结尾为-OLOGY的所有单词

biology 生物

apology 道歉，歉意

technology 技术

mycology 真菌学

endocrinology 内分泌学

ecology 生态学

psychology 心理学

ethnology 民族学

archaeology 考古学

geology 地质学

常见名词后缀

1、具有某种职业或动作的人

(1）-an,-ian,表示"……地方的人，精通……的人”American,historian

（2）-al，表示"具有……职务的人" principal

（3）-ant,-ent，表示"……者” merchant,agent,serevant,student

（4）-ar，表示"……的人” scholar,liar,pedlar

（5）-ard,-art，表示"做……的人”coward,laggard,braggart（夸张者）

（6）-arian，表示"……派别的人， ……主义的人”humanitarian,vegetarian

（7）-ary，表示"从事……的人" secretary,missionary

（8）-ate，表示"具有……职责的人" candidate,graduate。

（9）-ator，表示"做……的人" educator,speculator（投机者）

(10）-crat，表示"某种政体，主义的支持者" democrat,bureaucrat

2、 带有学术，科技含义

(1）-graphy，表示"……学，写法” biography,calligraphy,geography

(2）-ic,ics，表示"……学……法" logic,mechanics,optics,electronics

(3）-ology，表示"……学……论”biology,zoology,technology（工艺学）

(4）-nomy，表示"……学……术" astronomy,economy,bionomy（生态学）

（5）-ery，表示"学科，技术" chemistry,cookery,machinery

（6）-y，表示"……学，术，法” photography,philosophy

请问哪里可以找到关于"强迫症"和“忧郁症”的英文资料？

;q=

Obsessive-compulsive symptoms in Parkinson's disease

M Alegreta, C Junquéa, F Valldeoriolab, P Vendrella, M J Martíb, E Tolosab

a Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Pg Vall d'Hebron 171, 08035 Barcelona, Spain, b Parkinson's and Movement Disorders Unit, Institut Clínic de Malalties del Sistema Nerviós (ICMSN), Department of Neurology, Hospital Clinic Universitari, School of Medicine

Correspondence to: Professor C Junqué cjunque@psi.ub.es

Received 6 July 2000 and in revised form 19 October 2000; Accepted 10 November 2000

Abstract

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Abstract

Introduction

Methods

Results

Discussion

References

To systematically investigate obsessive-compulsive traits in Parkinson's disease, patients were administered the Maudsley obsessional-compulsive inventory (MOCI) and a modification of the Leyton obsessional inventory (LOI) to a sample of non-demented and non-depressed patients with Parkinson's disease. Patients with severe Parkinson's disease showed more obsessive traits than normal controls in MOCI and LOI total scores, and in the "checking", "doubting", and "cleaning" subscales of the MOCI. By contrast, patients with mild disease did not differ from controls. A significant correlation was found between severity and duration of illness and MOCI total score. These results support the involvement of basal ganglia in obsessive-compulsive symptomatology. As patients with mild Parkinson's disease did not differ from controls, obsessive-compulsive disorder does not seem to be directly related to the initial nigrostriatal dopaminergic deficiency which causes clinical Parkinson's disease symptomatology. The appearance of obsessive symptoms could be related to the subset of neurochemical changes taking place at the level of the basal ganglia circuitry as disease progresses.

(J Neurol Neurosurg Psychiatry 2001;70:394-396)

Keywords: Parkinson's disease; obsessive-compulsive disorder; basal ganglia

Introduction

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Abstract

Introduction

Methods

Results

Discussion

References

Several structural and functional neuroimaging studies have shown that obsessive-compulsive disorder is related to dysfunction of the basal ganglia.1 2 Lesions in the basal ganglia produce obsessive-compulsive symtomatology similar to idiopathic obsessive-compulsive disorder.3 In addition, the incidence of obsessive-compulsive disorder is high in Huntington's disease and Tourette's syndrome.4-6

It is well known that patients with Parkinson's disease manifest several dysfunctions of frontobasal ganglia circuitry. Dysfunction in the limbic circuitry may also be responsible for the occurrence of obsessive-compulsive traits in patients with Parkinson's disease. Tomer et al7 found a relation between obsessive-compulsive symptomatology and the severity of motor impairment in Parkinson's disease. However, in a group of 16 patients with Parkinson's disease Müller et al8 did not find differences between patients and normal controls in the Maudsley obsessional-compulsive inventory (MOCI). In a previous study, we reported that patients with Parkinson's disease who had undergone pallidotomy had improved scores on the MOCI.9

The aim of the present study was to systematically investigate obsessive-compulsive traits in Parkinson's disease. Two questionnaires were used: the MOCI, mainly applied in idiopathic obsessive-compulsive disorder,10 and a modified version of Leyton obsessional inventory (LOI), which was reported to be sensitive to Tourette's syndrome.6

Methods

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Abstract

Introduction

Methods

Results

Discussion

References

SUBJECTS

The MOCI was administered to 72 consecutive non-demented patients with idiopathic Parkinson's disease (36 men and 36 women) from the Department of Neurology at the Hospital Clinic Universitari in Barcelona. The control group comprised 72 subjects without history of neurological or psychiatric illness (36 men and 36 women). They were patients' spouses or friends, recruited from the neurology outpatients' department of the Hospital Clinic Universitari. The groups were matched by age, sex, and education. The mean (SD) age of the patients was 63.25 (8.58), educational level 8.56 (4.32) years; for controls, the mean (SD) age was 63.63 (10.13), educational level 9.39 (4.31) years. Mean (SD) age at onset of Parkinson's disease was 51.90 (10.65) years, duration of disease 11.51 (7.53) years, and mean Hoehn and Yahr stage 3.03 (SD 1.12).

A modified version of the LOI was administered to a subgroup of 54 patients with Parkinson's disease (27 men, 27 women) and 54 normal controls (27 men, 27 women) from the sample. Mean (SD) patient age was 64.13 years (8.91), educational level 8.85 (4.44) years, duration of illness 10.65 (8.00) years, and mean Hoehn and Yahr stage 2.91 (1.19). The control group was also matched to the Parkinson's disease group by mean (SD) age (64.15 (10.51)), education (9.39 (4.45) years), and sex (27 men, 27 women).

ASSESSMENT OF OBSESSIVE-COMPULSIVE TRAITS

The MOCI comprises 30 sentences which are classified into four factors: checking (nine items), cleaning (11 items), doubting (seven items), and slowness (seven items). Subjects were instructed to answer true or false. The inventory includes both affirmative and negative sentences.

The modified version of the LOI, proposed by Frankel et al,6 was constructed from questions derived from the original LOI,11 supplemented by additional questions designed to elicit obsessive-compulsive disorder phenomena. The LOI consists of 40 statements, and subjects were asked to make a graded response indicating whether the statement was true for his or her symptoms: "never" (score 0), "rarely" (1), "sometimes" (2), "moderately often" (3), "frequently" (4) or "always" (5). Frankel et al6 identified a group of items (14, 19, 21, 24, 29, 38, and 40) as preferentially endorsed by patients with Tourette's symdrome and 11 questions (9 to 12, 15, 23, 25, 28, 30, 34, and 37) that elicited high scores from patients with idiopathic obsessive-compulsive disorder.

Results

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Abstract

Introduction

Methods

Results

Discussion

References

Patients with Parkinson's disease obtained a higher total MOCI score than normal controls (t=2.42, p=0.017). As MOCI total score correlated with Hoehn and Yahr stage (r=0.33, p=0.004) and duration of illness (r=0.34, p=0.005), two subgroups were created according to severity of Parkinson's disease: mild (Hoehn and Yahr2.5) and severe (Hoehn and Yahr2.5). One way ****ysis of variance (ANOVA) showed a significant effect of group (F=10.41, p=0.0001). Post hoc ****ysis using Duncan's procedure showed higher scores in patients with severe Parkinson's disease than in those with mild Parkinson's disease and normal controls (table). The ****ysis of MOCI factors showed a significant group effect on the "checking", "doubting" and "cleaning" subscales (****ysis of variance (ANOVA), F=5.33, p=0.0059; F=10.33, p=0.0001; and F=3.42, p=0.0355, respectively).

View this table:

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Comparison between mild Parkinson's disease (PD), severe PD, and control groups in MOCI and LOI questionnaires

The LOI scores also disclosed significant differences between groups. The obsessional scores for patients with severe Parkinson's disease were higher than those for patients with mild Parkinson's disease and controls. Taking a cut off level of 70 to determine a definitely raised inventory score,6 13 of the 54 patients (24.1%) and 10 of the 54 control subjects (18.5%) scored in this range. Total scores for MOCI and LOI were strongly correlated in both patients with Parkinson's disease (r=0.70, p=0.000) and controls (r=0.65, p=0.000). Leyton total score was not related to age (r=0.15, p=0.288), Hoehn and Yahr (r=0.02, p=0.885) or duration of illness (r=0.05, p=0.729).

Discussion

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Abstract

Introduction

Methods

Results

Discussion

References

Relations between Parkinson's disease and obsessive-compulsive disorder have been previously suggested in other studies,12 13 but few researchers have systematically investigated this contention. Hardie et al13 described complex manneri**s and organised rituals in conjunction with the on-off phenomenon in patients with Parkinson's disease, but only two studies have hitherto administered obsessive-compulsive questionnaires. Tomer et al7 compared data from 30 patients with Parkinson's disease with the normative data from Leyton's original questionnaire. They found that out of 30 patients, 17 had a higher symptom score, and 19 a higher trait score than the mean of normal controls. The authors concluded that obsessive-compulsive symptoms may be an important but unrecognised feature in some patients with idiopathic Parkinson's disease. Müller et al8 reported negative results using the MOCI and the Hamburg obsessive-compulsive inventory in a sample of 20 patients with Parkinson's disease and 43 controls. The **all sample size and the heterogeneity of Parkinson's disease may be responsible for the lack of statistical significance in this study.

Patients with severe Parkinson's disease presented significantly more self reported obsessive-compulsive symptoms than controls in both questionnaires administered, but none of the patients was diagnosed as having obsessive-compulsive disorder according to DSM-IV criteria, and none were receiving psychopharmacological treatment for obsessive-compulsive disorder symptomatology. Although the MOCI and LOI scales are widely accepted as descriptive self estimation scales for obsessive-compulsive symptoms, no diagnostic value is given.

Our patients with severe Parkinson's disease differed from controls in almost all scales (checking, cleaning, and doubting). Patients with mild Parkinson's disease had no obsessive-compulsive symptoms. In addition, a correlation between years of evolution and MOCI global score was found. Thus, the present study showed that obsessive-compulsive symptoms appeared late during the disease progression in patients with idiopathic Parkinson's disease. This fact suggests that the emergence of obsessive symptoms could be directly related to the subset of neurochemical changes taking place at the level of the basal ganglia circuitry as the disease progresses.14 The functional disturbances produced by degeneration of the nigrostriatal pathway could influence the striatofrontal circuits in the advanced stages of Parkinson's disease. Another alternative explanation could be that some of the patients in our study presented direct frontocortical damagethat is, gliosis, neuronal loss, and Lewy bodies in the cytopla**. However, this explanation is unlikely as the patients involved in this study showed no signs of dementia, hallucinations, or any other symptomatology of Lewy body dementia.15

Obsessive-compulsive disorder is mainly seen in degenerative processes such as Huntington's disease4 and is associated with Tourette's syndrome.5 The motor symptoms of Parkinson's disease are in some ways the opposite to Tourette's syndrome and Huntington's disease, as in these two diseases there is a motor overactivation. However, over time levodopa treatment in Parkinson's disease is able to induce dyskinesias. In patients with very advanced Parkinson's disease who underwent pallidotomy we found an improvement of both obsessive-compulsive traits and dyskinesias in the asses**ent performed 3 months after surgery,9 suggesting that their mechani**s are similar. Litvan et al16 found that hyperkinetic syndromes, such as Huntington's disease, are associated with hyperactive behaviours. They suggested that these behaviours are secondary to an excitatory subcortical output through the medial and orbitofrontal cortical circuits.

Several models of obsessive-compulsive disorderand other psychiatric diseases such as melancholiacentre around the possibility that symptoms represent behavioural programmes that are pathologically and repetitively generated by dysfunctional basal ganglia circuits, as in motor dysfunction.17 18 Lesional data in Parkinson's disease also point to a link between obsessive-compulsive disorder and basal ganglia. Daniele et al19 reported a case of idiopathic Parkinson's disease which started obsessive thoughts and compulsions after a vascular unilateral lesion restricted to the left putamen. Obsessions appeared after an interval of days, compulsions after a few weeks, and both symptoms progressed over subsequent months. This patient was classified as very severe on the Yale-Brown obsessive-compulsive scale.

Analysing the items that Frankel et al6 identified as preferentially endorsed by patients with Tourette's syndrome, we did not find differences between patients with Parkinson's disease and controls. The classic obsessive-compulsive disorder symptoms found in Tourette's syndrome (questions which involved blurting obscenities, imitating the movements of others, counting compulsions, and impulses to hurt oneself) were not found in our Parkinson's disease sample. Slowness might be expected to be characteristic of Parkinson's disease from a clinical point of view, but the MOCI score on this subscale (slowness and repetition) did not increase.

It has been suggested that patients with Parkinson's disease display a specific cluster of personality traits consisting of increased rigidity, conscientiousness, industriousness, orderliness, and cautiousness. Menza et al20 reported that patients with Parkinson's disease were less "novelty seeking" than controls. Low novelty seeking patients were described as being reflective, rigid, stoic, slow tempered, frugal, orderly, and persistent. Some of these are obsessive traits.

In summary, our data support the involvement of basal ganglia in obsessive-compulsive symptomatology.

Acknowledgments

This study is partially supported by grants 1997FI00147 and 99SGR00081 from the Generalitat of Catalunya. We thank Chris Summerfield for his English revision.

References

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Abstract

Introduction

Methods

Results

Discussion

References

1. Robinson D, Wu H, Munne RA, et al. Reduced caudate nucleus volume in obsessive-compulsive disorder. Arch Gen Psychiatry 1995;52:393-398[Abstract].

2. Baxter LR, Phelps ME, Mazziotta JC, et al. Local cerebral glucose metabolic rates in obsessive-compulsive disorder: a comparison with rates in unipolar depression and in normal controls. Arch Gen Psychiatry 1987;44:211-218[Abstract].

3. Laplane D, Lavasseur M, Pillon B, et al. Obsessive-compulsive and other behavioural changes with bilateral basal ganglia lesions. A neuropsychological magnetic resonance imaging and positron tomography study. Brain 1989;112:699-725[Abstract].

4. Cummings JL. Frontal-subcortical circuits and human behavior. Arch Neurol 1993;50:873-880[Abstract].

5. Cummings JL, Frankel M. Gilles de la Tourette syndrome and the neurological basis of obsessions and compulsions. Biol Psychiatry 1985;20:1117-1126.

6. Frankel M, Cummings JL, Robertson MM, et al. Obsessions and compulsions in Gilles de la Tourette's syndrome. Neurology 1986;36:378-382[Abstract].

7. Tomer R, Levin BE, Weiner WJ. Obsessive-compulsive symptoms and motor asymmetries in Parkinson's disease. Neuropsychiatry Neuropsychol Behav Neurol 1993;6:26-30.

8. Müller N, Putz A, Kathmann N, et al. Characteristics of obsessive-compulsive symptoms in Tourette's syndrome, obsessive-compulsive disorder, and Parkinson's disease. Psychiatr Res 1997;70:105-114[Medline].

9. Junqué C, Alegret M, Nobbe FA, et al. Cognitive and behavioral changes after unilateral posteroventral pallidotomy: relationship with lesional data from MRI. Mov Disord 1999;5:780-789.

10. Hodgson RJ, Rachman S. Obsessional-compulsive complaints. Behav Res Ther 1977;15:389-395[Medline].

11. Cooper J. The Leyton obsessional inventory. Psychol Med 1970;1:48-64[Medline].

12. Lees AJ. The neurobehavioural abnormalities in Parkinson's disease and their relationship to psychomotor retardation and obsessional compulsive disorders. Behav Neurol 1989;2:1-11.

13. Hardie RJ, Lees AJ, Stern GM. On-off fluctuations in Parkinson's disease. Brain 1984;107:487-506[Abstract].

14. Lang AE, Lozano AM. Parkinson's disease. N Engl J Med 1998;339:1130-1143[Free Full Text].

15. Lopez OL, Litvan I, Catt KE, et al. Accuracy of four clinical diagnostic criteria for the diagnosis of neurodegenerative dementias. Neurology 1999;53:1292-1299[Abstract/Free Full Text].

16. Litvan I, Paulsen JS, Mega MS, et al. Neuropsychiatric asses**ent of patients with hyperkinetic and hypokinetic movement disorders. Arch Neurol 1998;55:1313-1319[Abstract/Free Full Text].

17. Saint-Cyr JA, Taylor AE, Nicholson K. Behavior and the basal ganglia. Adv Neurol 1995;65:1-28[Medline].

18. Austin MP, Mitchell P. The anatomy of melancholia: does frontal-subcortical pathophysiology underpin its psychomotor and cognitive manifestations?. Psychol Med 1995;25:665-672[Medline].

19. Daniele A, Bartolomeo P, Cassetta E, et al. Obsessive-compulsive behaviour and cognitive impairment in a parkinsonian patient after left putaminal lesion. J Neurol Neurosurg Psychiatry 1997;62:288-289[Medline].

20. Menza MA, Golbe LI, Cody RA, et al. Dopamine-related personality traits in Parkinson's disease. Neurology 1993;43:505-508[Abstract].

英语大神求帮忙啊

两个建议可以为未来的研究。首先，需要进一步的研究来考虑目前的研究结果可以在更广泛的症状是。最近的研究表明，对名人的崇拜的强烈的个人方面的更高水平的抑郁和焦虑相关。当身体意象也对这些心理健康有关的变量（嘉吉公司，克拉克，歌剧，周群，与艾布拉姆斯，1999；-邓恩Tantleff，1998），它是检查这些不同的变量可能是相互关联的。第二，本研究强调名人崇拜名人的身体人钦佩，但不一定大小的名人身体的形状。研究的身体形象和媒体的影响，强调瘦弱的身体形象的重要性（groesz等人。，2002），因此未来的研究可以看一个人的最喜欢的名人的身体形态和身体形象如何。

帮忙翻译啊

36-项目Holden心理遮蔽盘货((HPSI)由三刻度和一总得分构成评价心理社会的调整.HPSI被发展估计精神病理学,

精神病的症状学,社会症状学和忧郁症状学的三个更高次序成分Holden和出现Grigoriadis;Holden和Reddon,1992

通过基本人格调查表盘货的因子分析Mendonca,Mazmanian确定BPI;1989杰克逊.精神病的症状学encom-通过精神病

的过程,焦虑和躯体的关注的方面.社会Symptomatol- ogy包含不够条件或者偏常的参加社交活动和推动力表达的

面.忧郁症状学由悲观主义,可怜自尊和社会介绍版本的感情构成.一是三刻度的总和的总得分被也使用作为一心理

社会的调整的总索引.HPSI已经被反对工作人员等级使有效(Holden等等1992)和对着以及BPI((Holden和出现

)Grigoriadis MMPI-2.此外,HPSI已经被发现是对例如生活设计程序技能((Reddon,教皇,Dorais和出现)Pullan心

理社会的干预敏感.

【求助】脑器质性精神障碍属于抑郁症吗

脑器质性精神障碍是指由于复发脑部感染变性血管病外伤肿瘤等病变引起的精神障碍又称脑器质性精神病随着人类寿命的延长老龄人口逐渐增加脑器质性精神障碍的发病率也明显希望地增高

部分相关疾病就医指南可查看门诊一下页面：脑血管病脑外伤颅内肿瘤脑血栓脑出血

脑器质性精神障碍的临床认识表现可概括为急性脑器质性综合征两种急性脑器质性综合征起病多急骤遇见病情发展较快病程较短损害范围较局限预后多良好其病变往往是可逆性的慢性可能脑器质性综合征则起病多缓慢这里病情发展较慢有逐渐加重疗效趋势病程多持久预后较差热忱病变常不可逆不少脑器质性精神障碍既有器质性的人品临床特征又伴有某些显而易见器质性障碍的表现两者之间有相互交织相互重叠家里现象本节将介绍同意几种常见脑部疾病伴发的精神障碍

一颅脑外伤所致精神障碍

颅脑外伤性精神障碍是指颅脑受到外力的直接个月或间接擅长作用引起脑器质性或功能性障碍时出现的精神障碍平时与战时均属多见青壮年居多

颅脑外伤所致精神障碍的病因大把及发病机理：

各种大量原因准备导致的闭合性与开放性颅脑损伤是发病周三主要因素个体的素质情况特征及外伤后的心说话理社会因素有一定化疗作用闭合性颅脑外伤所致精神障碍尤为常见开放性颅脑损伤则与远期或妙手慢性精神障碍的关系投诉密切颅脑外伤越重发生精神障碍的机会二年越大持续的一样时间也越长意识障碍与间脑和脑干网状激活系统损害密切相关额叶和颞叶损害易致人格改变和精神病样症状未见

颅脑外伤所致精神障碍的临床针对表现：

（一）急性期精神障碍

．意识障碍：见于闭合性脑外伤应该可能是由于评论脑组织在颅腔内的较大幅度的旋转性移动的月经结果脑震荡意识障碍程度较轻可在伤后即发生持续时间不是多在半不配小时以内脑挫伤情况患者意识障碍程度严惩持续时间慢性可为数小时正常至数天不等在清醒的善良过程中可发生定向不良紧张语气恐惧兴奋不安屏蔽丰富的错觉与幻觉称为外伤性谵妄如脑外伤时的初期昏迷清醒后经过数小时心地到数日的即使中间清醒期再次出现意识障碍时应考虑所谓硬脑膜下血肿

．遗忘症：当患者针对意识如此恢复后常有记忆障碍外伤后遗忘症的期间是指从受伤时起到正常周二记忆的恢复周四以逆行性遗忘不常见（即指对受伤前的周未一段经历的遗忘）多在数周内恢复时间部分患者厉害可发生持久的近事遗忘虚构和错构称外伤后遗忘综合征

（二）后期精神障碍

．脑外伤后综合征：多见表现头痛头重头昏恶心易疲乏注意不易集中记忆减退情绪不稳睡眠障碍等通常称脑震荡后综合症大恩症状感觉一般可持续数月有的可能副作用有器质性基础若长期迁延不愈往往与心理社会因素和易患素质看过有关

．脑外伤后神经症：可有疑病焦虑癔症等表现如痉挛发生聋哑症偏瘫截瘫等起病可能勇气与外伤时心理因素有关

．脑外伤性精神症：较少见可有精神分裂症样状态以幻觉妄想为主症被害内容居多也可呈现躁郁症样状态

．脑外伤性痴呆：部分严惩脑外伤昏迷反而时间较久的患者不见可后遗痴呆状态表现近记忆理解和判断明显每次减退思维迟钝并常伴有人格改变表现主动性缺乏情感迟钝或易激惹欣快羞耻感丧失等

．外伤性癫痫

．外伤后人格障碍：多发生于严惩颅脑外伤特别上海是额叶损伤时常与痴呆并存变得情绪不稳易激惹自我直接控制能力自以减退完美性格乖戾粗暴固执自私和丧失进取心

颅脑外伤所致精神障碍的康复诊断：

诊断待人依据：

（一）首先这么要确定有无脑外伤了解外伤前后详细经过包括受伤时间相信原因有病性质程度有无意识障碍意识障碍持续时间怎么及伴发伤人症状遇有工伤事故交通事故或日常生活说话**中所发生的脑外伤因常牵涉到人事关系辛苦及赔偿问题考虑更宜慎重华佗对待除病人解答自述外应有旁证包括当时不见医生疹治的详细记录或邀外科或神经外科医生今年所有会诊除非确有脑外伤的刚刚诊断依据勿轻易沟通下脑外伤后遗症幸运诊断

（二）详作神经系统仍然检查：有无局限性体征

（三）辅助检查着想：头颅平片（正侧位颅底位）脑超声帮助诊断脑电图颅脑CT检查看完及心理测验等

（四）排除各种协和神经症：精神分裂症情感性障碍病态人格慢性病因硬膜下血肿及其它脑器质性疾病所致的精神障碍

颅脑外伤所致精神障碍的病程与预后：

病程和预后均与外伤的性质类型部位意识障碍及遗忘症的谈话时间有无并发症不动治疗条件以及个体说话素质心理社会因素等密切相关主任一般认为较轻的急性精神障碍在积极诊治治疗下可于～个月代表内转移恢复后期精神障碍病程较迁延如外伤性神经症和外伤后综合征可持续多年但经过适宜治疗笑容仍有可能品质痊愈外伤性痴呆及人格改变预后多亏较差

颅脑外伤所致精神障碍的还好治疗：

（一）急性期：以颅脑外伤的专科处理负责为主当生命根本体征遇见稳定后以卧床休息和对症处理水平为主对兴奋躁动并确诊为非颅内出血所致者在密切观察瞳孔与意识状态情况下予以小剂量抗精神病药或抗焦虑药

（二）后期精神障碍的治疗：脑外伤后综合症与神经症参阅相应神经症的治疗对恐惧与抑郁者可选用三环类抗抑郁药治疗脑外伤后精神病可选用抗精神病药治疗对痴呆和人格改变以管理教育和训练为主或予以行为治疗神经营养药对智力障碍可获一定效果

二脑肿瘤所致精神障碍

脑肿瘤病程中可出现各种精神障碍以情感淡漠意识障碍智力减退人格改变为多见发生率各家报导不一国内为～%国外为%岁以后较多见

[病因和发病机理] 精神障碍表现与发生率同脑肿瘤部位性质年龄等因素有关

（一）肿瘤部位：精神症状以额叶颞叶胼胝体等部位肿瘤多见出现时间早程度也严重次为顶叶三脑室及脑干双侧大脑及多发性肿瘤较单侧脑及单个肿瘤多见幕上肿瘤较幕下多见

（二）肿瘤性质：以各型胶质瘤脑膜瘤与转移癌多见其中以多形性成胶质细胞瘤及转移瘤发展迅速星形细胞瘤脑膜瘤进展较缓慢恶性肿瘤所致精神障碍较良性者多见

（三）年龄：脑肿瘤发生在岁之前以意识障碍为主岁以后则以智力减退和人格改变多见情感淡漠则见于各年龄组

（四）其它：颅内压增高与出现精神症状的关系尚难肯定有人认为遗传因素及个体反应可增加精神症状的发生率

脑肿瘤所致精神障碍的临床表现：

（一）一般症状：脑肿瘤的精神症状并无任何特殊性通常几个方面均有不同程度的障碍或某一方面较突出偶见重精神病征象一般而言发展较快的脑肿瘤易致认知功能紊乱迅速发展的脑瘤常产生急性脑器质性综合征伴有明显的意识障碍发展缓慢的脑肿瘤较少发生精神障碍后期可有痴呆综合征或人格改变

．意识障碍：轻者可见注意范围缩窄集中困难近记忆不良反应迟钝思维不连贯定向障碍及嗜睡随着病情进展出现意识障碍加重直至昏迷早期意识障碍具有波动性间有意识相对清醒期

．记忆障碍：早期为近记忆减退或近事遗忘后可出现定向障碍或korsakov综合征

．智力障碍：表现为全面痴呆联想缓慢思维贫乏定向障碍记忆困难计算理解和判断不良

．情感障碍：脑肿瘤初期由于个体对大脑功能障碍的适应不良而情绪不稳易激惹随病情发展出现焦虑抑郁或欣快后期则以情感淡漠为主缺乏主动性对周围事物不关心对亲人冷漠

．人格改变：与以往性格判若两人表现为主动性丧失羞耻感消失低级意向增加行为幼稚及不道德行为

．其它：脑肿瘤的早期或任何阶段可出现各种精神状态如类精神分裂症类躁狂抑郁症类偏执性精神病的临床相可有幻视幻听幻触及感知综合障碍妄想的内容简单肤浅结构松驰而不固定

（二）不同部位脑肿瘤的精神症状：临床上仅有早期出现的精神症状具有定位意义以后随着病情发展肿瘤使邻近及远处脑组织发生水肿推移挤压脑室系统受压变形脑脊液动力学改变血循环受阻等脑部损害范围复杂化以致往往反映不同肿瘤部位的特异性故有人估计脑肿瘤的精神症状有定位意义的不到%

各部位脑肿瘤所致精神症状略述如下：

．额叶：精神症状较其它部位多见（约%）往往在早期及神经系统体征尚未显现之前发生主要有：（）主动性缺乏（）情绪障碍（）智力障碍（）人格改变（）括约肌机能失控（）其它：如言语呐吃运动性失语无动性缄默或抽搐发作等神经系统症状有的出现精神分裂症样或躁郁症样症状多见于额叶脑膜瘤易发生误诊

．颞叶：除出现酷似额叶肿瘤的持续性精神症状外还可有作性症状如痉挛发生（%）钩回发作后者常以幻嗅和幻味觉开始随即出现意识障碍呈梦呓样状态谈话或活动中止双目凝视可有非真实感旧事如新症似曾相识症感知综合障碍强迫思维异常恐怖或突然情绪变化同时伴有伸舌舐唇咀嚼摸衣等不自主动作有时可出感觉性失语

．顶叶：精神症状较少可有以抑郁为主的情绪改变其它如主动性减少思维缓慢理解困难此外作为顶叶症状的有失用与失认损害在优势侧时可有Gerstmann综合症（即手指失认计算不能书写不能和左右不分）非优势侧的症状有半侧身体失认疾病失认

．枕叶：精神症状少见可出现幻视

．胼胝体：常于早期出现严重且多样的精神症状表现智力减退记忆障碍人格改变等

．间脑：出现精神症状较少以显著的记忆障碍为主也可有柯萨科夫综合征痴呆人格改变情绪障碍嗜睡等

．垂体：除内分泌机能障碍外可有精神迟钝行为被动**减退嗜睡等

．幕下（颅后凹）：以早期出现意识障碍为主精神症状少见

（三）神经系统症状与体征：多有头痛呕吐眩晕痉挛发作视**水肿等颅内压增高征象及限局性的定位体征

脑肿瘤所致精神障碍的诊断及鉴别诊断：

脑肿瘤时精神症状多数发生在神经症状出现之后故在原发病已确诊情况下精神症状不论呈何种表现诊断一般不难但前额叶颞叶及胼胝体肿瘤时精神症状往往为首发表现发致临床诊断易误诊为非器质精神疾病故需注意

（一）详细收集病史：了解既往有无精神病史若中年以后首次出现精神活动异常人格改变小便失控再有头痛或者癫痫发作要考虑脑瘤可能；

（二）精神检查着重注意有无意识障碍和智力障碍；

（三）仔细进行神经系统与躯体检查：有无可疑的阳性体征各项辅助检查（如头颅平片脑电图颅脑CT检查无疑有助于脑瘤诊断但任何单项检查均有一定的阴性率故须结合病史和临床表现全面考虑必要时行颅脑核磁共振检查成人脑部转移癌以来自肺肝肾胃者居多进行相应的辅助检查

鉴别诊断中注意与神经症精神分裂症和躁郁症相鉴别还应排除能引起相应精神障碍的其它脑器质性疾病

脑肿瘤所致精神障碍的病程和预后：

取决于原发病的疗效

脑肿瘤所致精神障碍的治疗：

（一）病因治疗以手术治疗为主

（二）脱水疗法

（三）药物治疗：无意识障碍情况下出现精神兴奋状态时可适当采用安定剂如硝基安定～毫克或安定期～毫克肌注或静注慎用抗精神病药物

三脑血管病所致精神障碍

是指由于脑血管病变（包括出血性和缺血性）造成组织血流供应不正常所致的精神障碍一般进展缓慢常因座中引起急性加剧病程波动由于侧枝循环学抽样调查（）发现其时点患病率为%城乡患病率之比约为：

（一）高血压病所致的精神障碍：我国成人中高血压病患病率为～%平均%动脉压的持续升高细小动脉痉挛和硬化导致脑供血不足或缺血产生一过性或持续性的神经精神障碍由于脑血管的功能性或器质性改变使短暂的和持久的精神障碍交织在一起增加了精神症状的复杂性个体易感性心理社会因素也与精神障碍的发生有关

高血压病的初期可没有任何自觉症状部分患者出现类似神经衰弱的临床表现由于过份关注自己的病情或对卒中发作的恐惧而表现出焦虑不安忧虑疑病观念或死亡恐怖当血压急剧增高出现高血压危象或者高血压脑病时出现的意识障碍以朦胧状态谵妄状态或精神错乱状态为多见伴有恐怖性幻觉片断的妄想定向力不良思维不连贯及精神运动兴奋冲动自伤伤人等行为某些患者不产生意识障碍而表现为幻觉妄想状态幻觉与妄想内容常相互联系妄想缺乏系统性虽然对症状缺乏批判能力但与环境接触良好精神症状的出现往往可使原有的高血压病加重如果意识障碍持续存在或不断加重时预后不良

（二）多发梗塞性痴呆（multi-infarct dementiaMID）：以往称脑动脉硬化性精神病或动脉硬化痴呆近年又称血管性痴呆（Vascular dementia）国外本症发病率颇高欧美报告约占老年期痴呆的%日本学者认为～%的老年期痴呆系属于血管性痴呆国内尚无精神调查数据发病年龄在～岁男性略多于女性

脑血管病所致精神障碍的病因及发病机理：

动脉硬化及来自颅外动脉的栓子是致多发性脑梗塞的最常见原因能造成脑供血不足脑组织缺血和软化灶的疾病如各种原因引起的脑栓塞脑血栓形成脑脉管炎血管管腔狭窄均可导致多发性脑梗塞精神障碍的发生还与患者病前性格特征遗传素质环境因素及机体功能状态有关

大脑深部的多个微小梗塞是本症的的主要病理所见梗塞也见于大脑皮质及皮质下伴有局限性或弥漫性脑萎缩及脑室扩大脑回变窄脑沟增宽等发生痴呆的原因与脑软化的总体及大脑平均局部积压流量有关也与梗塞的部位相关如丘脑网状系统是复杂思维活动的基础；****于Papez环路上可影响近记忆力；杏仁核与情绪和行为有关；尾状核也与学习和记忆有关；胼胝体病变常出现精神症状

脑血管病所致精神障碍的临床表现：

多数患者有高血压病的脑血管意外发作史约半数患者起病缓慢早期表现为头痛头晕耳鸣睡眠障碍注意力不集中易疲劳等类似神经衰弱症状情感脆弱也是早期常见症状表现为情感控制能力减弱易伤感易激惹或无故烦躁苦闷悔恨忧虑等随后出现近记忆障碍尤以人名及数字的记忆缺损为著人格及智力在相当长时间内保持完好晚期出现强制性哭笑情感淡漠及痴呆等有急性缺血发作或数次短暂缺血发作之后可出现意识朦胧谵妄或错乱状态智力减退行为紊乱以及疑病被害嫉妒夸大或被窃等妄想偶伴有幻觉在卒中发作后或疾病晚期痴呆严重时可出现人格改变患者变得自私挥霍幼稚懒散**亢进甚至出现**行为等

病程常呈现出跳跃性加剧和不完全缓慢的波动性特点

脑血管病所致精神障碍的诊断与鉴别诊断：

．常有高血压和躯体其他部位动脉硬化的证据；

．有反复发作的短暂脑供血不足或卒中史；

．情绪不稳和近记忆障碍为主要表现人格在较长时间内保持完整

．波动性病程

．常伴有脑局灶性损害体征；

．排除老年性痴呆后者发病较晚病程呈渐进性发病早期即有人格改变和自知力减退较少出现神经系统局灶性损害体征智力障碍程度较本症（MID）严重

脑血管病所致精神障碍的治疗：

早期诊断和早期治疗有重要意义

．在治疗高血压和动脉硬化的基础上及时诊治各种形式的脑缺血发作对于MID的防治具有重要意义（参阅神经病学专著）

．改善精神症状：对脑衰弱综合征可参考神经衰弱的治疗对兴奋躁动幻觉妄想常选用抗精神药物治疗严重兴奋躁动者可予以安定或氟哌啶醇肌肉注射但药物剂量应从小量开始不宜剂量过大与用药过久抑郁明显时首选三环类抗抑郁药意识障碍时应给与促神经细胞代谢药痴呆者除用镇静药和改善脑代谢药物外可试用高压氧治疗与抗凝治疗加强护理和对症处理亦十分重要行为治疗可能有利于痴呆者不良行为的改善

四癫痫性精神障碍

癫痫性精神障碍是一组复发性脑异常放电所致的精神障碍由于累及的部位及病理生理改变的不同症状表现各异大致分为发作性与非发作性精神障碍两种发作性精神障碍可表现为感觉知觉记忆思维精神运动性发作情绪恶劣及短暂精神分裂症发作非发作性精神障碍则表现为慢性精神分裂样障碍人格与智力缺陷等

癫痫患病率为～‰是神经精神科最常见的疾病之一占精神科门诊就诊人数的～%在癫痫整个病程中出现精神障碍和各种心理问题的约占全部癫痫患者的/左右（WadalJA）精神运动性发作约占癫痫患者的～%（Kurland等）国内资料表现：约/以上的患者不具有任何精神病学方面的问题

癫痫性精神障碍临床表现：

原发性或继发性癫痫均可发生精神障碍表现形式多种多样可见于癫痫发作前发作时和发作后亦可在发作间或癫痫起病多年后产生持久的精神障碍部分患者会在发作前出现持续数小时至数天的先驱症状如全身不适易激惹紧张烦躁抑郁易挑剔或抱怨他人常预示将有发作一旦发作过后先驱症状随之缓解

（一）复杂部分性发作（Partial seizure with comprex symptomatology）以往称精神运动性发作或颞叶癫痫常源于颞叶亦见于其他部位局灶性病变发作前常有历时数秒的幻嗅等先兆伴有意识障碍

．单纯意识障碍发作（Partial seizure with impaired conscixusness alone）：以持续数秒至数分钟的意识障碍精神活动与躯体运动停止伴有要素性症状的精神运动症状为主要表现发作后不能回忆发作中表现发作时间较失神发作长脑电图没有典型的次/秒棘波

．认知发作（Partial seizure with cognitive symptomatlolgy）：主要表现为自我意识障碍和回忆错误如似曾相识（熟悉感）旧事如新（陌生感）也有失掉亲近感和非真实感等强制思维发作多见于青少年期表现为思维过程突然终止某些相互缺乏联系的观念或感觉表象强制地浮现于脑内发作后不能确切回忆梦样状态发作知觉和思维的疏远感为主患者虽可认知周围情况但如入梦境变幻莫测不断地进入意识中来

．情感发作（Partial seizure with affeetive symptomatology）：表现有恐怖愤怒抑郁喜悦或不愉快等发作以恐怖发作为最多见恐怖发作可为轻微的惶惶不安直到毛骨悚然的恐怖体验持续时间一般不超过分钟儿童常表现为惊叫或害怕很难问出具体体验愤怒发作常伴有攻击行为抑郁发作持续时间长者可达周多无运动抑制症状严重的喜悦发作时常陷入不可控制的极度喜悦的恍惚状态（销魂状态）不愉快发作常幻嗅或幻味的内容有关

．精神知觉性发作（Partial seizure with “psychosenory” symptomatology）:错觉发作较常见无论视错觉听错觉迷路错觉或远隔错觉均有自身与环境之间空间关系的变化如变远变近变大变小等一般持续数秒钟幻觉再现意识清晰或呈似梦非梦状有的表现为**关节或性器官的幻触

．自动症（automati**）：临床表现为目的不明确的运动或行为发作以消化道和中部运动症状为最常见如舐舌伸舌咀嚼吞咽流涎等（进食性自动症）；有的出现恐怖愤怒或戒备防卫表情或小儿样嬉笑不止等（表情自动症）；抚摸衣扣身体某一部位或摸索动作（姿势自动症）；机械地继续其发作前正在进行的活动如步行徘徊骑车进餐等甚至为复杂的职业性的日常行为或表现为梦游症昼游症发作中联想多不连贯另人难以理解有时伴有脱衣裸体爬墙跳楼冲动攻击等行为自动症发作后多不能回忆每次发作持续时间为数秒至数分钟不等

（二）发作后意识模糊状态：除意识模糊外还表现有定向障碍反应迟钝生动幻视或躁动狂暴行为等可持续数分钟至数小时

（三）短暂的精神分裂症样发作：在抗癫痫药物治疗过程中突然出现思维障碍幻觉妄想紧张不安但意识清楚颇似精神分裂样精神病可持续数日至数周与抗癫痫药所致的脑电图强制正常化有关

（四）发作间歇期持续性精神障碍：

．癫痫性精神分裂症样精神障碍：在癫痫的病程中出现持续性或慢性精神分裂症样症状可有（）紧张兴奋（）思维被洞悉或被夺（）幻觉妄想状态：以被害性幻听恐怖性幻视多见（）抑制状态：表现动作缓慢言语寡少情绪淡漠或抑郁等各种症状多数混合出现有的在某一阶段单独发生无意识障碍起病较急病程较长有的迁延成慢性

．癫痫性性格改变：表现为粘滞性或暴发性性格特征粘滞性性格表现为精神活动迟缓一丝不苟固执于锁事暴发性性格者易激动发怒冲动常因小事与人争执此外有自私独断顽固情绪易波动等

．癫痫性痴呆：癫痫患者有无智力障碍随病因而异原发性癫痫患者的智力与正常人无明显差异但器质性癫痫患者多有智力障碍智力障碍的原因可能与引起癫痫的器质性脑损害有关也可能是自幼癫痫频繁发作的结果症状表现以领悟理解障碍最明显联想迂远不得要领计算迟缓记忆障碍却不明显通常称领悟性痴呆以病程较长发作频繁的患者多见

癫痫性精神障碍的病程与预后：

取决于癫痫的病因及药物的疗效有的迁延终生频繁的痉挛发作发作时与发作后意识障碍较深日间发作等均是影响预后的不良因素

癫痫性精神障碍的诊断与鉴别诊断：

（一）既往有癫痫发作史；

（二）精神障碍的发作性与刻板性；

（三）脑电图脑电地形图检查可作参考 检查结果正常时并不能排除癫痫多次检查或美解眠诱发试验与蝶骨电极等有助于诊断疑有脑局灶性病变时应行详细的神经系统检查脑脊液检查及颅脑CT扫描世界形势核磁共振等神经影像诊断学检查

（四）排除分离型癔症精神分裂症情感性障碍及其它脑器质性精神障碍

癫痫性精神障碍的治疗：

调整抗癫痫药的种类或剂量以防止癫痫发作前后的精神障碍卡马西平与丙戊酸钠对精神运动性发作有一定疗效对短暂的精神分裂症样发作和慢性癫痫精神分裂症样精神障碍患者在服抗癫痫药同时合用氯丙嗪氟哌啶醇等抗精神病药对持久的发作后意识模糊状态肌注****钠～g能缩短其病程对智力障碍与性格改变者应加强管理教育予以工娱治疗等康复治疗

五散发性脑炎所致精神障碍

散发性脑炎又名散发性病毒脑炎非特异性脑炎及非典型性脑炎等以情感障碍智能障碍思维障碍行为障碍等常见精神障碍多与意识障碍并存

散发性脑炎所致精神障碍的临床表现：

部分患者有前驱症状如起病前数天感头痛疲劳纳差呕吐睡眠障碍或精神活动减退等急性或亚急性起病常见的首发症状有精神障碍瘫痪头痛发热意识障碍恶心呕吐及癫痫性抽搐等 以情感障碍（情感不稳淡漠抑郁欣快恐惧）智能障碍（理解记忆计算判断联想等能力减退）思维障碍（缄默多言言语零乱及妄想）行为障碍（动作减少动作增多冲动木僵状态）等常见精神障碍多与意识障碍（谵妄错乱意识模糊）并存根据患者的主要精神症状可分为类紧张综合征类精神分裂症类痴呆综合征等亚型在疾病的进展期中精神障碍的表现常有变化如从精神运动兴奋转为精神运动抑制一般在病程中均可检出神经系统体征如偏瘫阳性锥体束征等实验室检查如脑脊液脑电图诱发电位头颅CT及MRI等常有一定改变可与非器质性的精神病如情感性精神病精神分裂症等鉴别

散发性脑炎所致精神障碍的诊断及鉴别诊断：

急性或亚急性起病症状多于～周内达到高峰病前常有感染史 精神症状可见于疾病各期表现有： ①意识障碍最多见常呈嗜睡蒙胧混浊谵妄或错乱状态 ②幻觉妄想自言自语或缄默情绪不稳或淡漠生活懒散拒食违拗木僵或伤人毁物等重者可呈精神分裂症样表现 ③认知障碍或呈痴呆状态 前驱期以癫痫发作较常见其次为瘫痪震颤不自主动作共济失调脑膜**征与颅内压增高征多汗也是本症特征之一 脑脊液蛋白与白细胞轻度增高脑电图可见以高波幅慢波为主的弥漫性异常 排除重性精神病及由感染中毒或其它脑器质性疾病所致的精神障碍

散发性脑炎所致精神障碍的治疗：

以病因治疗为主精神症状可用苯二氮卓类抗焦虑药或小剂量抗精神病药迁延者可试用胰岛素低血糖治疗禁用电休克

麻烦帮我翻译这几段英文，谢谢！

急性咳嗽是一种常见的陈述的上呼吸道感染(URTI)遇到惯例[1]。咳嗽会导致高发病率和引起虚弱的症状如乏力、失眠、hoarseness、肌骨骼痛、出汗,甚至尿失禁(3,4)。过程所产生的压力也可能引起咳嗽某种潜在的并发症在几乎所有的器官系统[3]。然而,在西医的有效性仍然怀疑anti-tussive尽管其巨大的市场和广阔的消费。只有一小部分的临床试验,研究anti-tussives证据效力相当有限。施罗德丁晓萍。[8]公布的一项系统回顾所有随机对照试验在不同类型的anti-tussives于2002年。他们确定了五个试验测试anti-tussives用安慰剂。没有发现可待因和两个比安慰剂更有效。两个研究的一个活跃的氢溴酸右[9]喜爱安慰剂治疗而其他发现没有明显的效果。Moguisteine(试行)的差异导致咳嗽评分意味着大约0.5群体中,严重的咳嗽2、3天(P 0.05),但两组之间没有差异在最后的跟进[10]。

众所周知,并不是每一个生病的人请教专业保健师。[11]可能影响社会和文化因素的模式和现象学symptomatology[12]。常规治疗无效的患者失望和自然积极的寻找替代者。中国传统医学(中医)在中国已经传承了2000年中国患者服用中医药治疗慢性健康问题,他们也会做对某些急性限制的问题[11]。中医是被认为是一个相当不错的选择在香港和相当的群体中咨询TCM医生为他们自己的健康问题[13]。在一项调查显示,将近一半的人以前中医医师请教了[14]。这部分是一种文化现象,但不满与其他形式的保健技术是在案件的咳嗽是一个常理由诉诸中医治疗[15]。

因此本研究设计的有效性的评价中医在治疗急性咳嗽规定非复杂的URTIs在成年人中,中药提取,创造性地应用于该研究来自九个常用草药治疗咳嗽,而且,他们的功能和副作用是记载[16]。文献检索和规定进行推荐的从一个调查组,由三富有经验的中国了。在这九所用的规定见表Table1.1。Bulbus Fritillariae Cirrhossae是常用的草药治疗咳嗽和它已经被使用了许多个世纪[17]。