 缓解期所测艾森克人格特征 ， 探讨重性抑郁症患者的人格模式。
方法 ： 严格按照纳入、排除标准 ， 以遗传学研究用诊断检查 （ DIGS ） 作 为筛查工具 ， DSM-IV 作 为诊断标准 ， 收集 2004 年 5 月至 2006 年 12 月山西医科大学第一医院精神 卫生科门诊就诊的 120 例首 发重性抑郁症 （ MD ） 患者以及年 龄、性别与之相匹配的同期 93 例健康志愿者。收集一般人口学 资料包括性别、年龄、教育水平、职业等；采用艾森克人格问卷 (EPQ) 测量 MD 急性期精神 质（ P ）、内外向（ E ）、神 经质（ N ）三个人格 维度；治疗三个月后随访患者，对 HAMD 及 HAMA 总分均小于 7 分的 93 例患者再次 评定 EPQ 人格，比 较 MD 不同病期的人格特点，并与健康志愿者的人格比 较。统计分析用 t 检验、 χ2 检验等。
结果： 1. 一般人口学 资料：对病例组和对照组的年龄、性别、受教育程度分别进行 t 检验和 χ2 检验，结果显示两组间年龄、性别、受教育程度差异均无统计学意义（ P>0.05 ）。 2. MD 患者 缓解期与急性期所测人格比较：病例组缓解期 P 分与急性期相比无明 显差异（ P >0.05 ）； E 分（ 48.32±10.83 ）明 显高于急性期（ 45.79±11.36 ），差异有 统计学意义（ t = -2.152 ， P =0.034 ）； 缓解期 N 分（ 56.40±10.74 ）明 显低于急 性期（ 60.60±11.20 ），差异有 统计学意义（ t = 3.448 ， P =0.001 ）。 3. MD 患者 缓解期与对照组所测人格比较：病例组缓解期 P 分（ 51.55±9.07 ）明 显高于对照组（ 46.51±8.23 ），差异有 统计学意义（ t = 4.385 ， P =0.000 ）； 缓解期 E 分（ 48.32±10.83 ）明 显低于对照组（ 55.44±9.92 ） , 差异有 统计学意义（ t = -4.663 ， P =0.000 ）； 缓解期 N 分（ 56.40±10.74 ）明 显高于对照组（ 44.36±10.47 ），差异有 统计学意义（ t =7.800 ， P =0.000 ）。
结论： 1 、重性抑郁症患者 缓解期与急性期所测人格有明显差异。 2 、重性抑郁症患者 缓解期所测人格具有高精神质、高神经质以及内倾性特点。
Objective: To assess the influence of the symptoms to the measured personality by investing the Eysenck Personality Questionnaire (EPQ) personality of patients in catabasis.
Methods: Collected 120 MD patients who visited the Psychiatry Department in the first Hospital of Shanxi Medical University from 2004.5 to 2006.12 and 93 healthy volunteers who were matched with the patients in gender, age at the same time.To collect the demography data including gender, age, educational level, occupation. Three personality dimensions (Neuroticism, Extraversion and Psychoticism) were assessed with EPQ, MD symptom severity were assessed with HAMD, the anxiety symptom severity were assessed with HAMA . Follow up the patients after being cured for 3months, to those whose HAMD and HAMA scores were less than 7, assess the EPQ again. Compare the EPQ personality among different stages and compare the EPQ personality between MD patients and healthy volunteers. The t-test, chi-square-test and correlation analysis were used for statistical methods. .
Results:
1.Demography data: Use t-test and chi-square-test to gender,age, educational level between MD patients and normal controls,results show there were no statistical significance(P>0.05) between two groups.
2.To compare EPQ personality between MD patients catabasis and acute stage:There were no statistically significant difference of P personality between MD patients catabasis and acute stage;E scores （ 48.32±10.83 ） were obviously higher than acute stage （ 45.79±11.36 ）（ t = -2.152, P =0.034 ） , N scores （ 56.40±10.74 ） were obviously lower than acute stage(60.60±11.20)(t = 3.448 ， P =0.001).
3.To compare EPQ personality between MD catabasis and healthy volunteers: P scores in MD catabasis （ 51.55±9.07 ） were obviously higher than healthy volunteers （ 46.51±8.23 ）（ t = 4.385 ， P =0.000 ） ,E scores in MD catabasis （ 48.32±10.83 ） were obviously higher than healthy volunteers(55.44±9.92)(t = -4.663 ， P =0.000). N scores in MD catabasis （ 56.40±10.74 ） were obviously higher than healthy volunteers (44.36±10.47)(t =7.800 ， P =0.000).
Conclusions:
1. There are significant differences between personality measured in MD catabasis and that in acute stage.
2. MD patients in catabasis show high psychoticism, high nervousness and introversion personality.
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