• P172
  精神分裂症 谱系障碍：错误监测的电生理学特征研究 - Study of Mistaken Monitoring Electrophysiological Characteristics in Schizophrenia Spectrum Disorder
  云翔 唐 1 , 继军 王 1 , 明 岛 张 1
  1 上海市精神 卫生中心 , 上海 , Chinese Mainland
  
  目的： 精神分裂症与分裂型人格障碍患者在 临床表现上的差异可能源于他们自身错误监测功能的差异。因此，本研究通过错误相关负电位（ Ne/ERN ）、 错误正电位（ Pe ）、正确反 应负电位（ CRN ）或正确反 应正电位（ Pc ），研究 SPD 患者、精神分裂症患者在 错误监测时存在的差异。
  方法： 记录 12 名精神分裂症患者、 17 名 SPD 患者和 25 名正常 对照在执行一项 go/no-go 任 务时的事件相关电位，计算出 ERN 、 Pe 、 CRN 、 Pc ，以及 ERN 和 Pe 的差异波 进行比较。同时对三组被试的 ERN 数据 进行 LORETA 分析和比 较。
  结果： ①部分 电极中精神分裂症组 ERN 波幅（ FCz ）、 ERN 差异波波幅（ Fz ）明 显小 于正常 对照组； ②部分 电极中（ FCz ， Cz ），精神分裂症 组 ERN 波幅明 显小于正常对照组但与 SPD 组相比，无统计学显著差异； ③ SPD 组 Pe 差异波（ PZ ）波幅大于精神分裂症 组，但与正常对照组相比无统计学显著差异 ④在 ERN 时间窗口内，使用 LORETA 分析 显示错误反应前 51-0ms ，精神分裂症 组额叶及颞叶部分结构的激活程度显著低于正常对照组，在错误反应后 51-100ms 颞叶和额叶的激活程度显著低于正常对照组。在 Pe 时间窗口内， LORETA 分析亦 显示在错误反应后 101-150ms ，精神分裂症患者的 颞叶的激活程度显著低于 正常 对照组，而在错误反应后 251-350ms 额叶和颞叶的激活程度显著低于正常对照组。 ⑤无 论是在事件相关电位水平还是 LORETA 水平，均未 发现正常对照和 SPD 患者之 间存在统计学显著差异。
  结论： 正如我 们假设的一样，本研究结果提示， SPD 患者之所以未出 现更多的临床症状，可能得益于其相对完好的错误监测功能，额叶与颞叶的激活可能与这种功能的产生有关。
   
  
• P173
  对缓解期精神分裂症预防精神病复发的救护性治疗 - Rescue Medications for the Prevention of Psychotic Relapse in Remitted Schizophrenia
  John R Bola 1 , Nina Schooler 2 , Dennis Kao 3
  1 Univeristy of Southern California, School of Social Work, Los Angeles, United States, 2 Georgetown University, School of Medicine, Washington, United States, 3 University of Southern California, School of Social Work, Los Angeles, United States
  
  目的 ： 本文回 顾了有关给予缓解期精神分裂症病人前驱症状救护性治疗对预防精神病复发的影响。
  方法 ： 该研究是一项由美国国立精神卫生研究所资助的有关精神分裂症治疗策略的研究 ， 313 例 处于稳定状态的精神分裂症病人随机分为三组 ， 分别接受 100 ％ 稳定治疗剂量治疗、 20 ％ 稳定治疗剂量治疗或有症状才治疗 ， 每 2 周随 访一次 ， 随访 2 年。
  结果 ： 29 ％ 的病人 （ 92/313 ） 有精神病 复发 ， 但在接受救护 性治 疗的病人中有 58 ％ 的病人 （ 122/211 ） 避免了 复发。 67 ％的病人（ 211/313 ）接受了救 护性治疗，其中低剂量治疗组得到了更多的救护性治疗（标准剂量组为 44 ％，低 剂量组为 67 ％，目 标治疗组为 93 ％）。与首 发病人相比，多次发作病人有更多的接受救护性治疗（ 75 ％比 48 ％）。低 剂量组复发率高（ 22 ％比 30 ％比 37 ％），同 样多次发作病人比首发病人复发率高（ 33 ％比 20 ％）。各 组的避免复发率相同（ 51 ％～ 60 ％，平均 58 ％），避免 复发率在首发病人中为 57 ％，在多次 发作中为 60 ％。
  结论： 结果显示救护性治疗对预防 精神病 复发有明显效果。尽管低剂量治疗组更多的接受救护性治疗及有更多的复发率，但对首发和多次发作的病人，经过治疗其避免复发率也同样较高。这些结果显示了救护性治疗对避免精神病复发的价值。
  
  Objective: This paper reviews the influence of rescue medications administered in the prodrome on the prevention of psychotic relapse in remitted schizophrenia patients.
  Methods: In the NIMH funded Treatment Strategies in Schizophrenia study, N=313 stabilized schizophrenia patients were randomly assigned to one of three antipsychotic medication treatments (100% of stabilized dose, 20% of stabilized dose, or targeted medication only when symptomatic) and followed every two weeks for 2-years.
  Results: Psychotic relapse occurred in 29% of patients (92/313) but appears to have been averted in 58% (122/211) of patients receiving rescue medications but not relapsing. Rescue medications were given to 67% (211/313) of patients, with lower dose treatment groups more often receiving rescue medications (44% of the standard dose, 67% of the low-dose, and 93% of the targeted medication groups). Compared to first-episode patients, multi-episode patients more frequently received rescue medications (75% vs. 48%). Relapse rates were higher in the lower dosage treatment groups (22% vs. 30% vs. 37%) and for multi-episode compared to first-episode patients (33% vs. 20%). Relapse aversion rates are similar across treatment groups (mean 58%, range 51% to 60%), and for multi-episode (57%) compared to first-episode (60%) patients.
  Conclusions: Results suggest a large effect size for rescue medications in the prevention of psychotic relapse. Despite both more frequent use of rescue medications and more frequent relapse for lower dose treatment groups, relapse aversion rates are comparably large across treatments and for first-episode and multi-episode patients. These results underscore the value of rescue medications in averting psychotic relapse.
   
  
• P174
  Schizophrenia Spectrum Disorders: Electrophysiological Features of Error Monitoring
  Yunxiang Tang 1 , JiJun Wang 1 , MingDao Zhang 1
  1 ShangHai Mental Health Hospital , Shanghai , Chinese Mainland
  
  Objectives: Schizophrenia(S) is characterized by reality distortion and impulsive, poorly planned behavior. Schizotypal personality disorder (SPD) is also characterized by reality distortion in some extent, but not that “ill” as schizophrenia. Our hypothesis is this difference may originate from the function difference of Error Monitoring between these two diseases. So, the aim of this study was to determine if error negativity/error-related negativity (Ne/ERN), error positivity (Pe), correct response negativity (CRN) or correct response positivity (Pc) are different in SPD, schizophrenia and normal people.
  Methods: Event-related potentials (ERP) were recorded from 12 schizophrenia, 17 SPD and 25 normal control (NC) participants who performed a go/no-go task. After ocular correction, filters, segmentation, baseline correction, ERN(-100-150ms), Pe(100-380ms), CRN(-100-150ms), Pc(100-380ms) and different waves of ERN, Pe were computed, and the source of ERN were resconstructed based on LOW RESOLUTION BRAIN ELECTROMAGNETIC TOMOGRAPHY (LORETA) in all three groups, and compared with each other.
  Results: ① ERN amplitude (FCz) is smaller (more positive) in Schizophrenia (-3.38±3.57uv) compared with NC(-7.76±5.03 uv) (P<0.05) and with SPD(-7.39±4.22 uv )(P<0.05). ② The amplitude of different wave of ERN(Fz) is smaller(more positive) in Schizophrenia (-3.43±4.96 uv) compared with NC(-10.17±5.22 uv) (P<0.05) and with SPD(-8.24±7.13 uv )(P<0.05). The amplitude of different wave of ERN is smaller(more positive) in Schizophrenia (FCz-3.95±6.38 uv,Cz-4.68±6.46 uv) compared with NC(FCz-12.48±7.45 uv,Cz-11.01±6.51 uv) (P<0.05) but not with SPD(FCz-9.48±7.12 uv,Cz-9.71±6.19 uv)(P>0.05). ③ The amplitude of different wave of Pe(Pz) is larger in SPD (9.84±8.46 uv) compared with Schizophrenia(3.74±4.69 uv) (P<0.05) but not with NC(6.40±3.30 uv )(P>0.05). ④ In ERN time windows, LORETA analysis found that there are significant difference between NC and Schizophrenia at Frontal Lobe (Inferior Frontal Gyrus ,Middle Frontal Gyrus, Superior Frontal Gyrus, Insula,Precentral Gyrus) and Temporal Lobe (Middle Temporal Gyrus),-51-0ms pre-error responses, and at Temporal Lobe(Superior Temporal Gyrus, Middle Temporal Gyrus)and Frontal Lobe (Inferior Frontal Gyrus), 51-100ms after error responses. As in ERN time windows, in Pe time windows, LORETA analysis also found there are significant difference between NC and Schizophrenia at Temporal Lobe (Superior Temporal Gyrus, Middle Temporal Gyrus, Inferior Frontal Gyrus), 101-150ms after error responses, and at Frontal Lobe (Superior Temporal Gyrus, Middle Temporal Gyrus, Inferior Frontal Gyrus, Superior Frontal Gyrus) and Temporal Lobe (Middle Temporal Gyrus), 251-350ms after error responses. ⑤ There was no significant difference between NC and SPD, both in Events-related potentials and LORETA analysis.
  Conclusions: Confirming our hypothesis, our results suggest that SPD patients not representing much clinical symptoms may be thanks to their relatively good function on error monitoring. The activation of Frontal Lobe and Temporal Lobe may relate to this kind of function.
   
  
• P175
  Follow-up Study on Auditory Evoked Potential P50 in First-Episode Schizophrenia
  XingShi Chen 1 , Yunxiang Tang 1 , MingDao Zhang 1 , HongXing Wang 1 , FeiYing Lou 1 , JianHua Liang 1 , Chong Chen 1
  1 ShangHai Mental Health Hospital, Shanghai, Chinese Mainland
  
  Objective ： Auditory evoked potential P50 is the most frequently used neurophysiological method of assessing sensory gating. Researches suggested that sensory gating deficits might be one of the most important pathogenesis of schizophrenia. This study would take attempts to investigate the variations of auditory evoked potential P50 in first-episode schizophrenia during the follow-up.
  Method ： P50 was recorded from 66 schizophrenics （ 39 men, 27 women; mean age: 28±6 years; mean PANSS score was 111.5±10.9. ） and 92 normal controls （ 52 men, 40 women; mean age: 25±5years; Each of them was in good physical and mental health, and had no history of alcoholism or drug abuse and no family history of psychiatric illness. ）， with American Brova instrument, and assessing their psychotic symptoms with PANSS.
  Results ： Compared with NC, schizophrenics showed sensory gating deficit, reflecting by increased S2/S1 ratio (NC: 42±21 ％ , Sch: 86±42 ％ , P<0.01). No significant correlation were found between PANSS score and the three markers for assessing the sensory gating, such as the S2/S1 ratio, S2-S1, and 100 (1-S2/S1)(P>0.05). Schizophrenics showed no difference with P50 markers between the 5 weeks and 12 weeks of treatment.
  Conclusions ： Our results found that no correlation between PANSS and the S2/S1 ratio, S1-S2, and 100(1-S2/S1), which for assessing the SG, suggesting that SG deficit might be trait marker of schizophrenia and not be association with severity of schizophrenia. The results also meant that drugs might not play an important role in affecting P50 variation. The above mentioned abnormal P50 might be the trait marker, not only the figure change. All results suggested that SG deficit might be one of the important pathogenesis of schizophrenia.
   
  
• P176
  精神疾病就 诊方式和途径及相关问题 - Seeking Behavior of Patients with Mental Disorders and Interfering Factors
  玉生 任 1
  1 湖北省武 汉市武昌铁路医院武东分院 , 武 汉市 , Chinese Mainland
  
  目的 ： 研究各 类精神疾病就诊方式和途径及其相关问题。
  方法 ： 采用自制 “ 精神疾病就 诊调查表 ” 调查就诊于精神科的病人共 597 例。
  结果 ： 68 ％ 为躁狂症、 92 ％ 为神经症和抑郁症首诊于非精神科 ， 77 ％ 不首 诊于精神科的属正常原因为视病情的现 象、性格、思想和情 绪问题。 34 ％于患病 1 年后才来 专科就诊。其中多数病例在非精神专科机构接受多种检查和冶疗，约 10 ％的抑郁症、神 经症和精神分裂症首诊精神专科之前，巳花费逾万元。
  结论 ： 目前精神疾病就 诊途径和方式仍是较为突出的问题。建议加强卫生知识在公众和综合医院的普及工作。
  
  Objective: To approach different halp seeking behavior and its effects on patients with mental illness.
  Methods: We investigated the patients first seeking help in psychiatry department, by aplying the scale of help seeking behavior of mental illness.
  Results: There were significant differences among different mental disorders. 42%patients with mania, 68% with schzophrenia, and abort 92% with depression or neurosis first went to general hospital when their illness began. About 77% patients considered their symptoms as normal, temperament, and mood problems. The course of 34% patients was one year, and most patients were treated with traditional herbs, wast drugs and tests. Narly 12% patients with depression, neurosis and schizophrenia spent more then 10000yuan before seeking the doctor in psychiatry.
  Conclusions: Now then it is still a main problem for patints with mental disorders in seeking behavior. We suggest that the prepaganda of the knowledge of mental health should be paid more attention, especially for the people in community and doctors in general hospital.
   
  
• P177
  分裂症患者情 绪认知缺陷述情障碍和情感淡漠的相关性研究 - A Correlation Study on the Emotion and Cognition Defect, Alexithymia and Apathy in Schizophrenia
  毅 董 1 , 凯 汪 1 , 晓驷 李 1
  1 安徽省精神 卫生中心 , 六病区 , 合肥 , Chinese Mainland
  
  目的 : 精神分裂症患者情 绪处理存在缺陷 ， 情感淡漠作为分裂症患者的基本症状早已被认知 ， 情绪认知障碍和述情障碍也被研究所证实 ， 但患者三者间的关系尚不清 楚。本研究 试图探讨发病期未用药的精神分裂症患者面孔情绪认知缺陷、述情障碍和情感淡漠症状的相关性。方法 采用中国人面孔情 绪测验（ CFET ）和多 伦多述情障碍量表（ TAS-26 ） 对 82 例精神分裂症患者 进行测试，与 88 名正常健康者比 较，同时对患者作阴性症状量表（ SANS ）情感淡漠或 迟钝分量表评定。结果 分裂症患者 CFET 总分及六种基本情绪认知评分均显著低于对照组， TAS 总分、因子 1 、因子 2 和因子 4 评分均显著高于对照组。相关分析显示，患者 CFET 正确数 评分与 TAS 总分、因子 1 、因子 2 和因子 4 分呈 负相关， 35 项相关系数 中 27 项（ 77.1% ）达到 显著性统计意义。 SANS 情感淡漠或 迟钝分量表评分与一些 CFET 评分呈负相关， 49 项相关系数中 15 项（ 30.6% ）达到 统计学显著性意义。而与 TAS 评分间，除眼神接触差评分与 TAS 总分呈正相关外，余变量间相关均无显著性意义。结论 情 绪认知是对外界情绪刺激的一种认知处理过程，自身情绪表述也是一种情绪的认知处理过程，但其是对自身情绪体验的认知，这更多地可能涉及自我意识过程；情感淡漠则是患者在检查的情绪氛围中所表现出的一种反应性特征，虽然这一过程可能涉及对周围情绪氛围的觉察、体验和反应过程， 但 这一过程可能更多地具有自动性质。研究结果支持我们的假设，分裂症患者的广泛的面孔情绪认知障碍与述情障碍可能更多地反应了一种素质性特征，可能存在某种共同的病理生理基础，而述情障碍与情感淡漠间可能具有不同的病理性情绪处理过程。
   
  
• P178
  A Correlation Study of Facial Emotion Recognition Deficits, Alexithymia and Flat Affect in Schizophrenic Patients
  Yi Dong 1 , Kai Wang 2 , Xiaosi Li 1
  1 Anhui Mental Health Centre, Hefei, Chinese Mainland, 2 Anhui Medical University, Hefei, Chinese Mainland
  
  Objective: Patients with schizophrenia have emotion processing deficits. Flat affect as “fundamental symptoms” for schizophrenic patients has been well described, and the emotional recognition deficit and alexithymia were also documented in literature. But the relationship of the three emotional processing deficits in schizophrenia has not been well known. In this study we analysis the correlation between the facial emotion recognition deficits and alexithymia or flat affect in patients with schizophrenia.
  Methods: Eighty-tow no-medication schizophrenic patients and Eighty -eight healthy subjects were tested with the Chinese Facial Emotion Test (CFET)and Toronto Alexithymia Scale (TAS-26),and rated on the flatten affective subscale of the SANS.
  Results: For patients with schizophrenia, the total correct score and scores of recognition for each of six basic emotions were significantly less, and the scores of factor I, II, or IV on TAS-26 were significantly more than that of controls. There is a significantly negative correlation between scores of CFET and the scores of factor I, II, or IV on TAS-26. and also between some scores of CFET and flatten affective subscale of the SANS. There is no significant correlation between scores of TAS-26 and subscales of symptom, apart from subscale of eye attach.
  Conclusion: Emotional recognition is a cognitive process for external emotional stimuli, but the alexithymia reflect a failure of self-emotional recognition which may be more related with self-consciousness, Flat affect may represent a reactive and automatic processing characteristics which may be involved in perception, experience and reaction in the examination environment for patients. As we supposed, the impairment of facial emotion recognition as well as alexithymia indicated a special trait in schizophrenics. both of two symptoms may be involved in a common neural substrates, while the dissociation between alexithymia and flatten affection may suggested that there is a difference on neural substrate of each other.
  
• P179
  丙戊酸 镁缓释片对难治性精神分裂症患者认知功能的影响 - The Effects of Magnesium Valproate Sustained Release Tablets on the Cognitive Function in Treat-resisitant Schizophrenic Patients
  孙群 星 1 , 郭 华 1 , 张红 梅 1 , 刘 勇 1 , 朱玉 星 1 , 张爱 荣 1
  1 驻马店市精神病院门诊部 , 河南 驻马店市 , 驻马店市 , Chinese Mainland
  
  目的 : 探 讨丙戊酸镁缓释片治疗对难治性分裂症患者的认知功能的影响。
  方法 : 用入院 顺续分层随机法 ， 将 80 例 难治性精神分裂症患者平均分为研究组 （ 丙戊酸镁缓释片 + 利培 酮 ） 和对照组 （ 利培酮 ＋ 安慰剂 ） 。在治疗前和治疗后 2 、 4 、 8 、 12 周末，用阳性症状及 阴性症状量表（ PANSS ），不良反 应量表（ TESS ） 评定疗效及副反应，用韦氏成人智力量表（ WAIS-R ）、 韦氏记忆量表（ WMS ）和威斯康星卡片分 类 测验（ WCST ）平定治 疗前后患者认知功能的改变。分析量表中各领域的计分。
  结果： 两 组 PANSS 总分在治疗后与治疗前比较有显著性差异 (p<0.05) ，研究 组有效率 72.5% ， 显效率 20% ； 对照组有效率 52.5% ， 显效率 12.5% 。两 组间疗效有显著性差异（ p<0.05 ），两 组言语量表、操作量表、全量表和记忆量表分治疗前研究组： 65.35±7.43 、 66.51±9.42 、 68.83±8.34 、 66.54±10.96 ； 对照组： 66.03±7.10 、 65.01±6.93 、 69.11±8.24 、 66.68±10.94 。治 疗后研究组： 82.95±4.12 、 81.01±5.72 、 81.26±5.51 、 78.26± 12.31 ； 对照组： 77.41±3.95 、 75.73±5.56 、 76.87±5.34 、 76.15±12.19 。
  两 组比治疗前明显提高，研究组与对照组比较也有一定差异（ p<0.05 ）。治 疗后 2 、 4 、 8 、 12 周末 TESS 评分，两组无显著性差异（ p>0.05 ）。 结论 ： 丙戊酸镁缓释片合并利培酮治疗难治性精神分 裂症 疗效确切 ， 且安全性高 ， 对认知功能的改善彻底。
  关键词 : 丙戊酸 镁缓释片 ； 分裂症 ； 认知功能
   
  
• P180
  Effect of Magnesium Valproate Sustained Release Tablets on Coginiton Function in Difficult Cure Sex Schizophrenic
  孙群星 星 1
  1 驻马店市精神病院门诊部 , 河南 驻马店市 , 驻马店市 , Chinese Mainland
  
  Objective: To investigate the influence on coginiton function of magnesium valproate sustained release tablets in difficult cure sex schizophrenia.
  Methods: Being used the vendom control stady, Will 80 difficult cure sex schizophrenia disease, the sufferer equally is divided into the research set(magnesium valproate sustained release tablets + Rispreidone) with the matched control. (Rispreidone +placebo). The Positive and Negative Syndrome Scale (PANSS), while the adverse events were determined by the treatment emergent symptoms scale (TESS), respectively WAIS-R, WMS, WCST were evaluated before treatment and after 2.4.8.12 weeks treatment. by menas of analyzing the scores in every domains.
  Results: Two cent with total PANSS before treat after with treat relatively showed the difference of with on significance(p<0.01). The efficacyrate of magnesium valproate sustained release tablets group was 95%, in which 80% were improved markedly. The efficacyrate of Rispreidone group was 85%, in which 72.5% were improved markedly. The Two sets of speech quantity form, the operation quantity form, the the whole quantity watch and memory measured watch for cent to study a set before cure: 65.35±7.43 、 66.51±9.42 、 68.83±8.34 、 66.54±10.96 ； the Matched control: 66.03±7.10 、 65.01±6.93 、 69.11±8.24 、 66.68±10.94 。 Study a set after cure:82.95±4.12 、 81.01±5.72 、 81.26±5.51 、 78.26± 12.31 ； Matched control:77.41±3.95 、 75.73±5.56 、 76.87±5.34 、 76.15±12.19 。 Two sets of ratio treatments raised obviously ago, the research set and matched control relatively also had certain difference (p<0.05) the language scale,operation scale, totalscale, and memoryscale were improved significantly in two group compared with befere treatment, 2,4,8 and 12 weekend TESS grade points after cure, two sets of do not show the high difference.(p>0.05).
  Conclusion: The magnesium valproate sustained release tablets treats the schizophrenia disease curative effect accurate, and the safety is high, to the cognition the improvement of the function is thoroughly.
   
  
• P181
  阿立 哌唑对首发精神分裂症患者认知功能的影响 - The Effects of Aripiprazole on the Cognitive Function in First-episode Schizophrenia Patients
  孙群星 星 1
  1 驻马店市精神病院门诊部 , 河南 驻马店市 , 驻马店市 , Chinese Mainland
  
  目的 : 探 讨阿立哌唑治疗对首发精神分裂症患者的认知功能的影响。
  方法 : 用入院 顺续分层随机法 ， 将阿立哌唑与氟哌啶醇治疗首发精神分裂症各 60 例作 对照研究 ， 在治疗前和治疗后 2 、 4 、 8 、 12 周末 ， 用阳性症状及 阴性症状量表 （ PANSS ）， 不良反 应量表 （ TESS ） 评定疗效及副反应 ， 用韦氏成人智力量表 （ WAIS-R ） 、 韦氏记忆量表 （ WMS ） 和威斯康星卡片分 类 测验 （ WCST ） 平定治 疗前后患者认知功能的改变。分析量表中各领域的计分。结果：两组 PANSS 总分在治疗后与治疗前比较有显著性差异 (p<0.01) ，阿立 哌唑组有效率 93.3% ， 显效率 76.7% ；氟 哌啶醇组有效率 90% ， 显效率 75% 。两 组间疗效无显著性差异（ p>0.05 ），且两 组言语量表、操作量表、全量表和记忆量表分研究组分别为： 86.15±4.12 、 82.01±5.72 、 84.26±5.51 、 80.26± 12.31 ； 对照组分别为： 84.41±3.95 、 80.73±5.56 、 82.87±5.34 、 79.25±12.19 。两 组比治疗前均明显提高。治疗后 8 、 12 周末 TESS 评分，研究组均低于对照组，有显著性差异（ p<0.01 ）。
  结论 ： 阿立 哌唑治疗首发精神分裂症疗效确切 ， 且安全性高 ， 对认知功能的改善彻底。 [ 关键词 ] 阿立 哌唑 氟 哌啶醇 分裂症 认知功能
   
  
• P182
  Effect of Aripiprazole and on Coginiton Function in Schizophrenic
  Hua Li 1 , Hong-mei Zhang 1 , Yong Liu 1
  1 HeNan Sen Zhumadian Mental Hospital, Zhumadian, Chinese Mainland
  
  Objective: To investigate the influence on coginiton function of aripiprazole in schizophrenia.
  Methods: Being used the vendom control stady, 60 schizophrenic patients were treated with sisperidone as the controlled group. The Positive and Negative Syndrome Scale(PANSS), while the adverse events were determined by the treatment emergent symptoms scale (TESS), respectively WAIS-R, WMS, WCST were evaluated before treatment and after 2.4.8.12 weeks treatment. by menas of analyzing the scores in every domains.
  Results: Two cent with total PANSS before treat after with treat relatively showed the difference of with on significance(p<0.01). The efficacyrate of aripiprazole group was 93.3%, in which 76.7% were improved markedly. The efficacyrate of Haloperidol group was 90%, in which 75% were improved markedly. Two groups showed similar effects, with no significance (p>0.05). the language scale, operation scale, totalscale, and memoryscale were improved significantly in two group compared with befere treatment 。 The TESS scores of study group were lower than that of coutrol group after 8.12 weeks treatment (p<0.01).
  Conclusion: The aripiprazole treats the schizophrenia disease curative effect accurate, and the safety is high, to the cognition the improvement of the function is thoroughly.
  Key: Aripiprazole Haloperidol Schizophrenic Coginiton function
   
  
• P183
  215 例慢性精神分裂症住院患者合并躯体疾病的 临床研究 - Clinical Study of 215 Chronic Schizophrenia in-Patients with Body Diseases
  Pei-hua Gu 1 , Ren-gang Wu 1
  1 Yangzhou Wutaishan Hostipal, Yangzhou , Chinese Mainland
  
  目的 ： 分析慢性院精神分裂症患者的躯体疾病特点和影响。
  方法 ： 对慢性精神分裂症住院患者 215 例 ， 进行心电图、血糖、血压、血常规、血钾等检验 ， 并与一般人群进行比较。
  结果 ： （ 1 ） 心 电图异常 (48.52 ％ ) ， 血糖增高 (33.95 ％ ) ， 低 钾 (6.98 ％ ) ， 与正常人群相比有 显著差异 （ p ＜ 0.01 ）；（ 2 ） 慢性院精神分裂症患者高血 压病患病率 (7.44 ％ ) 低于一般人群 (11.88 ％ ); （ 3 ） 高 龄组冠心病、糖尿病、肺结核患病率明显高于低龄组 ， 而窦性心动过速明显低龄组 （ p ＜ 0.01 ）；（ 4 ） 经检验躯体疾病与使用药物无明显差异 ；， 其他各躯体疾病患病率均高于一般人群。结论：精神科医生平时要注意长期住院病人的用药情况，及时调整药物，以减少心脏副作用及冠心病的发生；在合理用药的同时，注意日常的康复治疗，增强 体 质以减少精神衰退及并发的躯体疾病。
  关键词 ： 慢性精神分裂症 ； 住院病人 ； 躯体疾病 ； 冠心病 ； 糖尿病 ； 高血 压病
  
  Objective: To study the characteristic and influence of the body disease in chronic schizophrenia in-patients.
  Method: 215 schizophrenia patients were determined cardiogram, glucose, blood pressure, hemogram ， kalium ， and to comparer the differences of them with the normal.
  Results: (1) 48.52 ％ abnormal cardiogram, 33.95 ％ hyperglycemia, 6.98 ％ lower kalium, compare with the normal the significantly increased （ p ＜ 0.01 ） .(2) The hypertension (7.44 ％ )in chronic schizophrenia patients were less than the normal(11.88 ％ ).(3) The coronary heart disease, diabetes, pulmonary tuberculosis in agedness schizophrenia patients were more than the others. The tachycardia in agedness schizophrenia patients were less than the others （ p ＜ 0.01). (4) The changes of body disease were no related to medicament.
  Results: The psychiatrist should take care of the patients and change the medication on time, to reduce the adverse reactions to heart, take more activity to the chronic schizophrenia patients, to strengthen the patients' body and reduce the mental decline and body disease.
  Key words: Chronic Schizophrenia, in-patient ， Body Disease, Coronary Heart Disease, Diabetes Mellitus, Hypertension
   
  
• P184
  阿立 哌唑治疗女性精神分裂症的疗效及安全性观察 - An Open-label Clinical Study of Efficacy and Safety of Aripirazole Treatment in Female Patients with Schizophrenia
  Jing Yao 1
  1 Yangzhou Wutaishan Hospital, Yangzhou, Chinese Mainland
  
  目的 ： 探 讨阿立哌唑治疗女性精神分裂症的疗效及安全性。
  方法 ： 29 例女性精神分裂症患者 给予阿立哌唑治疗 16 周 ， 采用阳性症状和 阴性症状量表 （ PANSS ） 评定临床疗效 ， 副作用量表 （ TESS ） 评定副反应。
  结果 ： 完成 16 周治 疗的女性精神分裂症病人临床总有效率 89.66%, 不良反 应轻 ， 未见明显体重增加。
  结论 : 　阿立 哌唑治疗女性精神分裂症有明显疗效 ， 未见明显不良反应。
  关键词 : 　阿立 哌唑 精神分裂症
  
  Objective: To investgate the efficacy and safety of aripirazole treatment in female patients with schizophrenia.
  Methods: 29 case female schizophrenics were treated with aripirazole for 16 weeks,the Postitive and Negetive Syndomly Scale(PANSS) and Treatment Emergent Symptom Scale (TESS) were used to access the therapeutic efficacy and side effect respictively.
  Results: After 16-week treatment, effective rate of aripirazole was 89.66%, its side effects were milder and patients had no obvious weight gain.
  Conclusion: Aripirazole has distinct efficacy in treating the acute onset of schizophrenia without obvious side effects.
  Keywords: Aripirazole Schizophrenia
   
  
• P185
  聋哑精神分裂症病人伴幻听 1 例 报告 - A Acousma Symptom Report in a Schizophrenia Patient of the Deaf-mute
  爱粉 秦 1
  1 解放 军正定 256 临床部精神卫生中心 , 精神二科 , 正定 , Chinese Mainland
  
  一、病例 资料
  病案号 ： 221392 。患者梁某，女， 55 岁，文盲，已婚，农民，聋哑残疾人，病史由其丈夫提供，可靠。主因凭空闻语、凭空视物 3 月首次入院。入院前 3 个月无任何 诱因逐渐 出 现凭空视物，看到有两个长得像猴子一样的人，他们在纸上写字（内容不清），然后擦掉，将纸夹到腋下转身离去，病人为此生气发脾气。有时凭空闻语，对着天空吼叫，似与人吵架状，丈夫诉是有人辱骂病人，有时听到有人叫自己，拽自己，多次出走，一次出走 2 里地，后被家人 强制回家，有 时感觉心里难受，像有猴子在挠，对家人发脾气，为治疗入院。以上症状无昼轻夜重的规律，发病来，无发热、头痛、昏迷，无一侧肢体无力，无口角歪斜表现，饮食好，夜眠差，大小便无异常。
  既往史：病人 为先天聋哑，自幼发育正常，未上学，能干农活和家务，无躯体疾病和传 染病史，无外 伤和手术史，无药物过敏史。 20 岁结婚，夫妻感情较好，生育三子。
  入院后 查体：生命体征平稳，心肺未见阳性体征，腹部平软，肝脾未触及。生理反射存在，病理反射未引出，脑膜刺激征阴性。精神检查：意识清晰，年貌相符，衣着欠整洁，表现安静，个人生活部分能自理。精神检查在其丈夫的协助下完成，病人定向力存在，能用手势进行简单交流，病人用右手指着右耳，嘴里 “ 叽里咕噜 ” 发出声音，又伸出 2 个手指，用表情做出猴子的 样子，然后用手比划在纸上写字，又擦掉，将纸夹到腋下转身离开。整个过程表情愤怒，并握拳作出打的动作，情感反应 受精神症状的支配，无自知力。其他精神 检查的内容无法交流。根据病史和精神检查推测病人存在幻视和幻听。各项化验结果正常，心电图提示 ST-T 改 变，头颅 CT 提示左基底 节区腔隙性脑梗塞。
  入院后 诊断为 1. 精神分裂症； 2. 左基底 节区腔隙性脑梗塞。给予富马酸喹硫平 0.4/ 日口服，静点舒血宁等治 疗，半月后精神症状控制出院，经随访 2 个月病情 稳定。
  二、 讨论 幻听是重性精神疾病的常 见症状之一，也是诊断精神分裂症、判断其严重程度和临床疗效的重要指标之一。虽然经过几十年的探索，幻听发生机制的研究取得了一些进步，但至今仍无一致性的结论。神经心理学关于幻觉的起源目前主要有两种，第一种是抑制学说，简单的说就是外界作用于感官的刺激减少时，大脑皮层就会兴奋而产生幻觉〔 1 〕。 临床上对一些因视神经、视交叉、视放射损伤而致盲的患者进行观察，发现 10~30% 的忙人曾 经有过幻视〔 1 〕，支持 这个观点。关于幻听与听觉损害之间的关系研究，目前认为正常人的音乐性幻听与耳聋存在联系，一些片段、凌乱的病理性幻听与耳聋也存在一定的联系。第二种为大脑皮层刺激学说，当大脑皮层感受区的自发性兴奋，使以往映像的痕迹活化，重现出来非常鲜明生动，并向客观外界 “ 透射 ” ，达到 现实 刺激所 产生的映像同样鲜明的程度，患者往往认为是通过感觉器官传入的。根据以上两个学说，可以解释后天耳聋者幻听产生的机制。脑尸检研究提示颞叶是产生幻觉的主要神经基础〔 2 〕，初 步 fMRI 研究 结果均提示，幻听可能与皮层和皮层下神经网络调节紊乱相关，如额颞活化联系失常，而在正常状态下，额叶对颞叶内源性激活有抑制作用，当该抑制作用紊乱时即导致病人将内生刺激误感受为外来声音而产生幻听。患者幻听时额颞叶异常激活的发现支持幻听是因为对内生刺激失控而产生的理论〔 2 〕。 这是否为先天性耳聋者产生幻听的机制，仍需进一步验证。
  聋哑人 精神疾病和 聋哑人幻听症状，虽然在精神病学专著中少有描述，但聋哑人出现精神疾病和幻听却是一个不争的事实，因此聋哑人的精神健康也应引起我们足够的重视，使其得到及时的诊断和治疗。
   
  
• P186
  The Application of CRP and IL-6 in Psychiatric Clinic
  Jie Guo 1
  1 Tianjin'anding Hospital, Tianjin, Chinese Mainland
  
  C-reactive protein is a kind of acute phase reactive protein caused by inflammatory lymphakine (interleukin 6, interleukin 1,tumor necrosis factor) stimulating liver epithelial cell. The tissue damage of various kinds causal will cause the CRP density in the serum heighten. Interleukin-6 is a kind of cytokine, having various biology functions including applied CRP. The text is from three applied value which summarized CRP and IL-6 in the psychiatric clinic. ① The CRP and IL-6 are meaningful to the estimation of cardiovascular event occurrence. ② Not only the antipsychotic drugs, but also the change of CRP and IL-6will cause metabolic syndrome,. ③ CRP and IL-6 are related with schizophrenia, depression and dementia.
  Key words: C-reactive protein; interleukin-6
   
  
• P187
  首 发精神分裂症脑脊液和血清细胞因子水平及其与精神病理学的关系 - The Relation between the Level of Cerebrospina Fluid and Serum Cytokine and Psychopathology in First-episode Schizophrenia
  海兵 朱 1
  1 广州市精神病医院 , 精神科 , 广州 , Chinese Mainland
  
  我 们检测 42 例首 发分裂症患者脑脊液和血清细胞因子 IL-2 、 6 和 TNF- α 水平 , 探 讨其与 PANSS 得分的 关系。发现患者组脑脊液和血清 IL-2 和 TNF-α 水平均 显著低于对照组 , 脑脊液 IL-6 水平高于 对照组，血清 IL-6 与 对照组无差异。患者脑脊液和血清 IL-2 、 IL-6 和 TNF-α 水平与 PANSS 总分及其亚得分相关不明显。可见 , 首 发精神分裂症患者中枢和外周均存在细胞免疫障碍 , 可能 为细胞因子 Th1 向 Th2 漂移 , 但未 发现其与临床症状相关。
  
  We investigated Cerebrospinal flud(CSF) and serum cytokines levels such as IL-2, 6, TNF- α in 42 patients with first-episode schizophrenia and the relation with psychopathology.We found both the levels of CSF and serum IL-2 and TNF- α in first-episode schizophrenia were lower than controls, and CSF IL-6 were higher than the control. No significantly correlations between CSF and serum cytokines and the P,N,G and the totoal PANSS were found.It suggested cytokines mediate a specific immune disturbance with Th1 deceased and Th2 increased in first-episode schizophrenia. CSF and serum cytokines were negatively related to symptomatology.
  
• P188
  云南 汉族、基诺族色氨酸羟化酶 2 基因多 态性 与精神分裂症 关联研究 - Association Study of Tryptophan Hydroxylase2 Gene Polymorphism and Schizophrenia in YunNan Han, Jino Ethnic Group
  壮 飞 陈 1 , 勇 曾 1 , 秀峰 许 1
  1 昆明医学院第一附属医院 , 昆明 , Chinese Mainland
  
  目的 : 探 讨云南地区汉族与基诺族精神分裂症患者 TPH2 基因 rs1386494 、 G1463A 单核苷酸多态性与精神分裂症的关联关系。
  方法 : 采用病例 对 照研究的方法 ， 共采集 91 例精神分裂症患者 （ 云南昆明地区 汉族 60 例 ， 基 诺族 31 例 ） 、 93 例正常 对照者 （ 汉族 61 例 ， 基 诺族 32 例 ） 及 20 例基 诺族同胞对照者 ， 运用聚合酶链式反应 - 限制性片段 长度多态性 （ PCR-RFLP ） 和 扩增阻碍突变 PCR 技 术 （ ARMS-PCR ） 检测 TPH2 基因两位点多 态性。结果 1 、 rs1386494 位点基因型 频率、等位基因频率在基诺族样本中分布差异无显著性；该位点基因型频率在汉族样本中分布差异有显著性，而基因频率分布差异无显著性。 2 、在两族 样本中均未观察到 G1463A 多 态性现象。 3 、基 诺族患 者同胞 对中两位点多态性分布差异无显著性。
  结论 : 1 、 TPH2 基因 rs1386494 多 态性与基诺族精神分裂症无关，该位点 AA 型突 变纯合子可能与云南汉族精神分裂症相关。 2 、 G1463A 多 态性与云南汉族、基诺族精神分裂症易感性无关。
  关键词 : 精神分裂症 ； 色氨酸 羟化酶 2 ； 基因 ； 多 态性
  
  Tryptophan Hydroxylase 2 gene discovered recently was proved to play important roles in various psychiatric disorders. It was reported that the polymorphism of rs1386494 was associated with depression and suicide. Recently identified SNP G1463A can result in a severe loss-of-function in TPH2, followed by a predominant reduction in 5-HT.
  Objective: To explore whether the polymorphism of Tryptophan Hydroxylase 2 gene (G1463A rs1386494) is associated with schizophrenia in Yunnan Han and Jinuo population.
  Methods: A case-control study was designed by collecting 91 patients (60 Han and 31 Jinuo) and 93 controls (61 Han and 32 Jinuo), tegother with 20 sibling controls of Jinuo. PCR-RFLP and ARMS-PCR was used to detect the polymorphism of Tryptophan Hydroxylase 2 gene (G1463A rs1386494).
  Results: 1. No significant difference in genotype and allele frequency of rs1386494 was observed in Jinuo samples. The allele frequency of rs1386494 was significantly different in Han samples, while, the genotype frequency was not. 2. No G1463A mutation was observed both in Han and Jinuo samples. 3. The polymorphism of both loci has observed no difference in case-sibling control study of Jinuo. Conclusions: 1. There is no association between polymorphism of rs1386494 and schizophrenia in Jinuo. AA homozygote of rs1386494 SNP may relate with schizophrenia in Yunnan Han. 2. There is no relationship between G1463A polymorphism with susceptibility of schizophrenia both in Yunnan Han and Jinuo.
  Keywords: Schizophrenia; Tryptophan Hydroxylase 2; gene; Polymorphism
   
  
• P189
  门诊首发精神分裂症首次用药情况分析 - Analysis the First Use of Antipsychotics in the Outpatients with First-episode-schizophrenia
  传福 宋 1 , 仲 夏 1
  1 芜湖市第四人民医院 , 芜湖市 , Chinese Mainland
  
  目的 : 了解 门诊首发精神分裂症患者首次用药情况。
  方法 : 采用自行 设计的调查表对 1995 年 1 月 ~10 月、 2000 年 1 月 ~10 月及 2005 年 1 月 ~10 月在 门诊首次治疗的首发精神分裂症患者用药及一 般 资料进行调查。结果 1995 年共有 158 例，其中 单用抗精神病药物（ APD ） 142 例（ 89.87% ） , 以 氯氮平为首；联合用 APD16 例（ 10.13% ），以 氯氮平联合舒必利为首；预防性应用安坦 18 例（ 11.39% ）；合用苯二氮卓 类药物（ BZD ） 20 例（ 12.66% ）。 2000 年共有 180 例，其中 单用 APD133 例（ 73.98% ），以利培 酮为首；联用 APD47 例 (26.11%), 以 氯氮平联合舒必利为首；预防性应用安坦 23 例 (12.78%); 合用 BZD46 例（ 25.56% ）。 2005 年共有 198 例，其中 单用 APD189 例（ 95.46% ） , 以阿立 哌唑为首；联合用 APD9 例（ 4.54% ），以 氯丙嗪联合阿立哌唑为首；预防性应用安坦 17 例（ 8.59% ）；合用 BZD109 例（ 55.05% ）。
  结论 : 目前 门诊首发精神分裂症患者首次治疗时单用 APD 以阿立 哌唑为首选，不主张预防性应用安坦，慎用 BZD 。
  
  Objective: To investigate the first use of antipsychotics in the outpatients with first-episode-schizophrenia.
  Method: 158 cases(Jan~Oct1995) 、 180 cases (Jan~Oct2000) and198 cases (Jan~Oct2005) with first-episode-schizophrenia were included. The antip-sychotics prescription among 536caseswerestudied.
  Results: Clozapine 、 Resperidone and Aripiprazole were respectively the most frequently used antipsychotics in 1995 、 2000and in 2005.
  Conclusion: At present, aripiprazole in the most frequently used antipsychotics among outpatients with first-episode-schizophrenia, prophylactic use of artane is not recommended, benzodiazepine drugs should be used carefully.
   
  
• P190
  The Abnormal of Metabolism in the Patients with Schizophrenia Used Clozapine
  Geng Zhi 1 , Ren Li 1
  1 The Psychiatric Centery Hospital of Liaoning Province, Kaiyuan, Liaoning, Chinese Mainland
  
  Objective: this study was to explore the influence of clozapine for the abnormal of glucose of the patients with schizophrenia
  Methods: After the glycosylated hemoglobin (HbA1c) was determined, 104 patients with schizophrenia were divided into normal and abnormal HbA1c groups, at 1.6.12 weeks, measured the plasma glucose , cholesterol and triglyceride .
  Results: Although no significant difference between the 2 groups, the 2HPG was increased from(7.2±1.3)mmol/L to (9.5±1.6)mmol/L,the cholesterol and triglyceride was increased differently ,but there was no significant difference(P>0.05), the Patients with abnormal HbA1c were at higher risk of developing clozapine –induced sugar metabolism than those with normal HbA1c (standard OR=8.9) 。
  Conclusion: The results indicate that schizophrenia patients with abnormal HbA1 are likely to develop metabolism disease 。
  Key words: Schizophrenia Hemoglobin A ， glycosylated ， Clozapine
   
  
• P191
  Performance of Data Construction Method in Assessing Relapse Risk over Time in Schizophrenia
  Tsuo-Hung Lan 1 , Chun-Jung Huang 2 , Hsien-Jane Chiu 1 , Tsung-Ming Hu 1 , El-Wui Loh 3 , Hsiao-Fan Wang 2 , Ching-Han Chao 1
  1 Yu-Li Hospital, DOH, Psychiatry, Hualien, Taiwan, Province of China, 2 National Tsing Hua University, Industrial Engineering and Engineering Managemen, Hsinchu, Taiwan, Province of China, 3 National Health Resaerch Institute, Mental Health, Taipei, Taiwan, Province of China
  
  Objective: The term relapse refers to deterioration or recurrence of clinical features of a disease, and the relapses appear to aggravate the disease; on the contrary, this is the term of steady. Even though highly effective neuroleptic drugs have been used for the past 40 years to reduce the relapse rate of schizophrenia, treated patients still experience inevitable relapses from time to time. To have early control of relapses in schizophrenia, methods for prediction of recurrences and their probability are demanded.
  Method: To achieve this goal, a procedure named Data Construction Method (DCM) was adopted to obtain estimation density functions of the elapsed time between relapse and steady events. Then, for validation and verification, an event-driven simulation model was provided for prospectively constructing an approximate sequence of the relapse and steady events in time intervals. When the constructed time-interval exactly contains the real time-point of the concerned event, this is a successful prediction so that the possible risk over time in schizophrenia can be reduced.
  Results: A preliminary experiment was performed from May 1, 2006 to April 30, 2007, of which 35 patients (20 males and 15 females) with mean and median ages of 51.6 and 50 years old were selected for verification. Since it is counted as a success whenever the predictive time-interval contains the relatively real time-point, the performance of the simulation model in each patient could then be concluded from the ratio of success. For instance, a patient had two relapse and two steady events respectively during the verification period, owing to three times of successful prediction, the ratio of success is equal to 0.75.
  To briefly illustrating the experiment results, we divided the ratio of success into 3 levels: if the ratio is no less than 70%, it can be regarded as reliable; if the ratio is between 70% and 40%, it can be regarded as acceptable; otherwise, it is denoted as unreliable. In this study, the predictions among 25 patients are reliable, 7 are acceptable, and only 3 are unreliable. We noticed that patients that had a relapse over a long period of time such like two years in average, the relative prediction performance would be unreliable. Overall, the obtained results show that the proposed method provides a good reference for prediction.
  Conclusions: In the viewpoint of rehabilitation, except a suitable amount and type of medicines, how to timely provide schizophrenic patients with medical treatments remains a critical issue. In this study, we proposed a novel method that provides an estimation function with more information when giving a small sample data. According to resultant functions, a time-event simulation model is derived to construct time intervals to contain time points of oncoming events in advance. Our study shows that the proposed method can provide a good reference for prediction, especially in patients who were with frequent relapses in a case history.
   
  
• P192
  Benchmark 精神科 试验结果对社区从业者的影响 ： 临床康精神病药疗效试验的病例研究 ( CATIE ) - Reach of Benchmark Psychiatric Trial Results to Community-Based Providers: A Case Study of CATIE
  Timothy Petersen 1 , Robert J Birnbaum 1 , Anthony P Weiss 1 , Jefferey C Huffman 1 , Charissa Andreotti 1
  1 Massachusetts General Hospital, Department of Psychiatry, Boston, United States
  
  目的 ： 在美国精神 卫生从业人员中了解下列问题 ： 1 ） 在研究 结果最初出版的一年后 ， 临床一线的工作人员对 CATIE 试验结果的熟悉情况 ； 2) 有精神病 专家提供的医学教育活动 （ CME ） 能否影响服 务提供者对 CATIE 试验重要细节的认识 ？
  方法 ： 参加麻省 总医院精神科学会 （ MGH-PA ） 于 2006 年 间在美国不同城市开设的 12 次 现场专题会的成员 ， 被要求在活 动前回答调查问题了解他们对 CATIE 试验数据的了解和使用情况 ： “ 请选择最恰当语言来总结 CATIE 试验对您治疗精神分裂症患者的影响。 ” 并且使用活 动前 / 后 问卷了解在活动中的学习情况： “ 在最近 CATIE 试验中评估了精神分裂症的不同治疗策略，最主要的结果评估方法是什么？ ” 其中一 项主题为 “ 精神分裂症治 疗修正 ” 的 专题会演讲聚焦于 CATIE 试验结果，并在 12 个不同城市的 专题会中持续进行。对提问回答评估的统计方法包括描述性统计、参数检验等，以此来评估学习情况以及不同参与者之间的学习差异。
  结果： MGH-PA 的 12 次 现场专题会总共有 3,333 名参与者。多数参与者是医 师，其中 60% 的身份属于精神科医 师或初级保健医师，但在不同的城市中医师的比例有明显差异（从迈阿密的 33% 到洛杉 矶的 75% ）。 总共 1,832 名参与者 (55.0%) 回答了前面的提 问。总体上，大约四分之三的参与者 (73%) 报告有治疗精神分裂症患者的经历。在这些人中， 82% 的人 报告他们要么不熟悉 CATIE 结果 (53%) 或者 结果没有改变他们的临床操作 (29%) 。 值得注意的是，治疗精神分裂症患者的参与者中有 32% 表示从没有听 说过 CATIE 试验。在不同的演讲地点，精神分裂症治疗者对 CATIE 结果的不熟悉率占了 40-71% 。 这种对提问回答得地域性差异没有统计学意义 (p>0.05) 。 800 名参与者 (28%) 同 时回答了活动前 / 后提 问。活动前 / 后提 问显示对提问（关于 CATIE 试验的主要结果评估方式）的回答准确性在活动后有了提高，在所有的会议地点都有类似发现。总体上，活动后的回答准确率是 65% ，而演 讲前是 24% 。 这种演讲前后的成绩差异有显著的统计学意义 (p<0.001) 。无 论是演讲的地点还是演讲者的身份都对演讲前后的问题回答变化没有显著影响。
  结论： 在最初的 结果公布一年后， CATIE 试验 不同地域和工作性 质的参与者的影响有限。超过一半的 MGH-PA 演 讲参与者在演讲前报告不熟悉 CATIE 试验结果。第二个主要发现是 MGH-PA 的 CME 精神科演 讲能有效强化对复杂而重要的 CATIE 试验中主要的方法细节的了解。另外有两个值得注意的发现。首先，无论是不同地区（讲座）的演讲前对 CATIE 试验的熟悉率低下，还是对研究关键细节的了解提高，都提示采用临床医学教育的形式是向不同人群讲授重要临床试验的有效方式。此外，在对试验结果的了解上有着潜在的地区差异，不熟悉率从 40% （ 华盛顿特区）到 71% ( 达拉斯 ) ， 这 同先前 对研究结论的实施情况上的地区是一致的，虽然我们还不能确定其它同不熟悉 CATIE 有 关的潜在变量（如专业）。
  
  Objectives: To determine, in a sample of United States psychiatric practitioners, answers to the following questions: 1) one year after initial publication of results, how familiar were front-line clinicians with the findings from the CATIE trial' and 2) can didactic CME, provided by experts in psychotic disorders, influence provider knowledge about key details of the CATIE trial'
  Methods: Attendees at twelve Massachusetts General Hospital Psychiatry Academy (MGH-PA) live symposia, held in different United States cities during 2006, answered both a pre-event polling question regarding their knowledge and utilization of data from the CATIE trial: “Which statement best summarizes the impact of the CATIE trial on your treatment of patients with schizophrenia?” and a pre/post activity question to assess learning during the event: “In the recent CATIE trial evaluating the various treatment options for schizophrenia, what was the primary outcome measure?” One of the symposia lectures, entitled, “An Update on Treatment of Schizophrenia,” focused on the CATIE trial results and was presented in an identical manner in each of the twelve cities. Data analytic approaches utilized to evaluate question response data included descriptive statistics and appropriate parametric tests to evaluate degree of learning and differences in learning between participant sub-groups.
  Results: A total of 3,333 participants attended the 12 MGH-PA live symposia. The majority of program participants were physicians; overall, over 60% identified themselves as either psychiatrists or primary care physicians, though there was some significant variation in proportion of physicians between the cities (ranging from 33% physicians in Miami to 75% in Los Angeles ). A total of 1,832 participants (55.0%) responded to the aforementioned polling question. Overall, approximately three-quarters of respondents (73%) reported that they treat patients with schizophrenia. Of these providers, 82% indicated that they were either unfamiliar with the CATIE results (53%) or that the results had not changed their clinical practice (29%). Of note, 32% of practitioners who care for patients with schizophrenia responded that they had never heard of the CATIE trial. Rates of unfamiliarity with CATIE results among the attendees who treat patients with schizophrenia ranged from 40-71% at the different lecture sites. These location-related differences in polling question responses were not statistically significant (p>0.05). Eight hundred (28%) participants responded to both the pre and post activity question. Accuracy on the pre/post-activity question (about the primary outcome measure in the CATIE trial) increased from pre- to post-lecture at each of the program sites. Overall, the proportion of correct answers on the question post-activity was 65%, compared to 24% prior to the lecture. This pre-post improvement in performance was statistically significant (p<0.001). Neither the location of the lecture nor the identity of the lecturer had significant effects on rates of improvement on the post-activity question above and beyond the effects of receiving the lecture.
  Conclusions: One year after publication of its initial results, the CATIE trial had very limited dissemination to, and impact on, a geographically and occupationally diverse sample of practitioners. More than half of the attendees reported being unfamiliar with the results from the CATIE trial prior to attending the MGH-PA lecture; in fact, approximately one-third had never even heard of the CATIE trial. The second major finding of this study was that the MGH-PA CME lecture on psychosis led to robust improvement in understanding of a key detail about the methodology of the complex and important CATIE trial. Two other findings in the trial were notable. First, both the low pre-lecture familiarity with CATIE and the improvement in understanding the key detail about study design cut across locations (and lecturers), suggesting that CME, as used here, is an effective tool for teaching about pivotal clinical trials to a diverse population. There was, however, some potential regional variance in dissemination of trial results, with rates of unfamiliarity ranging from 40% (Washington DC) to 71% (Dallas); this is consistent with prior studies finding regional variance in implementation of research findings, though we were not able to account for other potential covariates (e.g., discipline) related to unfamiliarity with CATIE.
   
  
• P193
  阿立 哌唑与得培酮治疗精神分裂症对照研究调查 - The Contral Research of Aripiprazole and Risperidone in the Treatment of Schizophrenia
  胜良 杨 1
  1 浙江省湖州市第三人民医院 , 科教科 , 浙江省湖州市 , Chinese Mainland
  
  目的 : 比 较阿立哌唑与利培酮治疗精神分裂症的有效性及安全性。
  方法 : 60 例符合 CCMD-3 精神分裂症患者随机分 为两组各 30 例 ， 分 别于予阿立哌唑和利培酮治疗 8 周。采用阳性症状与 阴性症状量表及不良反应症状量表评定疗效与副反应。结果 治 疗 8 周后，阿立 哌唑组显效率 63.3% 、有效率 90% ，利培 酮组显效率 63.33% 有效率 86.7% ，两 组疗效比较差异无显著性（ P>0.05 ）。不良反 应发生率阿立哌唑组显著低于利培酮组（ P<0.01 ）。
  结论 : 阿立 哌唑与利培酮对精神分裂症疗效相当，不良反应发生率低，是一种安全有效的抗精神病药物。
  关键词 : 阿立 哌唑 ； 利培酮 ； 精神分裂症 ； 有效性 ； 安全性
  
  Objective: TO compare the efficacy and safety of Aripiprazole and Risperidone in the treatment of Schizophrenia.
  Methods: 60 Schizophrenia patients comforming to CCMD-3 were randomly divided into two groups, and each was treatment with Ari and Ris respectively for 8 week. The efficacy and side effects were evaluated by PANSS and TESS.
  Result: The efficacy of Ari and Ris in the treatment has no significant difference (P>0.05), while the rates of side effects of Ari and group are signifantly lower than Ris group （ P<0.01 ） .
  Conclusion: Ari is as effective as Ris in the treatment of Schizophrenia while is safer than Ris.
  Key words: Aripiprazole; Risperidone; Schizophrenia; Efficacy; Safety
  
• 194
  Sleepless Can be Cured by Chinese Herbs
  Hong Chen 1 , Jie Ya Chen 2
  1 World Federation of Chinese Medicine Societies, Beijing, Chinese Mainland, 2 Haidian third Experimental Primary School, Beijing, Chinese Mainland
  
  Objectives: research work on sleep wakefulness disorders.
  Methods:
  1) sleeping pills
  2) Chinese herbs
  3) two groups of patients who have sleepless problems for ten years, one group take sleeping pills for one year,the other group take Chinese herbs for one year.
  Results: Compare with mental medications (sleeping pills), Chinese herbs have less side affects and better effect.
  Conclusions: After taking Chinese herbs,patients felt so happy because they had been suffered from sleepless for 10 years and now they could sleep.The bards of the olden days put so much value, and passion into their muses....They need a muse right now, something to spark them, inspire them, to stimulate, and replenish their creativity.... it ? s amazing how fast a person can be revitalized under such exposiers. Even though it IS A TOUGH WORK for experts to adapt Chinese Herbs.
   
  
• P195
  A Sleep Quality Investigation of the People Aged 18 Years and above of Shandong Province
  Jingxuan Zhang 1 , Chuanhua Lu 1 , Huimin Qiu 1 , Songbo Wang 1 , Aizhen Wang 1 , Lanfen Liu 1 , Jisheng Tang 1 , Dr. Jingxuan Zhang, Dr. Chuanhua Lu, Dr. Jisheng Tang, Dr. Huimin Qiu, Dr. Lanfen Liu, Dr. Songbo Wang, Dr.Aizhen Wang
  1 Shandong Mental Health Center, Jinan City, Chinese Mainland
  
  Objective: To investigate the sleep quality, prevalence of sleep disorders, and the prevalence in different groups of the people aged 18 years and above of Shandong province, To analyze the relationship between sleeping disorders and the quality of life, general mental health levels and mental disorders.
  Method: 23987 persons aged 18 years and above were sampled from Shandong province by multi-stage cluster random sampling. 22664 （ 94.48% ） persons completed the survey questionnaires. The main survey tools were Pittsburgh Sleep Quality Index （ PSQI ）， General Health Questionnaire （ GHQ-12 ）， Quality of Life Questionnaire, Simplified Coping Style Questionnaire, DSM-IV and SCID-P. 24 nurses and 60 psychiatrists trained for 4 weeks before survey completed the investigation costing 3 months.
  Result: The average score of sleep duration of 22664 cases who completed questionnaires was 7.86±1.43 hours, and their average score of PSlQI was 3.42±3.57, female 3.67±3.79, male3.13±3.26 (t=11.39,p<0.001),people aged 18-59 years 2.97±3.25, people aged 60 years and above 5.27±4.16 (t=34.32,p<0.001). If a person whose total score of PSQI was more than 7, we thought that he or she met diagnostic criteria of sleep disorders, then there were 2973 persons meeting sleep disorder criteria, The prevalence of sleep disorder was 13.12%, male 10.31%, female 15.50% （ χ 2=133.01 ， p<0.001 ） ; people aged 60 years and above 26.68%, people aged 8-59 years 9.80% （ χ 2=895.56 ， p<.0001 ） 。 There were significant relationship between sleep disorders and mental disorders, quality life, coping style, mental health levels and body health levels. 2624 cases met different mental disorders diagnostic criteria of DSM- Ⅳ . The prevalence of sleep disorders of 2624 people with mental disorders was 41.20%.
  Conclusion: The Norm of PSQI of the people aged 18 years and above of Shandong province was 3.42±3.57 ， the prevalence of sleep disorders was 13.12% ， according to that there are about 98.83 millions people aged 18 year and above with sleep disorders in Shandong province.
   
  
• P196
  正常人多 导睡眠监测首夜效应与人格相关性研究 - A Study on the Correlation between Personality and First Night Effect for Polysomnographic Monitoring in Normal People
  崇升 宋 1 , 健 王 1
  1 北京回 龙观医院 , 北京 , Chinese Mainland
  
  目的 ： 在 为被试进行多导睡眠图 （ PSG ） 检查时 ， 由于睡眠环境的改变 ， 以及头部需要连接电极、导线 ， 有可能会 引起不适而影响睡眠 监测的结果 ， 因此通常需要连续监测两个晚上。但首夜与第二夜实际的睡眠监测指标存在哪些差异，以及首夜效应与人格特征是否存在相关性，却少见报道。本研究试图进行这方面的探索。
  方法： 对 31 名医院青年 职工及实习大学生进行症状自评量表（ SCL-90 ）和 汉密尔顿抑郁量表（ HAMD ） 测查，选其中得分均在正常范围之内 29 人作 为研究对象，男性 13 人，女性 16 人。 进行多导睡眠监测当日进行明尼苏达多项人格测查（ MMPI ）和匹 兹堡睡眠质量指数（ PSQI ） 评定。所有受试者均连续监测两夜，实验条件相同。
  结果： 首夜睡眠 监测的觉醒时间、觉睡比均明显高于第二夜，差异非常显著（ P<0.01 ），而睡眠 维持率、睡眠效率明显低于第二夜，差异非常显著（ P<0.01 ）。首夜的 实际睡眠时间与 PSQI 的因子Ⅲ（睡眠 时间）得分呈正相关， Spearman 相 关系数为 0.428 （ P<0.05 ）。以首夜睡眠效率 90% 为划界点， 90% 以上者 15 人， 90% 以下 14 人。比 较两组 MMPI 各 临床量表得分，显示前者癔病分高于后者，差异显著（ P<0.05 ）。
  结论： 进行多导睡眠监测存在首夜效应，具体主要表现在首夜觉醒时间长，觉醒比例高，睡眠维持率及睡眠效率低等方面 ，与文献 报道部分一致。 PSQI 在睡眠 时间主观判定方面，与实际客观记录具有较高的一致性。首夜效应更容易出现在癔病量表高分者，提示对于此类性格特征突出者，检测前应进行充分的积极的解释，尽量减少陌生环境带来的负性自我暗示影响。首夜效应与其他人格特征的相关性不明显。进行多导睡眠监测，可能会影响被试的深睡眠，对快动眼睡眠影响不大。
   
  
• P197
  政府事 务部门有关成瘾预防的计划和执行情况 - The Programs and Performance of the Office of Addiction Prevention and Affairs
  Seyed-Mahmoud Mirzamani 1 , Mahdi Abdus 2 , Human Mohammadi 2
  1 Baqiyatallah Medical Sciences University, Psychology, Tehran, Iran, Islamic Republic of, 2 Welfare Organization, Prevention, Tehran, Iran, Islamic Republic of
  
  这些计划的主要关注点是初级预防、治疗和减少损害。
  A ） 初 级预防计划（以社区为基础的成瘾预防）。由于地方分权政策，结合之前的经验，并遵照在政府和公众之间授权这个目标，将两种方式合并而打造了这个计划。一个小的社团（市区或郊区的邻里之间、工作团体和教育中心）管理这个计划中的整个预防干预过程（发现问题、设定优先考虑的事务、设计方案、评估和修正进一步的实施方案），这个社团接受专业人员的帮助，并接受社团所属政府和私人基金的支持（公众基础的、自发的慈善机构）。 B ） 减少 损害和治疗方案。
  
  The main point of these programs is focused on the fields of primary prevention, treatment and harm reduction.
  A)Primary Prevention Programs (Community-Based addiction Prevention) The forging of such programs was due to the decentralization approach, along with previous experiences and followed the goal of empowering the relation between the public and government, and the two way cooperation amongst them. In these Programs the whole process of preventive intervention (problem finding, priority setting, program design, evaluation and correction for further implementation) is conducted by the members of a Small community (urban or suburban neighborhoods, work place and educational centers) which are helped by a professional facilitator and backed up by governmental and private funding found in small societies (charity, public based, self determined) B)Harm reduction and treatment programs
  

   

• P198

  Abstract withdrawn

  
  
• P199
  兴奋剂使用对运动员和青少年的精神病性影响 ： 需要早期干预 - Psychiatric Effects of Doping in Sports and in Adolescents: The Need for Early Intervention
  David Baron 1 , Li- Jing Zhu 2 , Thomas Wenzel 3
  1 Ttemple University, Psychiatry, Ambler, United States, 2 Beijing University, Psychiatry, Beijing, Chinese Mainland, 3 Heidelberg University, Psychiatry, Heidelberg, Germany
  
  毫无疑 问 ， 体育运动中的兴奋剂使用问题是最重要的、需要大书特写的全球性问题。兴奋剂丑闻比运动员打破世界纪录或赢得世界冠军更受人关注。随着 体育运 动中药检技术的进步，兴奋剂使用的隐蔽性也在不断提高。欺骗的技术都很高明。杨顺，北京奥组委的执行副主席，报告说，在正规运动员中使用兴奋剂的少了，但是在业余和社会体育运动中使用兴奋剂的增加了，在非运动员的青少年中使用兴奋剂的也增多了。本文将回顾有关青少年使用兴奋剂情况的相关数据，综述针对这一问题的成功的干预项目。文中将特别强调青少年使用兴奋剂的原因和动机，并着重介绍利用 “ 领袖 ” 策略 进行的文化相关教育项目。这个项目是针对专业人士的，包括与运动员、青年运动项目以及其他与青少年和学校项目相关的人士（教育者、管理 者和咨 询师）。论文报告过程中会举一些临床病例 ， 并鼓励听众积极参与。
  
  Doping in sports is without debate, the most important, written about, and discussed topic globally. More attention is given to a doping scandal than an athlete breaking a world record or winning a world competition. As drug testing in sport has advanced, so has the sophistication of doping strategies. Cheating has become high tech. Yang Shaun,Executive Vice-President of the Beijing Organizing Committee for the Beijing Olympic Committee has reported a decrease in elite athlete doping, but an increase in amateur and social sport doping, along with an increase in youth doping in non-athletes. This presentation will review data on doping in youth and success programs addressing this problem. Special emphasis will be made on reasons(motivation) for doping in this population and the role of culturally relevant education programs utilizing the "bell cow" strategy. This program is for professionals involved with athletes, youth sports programs, and those involved with adolescents and school programs(educators, administrators, and consultants). Clinical examples will be provided and audience participation will be encouraged.
   
  
• P200
  尼日利 亚东北部迈杜古里三流学院学生使用精神活性物质的发生率 - Prevalence of Psychoactive Substance Use among Students of Tertiary Institutions in Maiduguri North Eastern Nigeria
  Abdulaziz Olanrewaju Mohammed 1 , Said Jidda 1 , Isa Rabbebe 1 , Abba Wakil 1
  1 Federal Neuro Psychiatry Hospital Maiduguri, Mental Health, Maiduguri, Nigeria
  
  目的 ： 了解 迈杜古里三流学院中学生使用精神活性物质的发生率以及使用频率最高的精神活性物质。
  方法 ： 采用描述性的横向研究 设计。样本量为 484 ， 按人口比例分配到 5 个院校 ， 在 每 个院校中采用随机的方法 纳入研究对象。在研究开始之前先获得研究院校的许可，采用 “ 世界 卫生组织学生药物使用问卷 ” 作 为研究工具。研究在演讲后立即进行，并用不计名投票箱来收集问卷，以确保绝对保密。采用 SPSS 软件来分析数据。
  结果： 共有 484 名学生接受了 访谈（有效 率 为 96.8% ），其中， 198 人正在使用精神活性物 质（发生率为 40.9 ％）。使用 频率最高的三种精神活性物质分别是咖啡因 129 人（ 65 ％），酒精 52 人（ 26.03 ％）和大麻 44 人（ 22.2 ％）。使用 频率最小的是可卡因， 5 人（ 2.5 ％）。
  结论： 迈杜古里学生最常用的精神活性物质是咖啡因，一种兴奋剂，学生用来帮助学习。酒精和大麻次之。
  
  Objectives: To determine the prevalence of psychoactive substance use, among students of tertiary institutions in Maiduguri . To also determine the most frequently use psychoactive substances among the students.
  Methodology: A descriptive cross sectional study design was used. The sample size was 484 which was Allocated to the five institutions based on there population (proportionate allocation), and stratified Random sampling was used to distribute the samples in each institution. The approval of the institution was Obtained before the study and the instrument used for collection of data, is the WHO student drug use questionnaire. It was administered immediately after lectures and a ballot box was used to collect the questionnaire from the students to ensure absolute confidentiality. The data was analyzed using SPSS.
  Results: The total number of students interviewed was 484(response rate of 96.8%). Out of 484students, 198 were using psychoactive substances (prevalence of 40.9%). The most frequently used psychoactive Substances were caffeine, 129 (65%) , alcohol, 52 (2603%), and cannabis, 44 (22.2%). The least used Substance is cocaine, 5 (2.5%).
  Conclusion: The most frequently used psychoactive substance by students in Maiduguri is caffeine, a Stimulant, which they use to enhance there study. This was followed by Alcohol and cannabis.
   
  
• P201
  吸食大麻的 认知损害 ： 一个长程研究 - Cognitive Consequences of Marijuana Use: A Longitudinal Study
  Jake M. Najman 1 , Reza M. Hayatbakhsh 1 , William Bor 1 , Michael O'Callaghan 1 , Gail M. Williams 1
  1 University of Queensland , School of Population Health , Brisbane , Australia
  
  目的 ： 大麻是世界上使用最广泛的 违法毒品。尽管吸食大麻能导致心理和躯体健康的损害已经得到了证实，但是目前有两点对得出这样的结论具有阻碍性。（ i ） 许多大麻吸食可能导致的心理健康和行为损害在个体吸食大麻前而非吸食大麻后就已经出现了。（ ii ） 许多已经获得的研究结果来自于临床或治疗的样本而不是更广泛的一般人群样本，而在一般人群样本中吸食大麻的程度可能远低于这些样本。根据以上两点的考虑，本研究以决定吸食大麻前后的数据均可获得的一般人群为研究对象，检测吸食大麻可能产生的心理和生理损害。
  方法： 昆士 兰大学的怀孕母亲队列研究 (Mater-University of Queensland Study of Pregnancy ， MUSP) 是 对一般人群的研究，研究开始于妊娠早期。出生以后，孩子在 5 岁和 14 岁时进行评估， 21 岁时通过复合性国际诊断访谈（ CIDI ）采集大麻吸食的有 关资料，并将对多种吸食大麻的结果进行评估。 < 结果： 大麻吸食者在 认知、经济状况和心理健康等多方面可以被区别出来，对这些大麻吸食预测因素的控制提示以上这些结果出现于吸食大麻之后而非之前。
  结论： 研究 结果提示：（ i ）吸食大麻 导致的认知、心理和身体健康损害仅仅发生于事实上更高程 度的大麻使用。 （ ii ） 大麻吸食与多 种健康损害之间存在剂量 - 反 应的相关性。
  
  Objectives: Cannabis is the most widely used illicit drug in the world. Although a number of mental and physical health consequences of cannabis have been identified, current knowledge is hampered by two considerations.
  (i) Many of the mental health and behavioural consequences of cannabis use may precede rather than follow cannabis use.
  (ii) Many of the available findings are derived from clinical or treatment samples rather than the population at large. Levels of cannabis use are likely to be much lower in population samples.
  This paper addresses the above concerns by examining the mental and physical health consequences of cannabis use in a population sample for whom data are available prior to and after the decision to use cannabis.
  Methods: The Mater–University of Queensland Study of Pregnancy (MUSP) is a population study with recruitment of the study sample early in pregnancy. After birth, the children are assessed at 5 and 14 years of age, and cannabis use data is derived from administration of the CIDI at 21 years of age. A wide variety of outcomes of cannabis use are assessed.
  Results: Users of cannabis are distinguished by a wide range of cognitive, economic, and mental health outcomes. control for cognitive, economic, and mental health predictors of cannabis use suggests that the above outcomes follow the use of cannabis rather than precede its use.
  Conclusions: The study findings suggest that:
  (i) Cognitive, mental and physical health consequences of cannabis use are only of a substantial magnitude at higher levels of use.
  (ii) There is a dose-response association between cannabis use and a wide variety of health outcomes.
   
  
• 202
  美沙 酮替代治疗早期海洛因依赖者的多导睡眠图研究 - Sleep Patterns Changes in Male Methadone Treatment Patients: A Polysomnography Study
  Le Xiao 1 , Yilang Tang 1 , Guofu Zhang 1 , Song Guo 1 , Yanpin Ren 1 , Lixia Sheng 1 , Wanjun Du 1 , Yong Chi 1 , Zuoning Jiang 1 , Xiaonian Luo 1
  1 Beijing Anding Hospital, Beijing, Chinese Mainland
  
  目的 : 探 讨海洛因依赖者在美沙酮替代治疗早期的睡眠特征 .
  方法 : 选择 20 例美沙 酮替代治疗 2~10 天的男性海洛因依 赖者和 20 例年 龄与对照组相匹配的男性健康志愿者进行全夜睡眠监测 ， 并使用 PSQI 和 ESS 量表 对受试者的睡眠状况进行自评。
  结果 : 病例 组的睡眠时间及睡眠效率明显降低 ， 慢波睡眠减少及入睡后清醒时间显著增加 ， 入睡潜伏期和 REM 睡眠与 对照组无显著差异。正常对照组慢波睡眠与年龄增长呈显著负相关 ， 而病例组无此相关。病例组 PSQI 及 ESS 评分显著高于对照组，并且 ESS 评分与慢波睡眠的减少显著相关。
  结论 : 在美沙 酮替代治疗的早期阶段，主客观指标显示海洛因依赖者的睡眠质量下降及睡眠结构异常。阿片类物质对慢波睡眠有抑制作用。日间嗜睡与慢波睡眠的减少密切相关。
  
  Aims: To explore the sleep patterns of patients on methadone treatment.
  Design: A cross-sectional design.
  Method: Twenty male heroin dependent patients admitted to methadone treatment (MT) for 2~10 days and 20 age and body mass index (BMI) matched male healthy controls were assessed clinically and with overnight polysomnography (PSG). Sleep patterns were also assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS).
  Results: Compared with healthy controls, MT patients had lower sleep efficiency (p < 0.01), shorter total sleep time (p < 0.01), shorter slow wave sleep (SWS) (p < 0.01) and more frequent awakenings (p < 0.01). Rapid eye movement (REM) sleep remained unchanged (p > 0.50). The PSQI and ESS scores in patients were significantly higher than the controls (p < 0.01). ESS scores of the patients were associated with the decrease of SWS (p < 0.01).
  Conclusions: Patients in early methadone treatment have poor sleep quality and abnormal sleep architecture.
   
  
• P203
  男性酒依 赖者柯萨可夫综合症 （ WKS ） 一例 - A Case of Wernike-Korsakoff Syndrome in Male Alcohol Dependence
  Sungbin Choi 1 , Soohyung Park 1
  1 Keyo Hospital , Uiwang , Korea , Republic of
  
  柯 萨可夫综合症由于缺乏维生素 B1 所致 ， 主要影响大 脑神经系统功能。该病造成的大脑损害主要位于大脑中部，导致严重的近事记忆丧失。本次病例报告为一男性患者 58 岁，饮酒 30 余年， 记忆功能严重受损，主 要症状包括：定向障碍、抽象思 维能力下降、虚构。 头颅 CT 显示：大脑中度萎缩。神经心理测试：存在定向障碍、记忆损害、抽象思维能力下降。我们报告了此病例 ， 同时查阅了相关文献。患者上述临床症状也可以诊断为其他精神障碍 ， 如 “ 酒精性痴呆 ” 。
  
  Wernicke-Korsakoff syndrome(WKS) is caused by lack of thiamine (vitamin B1), which affects the brain and nervous system. In Korsakoff's pychosis, brain damage occurs in the mid part of the brain, resulting in severe short term memory loss. A 58-year-old male patient had a history of chronic alcoholism for at least 30 years. He had severe disturbance of memory function and showed disorientation, impairments of abstract thinking, and confabulation. The patient's brain C.T showed mild cortical atrophy. On neuropsychological test, he showed disorientation, impairments of memory, and inability of abstract thinking. We report a case of WKS in male alcohol dependence and reviewed the relevant literatures. His clinical symtoms may also be diagnosed as other psychiatric disorder, such as alcoholic dementia.
   
  
• P204
  阻断 ERK 通路再激活 对吗啡依赖大鼠已建立的条件性位置偏爱的影响 - Prevents ERK Cascade Reactivation of Influencing the Formation of Conditioned Place Preference Induced by Morphine in Rats
  邵 云 1 , 韩 继 阳 2 , 何 强 3 , 王 旭 梅 3
  1 中国医科大学盛京医院 , 临床心理门诊 , 沈阳 , Chinese Mainland, 2 中国 , 沈阳 , Chinese Mainland, 3 中国医科大学盛京医院 , 沈阳 , Chinese Mainland
  
  目的 : 研究阻断 ERK 通路再激活 对吗啡依赖大鼠已建立的条件性位置偏爱的影响。
  方法 : 将 80 只大鼠随机分成 8 组 ， 每组各 10 只 ， 在建立 吗啡的条件性位置偏爱后 ， 分别给予腹腔注射细胞外信号调节激酶激酶抑制剂 SL327 或生理 盐水后再次注射吗啡 ， 对照组则注射生理盐水 ， 并与 给药环境建立联系 ， 观察对已建立的条件位置偏爱的影响。并采用 western blotting 法 测定伏隔核中 P-ERK2 的表达水平。 结果 在再次注射 吗啡并暴露于以前给药环境前给予腹腔注射 SL327 ，能 够消除已建立的条件性位置偏爱。同时伏隔核中 P-ERK2 的表达水平同其它 组相比较明显减少。而注射 SL327 后再次 给予生理盐水或者是注射吗啡却放入大鼠自然生活的鼠笼均不能消除已建立的条件性偏爱。
  结论 : 阻断 ERK 通路再激活可以消除 吗啡依赖大鼠已建立的条件性位置偏爱。
   
  
• P205
  Influence of Blokade Reactivation of ERK Pathway during Reexposure to Morphine to Previously Learned Place Preference
  Yun Shao 1 , Yang Ji Han 1 , Qiang He 1 , Mei Xu Wang 1
  1 Sheng Jing Hospital of China Medical University, Shenyang, Chinese Mainland
  
  Obiective: To study the influence of blokade reactivation of ERK pathway to previously learned place preference in morphine addiction rat
  Methods: Eighty rats were randomly divided into eight groups of ten each: Aftter estab-lishment of morphine-produced conditioned place preference(CPP) in rat , were peritoneal injected with SL327, which is inhibitor of ERK or saline and, 1 h later, were injected with morphine or saline and placed in the drug-paired compartment or rat home cage differently. To observe in-fluence to previously learned place preference and change of the P-ERK in rat nucleus accumbens septum (NAcs) by Western blotting.
  Results: Pe-ritoneal injection with SL327 before injected morphine again in a previously drug-paired com-partment erased established CPP and the expre-ssion of P-ERK in NAcs obviously decreased com-parad to the other groups. In contrast, rats that received morphine in the presence or absence of SL327 in their home cage displayed a normal CPP.
  Conclusions: Blokade reactivation of ERK pathway erased learned previously place preference in morphine addiction rat.
  Key words: Morphine addiction CPP ERK NAcs
   
  
• P206
  泰国医学生的 饮酒方式 - Alcohol Drinking Pattern among Thai Medical Students
  Suwanna Arunpongpaisal 1 , Poonsri Rangseekajee 1 , Surapol Virasiri 1 , Suthatip Sraprom 1
  1 Khon Kaen University , Psychiatry, Khon Kaen , Thailand
  
  目的 ： 调查 Khon Kaen 大学医学生的 饮酒方式 ， 如危险性、有害性或依赖性饮酒等的时点患病率。
  方法 ： 在 2005 年运用 AUDIT 对所有的医学生进行了描述性混断面的调查。 结果 ： 1022 名医学生中的 787 人 （ 75 ％） 接受了 调查 ， 饮酒问题的患病率为 6.39%(95%CI=6.36-6.42) ， 其中危 险饮酒为 1.56%(95%CI=1.53-1.57), 有害性 饮酒 2.6%(95%CI=2.57-2.63), 依 赖性饮酒 2.4%(95%CI=2.37-2.43%) 。 进入临床年的学生高于未进入临床年的学生。饮酒的主要原因是社交性的娱乐活动，。
  结论： 泰国医学生的 饮酒问题的患病率为 6.39% ， 进入临床年 的学生有更高的患病率。因此 进入临床年的医学生应考虑进行饮酒问题的筛查并采取控制医学院的酒精消耗的措施来预防。
  
  Objective: To examine point prevalence of alcohol drinking pattern such as hazardous, harmful, dependent drinking among medical students at Khon Kaen University
  Methods: A descriptive cross-sectional survey using AUDIT to total medical students in 2005.
  Results: 787 of 1022 medical students(75%)participated in this study. Prevalence of alcohol drinking problems was 6.39% (95%CI=6.36-6.42). There were the hazardous drinking as 1.56% (95%CI=1.53-1.57), harmful drinking as 2.6% (95%CI=2.57-2.63), and dependent drinking as 2.4%(95%CI=2.37-2.43%). Clinical year class was higher than preclinical. Social recreation was the main reason for drinking.
  Conclusions: Thai medical students had alcohol drinking problems was 6.39%. Clinical year trend to have higher prevalence. Therefore, screening for alcohol drinking problem shoud be considered in clinical year and prevention program for controlling alcohol consumption in medical campus.
   
  
• P207
  康 复期海洛因依赖者负性情绪与视觉 P300 的 关系 - A Study on the Relationship between the Negative Mood and Visral P300 in Male Patients with Heroin Dependence
  Wu Li 1
  1 Jining Mental Hospital of Shan Dong Province, Jining, Chinese Mainland
  
  目的 : 探 讨处于康复期的海洛因依赖者负性情绪及其视觉 P300 （ VEP-P300 ） 的 临床价值。方法 采用抑郁（ SDS ）、焦 虑自评量表（ SAS ）及症状自 评量表（ SCL-90 ）， 对 38 例男性海洛因依 赖者（ MPHD ）与 14 例健康 对照进行心理评估，并于 1 周内 测受试前额区（ Fz ）、中央区（ Cz ）及 顶区（ Pz ）的 VEP-P300 。 结果： 除 强迫 状 态、人际关系外， MPHD SCL-90 总分与其各因子、 SDS 总分及 SAS 总分均高于健康对照（ P<0.05 ）。 MPHD 与 对照组 VEP-P300 各指 标均无显著性差异。 SAS 、 SCL-90 总分及 SCL-90 多个因子与 Fz 、 Cz 、 Pz 点 VEP-P300 的潜伏期呈正相 关（ P<0.05 ）。 结论：康复期的 MPHD 负性情绪与 VEP-P300 密切相 关， VEP-P300 对海洛因依赖者负性情绪的预测具有一定的临床价值。
  关键词 : 海洛因 ； 心理学 ； 视觉 P300
  
  Objective: To explore the negative mood and the clinical value of visual P300 （ VEP-P300 ） in male patients with heroin dependence (MPHD) in a stage of rehabilitation.
  Methods: 38 MPHD (study group) and 14 healthy controls were evaluated with a self-developed data-collecting form, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90), and the visual cognitive potential P300 （ VEP-P300 ） were tested at forehead zone (Fz), central zone (Cz) and parietal zone (Pz) in the following week.
  Results: Compared with healthy controls, MPHD had significant higher total scores of SDS, SAS, and total and factor scores of SCL-90 except factor obsession-complusion and factor international sensitivity of SCL-90 （ P ＜ 0.05 or P ＜ 0.01 ） . Compared with healthy controls, when administered drug pictures as targets (DT), there was no significant difference at Fz, Cz and Pz between MPHD and controls （ P>0.05 ） , but except for the VEP-P300 amplitude at Pz, the VEP-P300 amplitude and latent period showed a elevated tendency at Pz, Cz and Pz. There were significant positive correlation between the total scores of SAS, SCL-90, the most factors of SCL-90 and the VEP-P300 latent period at Pz, Cz and Pz （ P<0.05 or P<0.01 ） . The values of correlation were from 0.323 to 0.480.
  Conclusions: In a rehabilitative period, MPHD still suffered from depressive, anxious mood and multitude psychosomatic symptoms. There were a close correlation between negative mood and VEP-P300 in MPHD in some extent.
  Key words: Heroin ； Depression ； Anxiety ； SCL-90 ； Visual P300
   
  
• P208
  视觉 P300 在海洛因依 赖者认知功能评估中的价值 - The Value of Visual P300 in Cognitive Function Assessment of Patients with Heroin Dependence
  Wu Li 1 , Wei Hao 1
  1 Jining Mental Hospital of Shan Dong Province, Jining, Chinese Mainland
  
  目的 : 探 讨处于康复期的海洛因依赖者认知功能及其视觉 P300 （ VEP-P300 ） 的 临床价值。方法 采用 韦氏记忆量表（ WMS ）、威斯康星卡片分 类测验 - 改良版 (M-WCST) ， 对 38 例男性海洛因依 赖者（ MPHD ）与 14 例健康 对照进行神经心理评估，并于 1 周内 检测受试前额区（ Fz ）、中央区（ Cz ）及 顶区（ Pz ）的 VEP-P300 。 结果：（ 1 ） MPHD 执行 功能与 记忆力显著差于对照。（ 2 ） MPHD 与 对照组 VEP-P300 各指 标均无显著性差异（ P>0.05 ）。（ 3 ） VEP-P300 的多个指 标与 WMS 及 M-WCST 的多个指 标密切相关。结论：康复期的 MPHD 仍存在明 显的认知功能损害， VEP-P300 可作 为对海洛因依赖者认知功能的损害评估的一个生物学指标。
  关键词 : 海洛因 ； 神 经心理测验 ； 视觉 P300
  
  Objective: To explore the cognitive function and the clinical value of visual P300 （ VEP-P300 ） in male patients with heroin dependence (MPHD) in a stage of rehabilitation.
  Methods: 38 MPHD (study group) and 14 healthy controls were evaluated with Wechsler Memory Scale (WMS) and Modified Wisconsin Card Sorting Test (M-WCST), and the visual cognitive potential P300 （ VEP-P300 ） were tested at forehead zone (Fz), central zone (Cz) and parietal zone (Pz) in the following week.
  Results: The scores M-WCST card sorted rightly, card number of right sortation and number of random error in MPHD were significantly lower than that in controls （ P<0.05 or P<0.01 ） , and number sorted wrongly and persistent error higher than that in controls （ P<0.01 ） . The score of WMS memory quotient (MQ) was significantly lower than that in controls （ P<0.01 ） . Compared with healthy controls, when administered drug pictures as targets (DT), there was no significant difference at Fz, Cz and Pz between MPHD and controls （ P>0.05 ） . The MPHD VEP-P300 amplitude at Fz showed positive correlation with 1-100, the latent period showed negative correlation with 100-1 and picture memory (P<0.05 or P<0.01). The MPHD VEP-P300 latent period at Cz showed negative correlation with M-WCST card number sorted rightly, 1-100, and showed positive correlation with number sorted wrongly （ P<0.05 ） . The MPHD VEP-P300 amplitude at Pz showed positive correlation with 1-100, 1-100, touch memory, MQ (P<0.05); the latent period showed negative correlation with M-WCST card number sorted rightly and picture memory, positive correlation with number sorted wrongly (P<0.05).
  Conclusion: In a rehabilitative period, MPHD still suffered from cognitive dysfunction. VEP-P300 may be taken as an biological evaluation index for cognitive dysfunction in MPHD.

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