Biological Study of the Mechanism of Refractory Schizophrenia (Treatment-Resistant or Liable to Relapse).

难治性精神分裂症（难治性或易复发）机制的生物学研究。

• 批准号: 06670995
• 负责人: MITSUSHIO Hiroshi
• 金额: $ 1.34万
• 依托单位: Department of Mental Disorder Research, National Institute of Neuroscience National Center of Neurology and Psychiatry
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-06670995/
• 关键词: Schizophrenia,; Treatment-resistant,; Relapse,; Japanese version of Manchester Scale,; Criteria for refractory schizophrenia,; Plasma HVA,; Plasma HMPG,; Agranulocytosis; 血液生化学; ニューロケム; 予後調査; BPRS; 抗精神病薬投与量; 血漿HVA濃度; 血漿MHPG濃度; 血漿prolactin濃度

Results in the investigation of treatment-resistant schizophrenia were as follows. (1) The reliability, internal structure and validity of the Japanese Version of the Manchester Scale (MS) were sufficiently high, and this scale was thought to be valuable. (2) The criteria of refractory schizophrenia were considered as follows ; (i) diagnosis of schizophrenia by ICD-10, (ii) continuous hospitalization for at least the past two years, (iii) Global Assessment Scale was 40 or less, (iv) item scores of marked or severe on at least three of the six MS items (flattened affect, psychomotor retardation, delusions, hallucinations, incoherence of speech, poverty of speech). (3) As the duration of the illness of schizophrenia became longer, incoherence of speech changed from a distinct symptom to a part of negative symptoms, and the symptoms complex of anxious-depressed symptomes and hallucinatory-delusional symptoms separated into independent symptoms. (4) Refractory schizophrenics had both sever … More e negative symptoms and severe positive symptoms, and they were treatment-resistance in spite of large dosage of antipsychotics. (5) Treatment-resistant schizophrenics showed poor improvement in positive symptoms during hospitalizaion, and they had not developed reductions in plasma HVA and MHPG levels. (6) There were high frequency of abnormalities in the hematological and blood chemical exzaminations in schizophrenic inpatients, and several unexopected medications caused these abnormalities. (7) Dryg induced agranulocytosis was not rare in the psychiatric field, the successful treatments of this side effect were the discontinuation of causal medications and the injection with granulocyte colony stimulating factor. (8) The forensic aspects of refractory psychosis were examined through the actual cases in the United Kingdom.Results in the study of the relapse in schizophrenia were as follows. (1) The reduction of antipsychotic medication, not the psycho-social stresses, caused the relapse in schizophrenics during the reduction process. The increase in the score of anxious-depressed symptoms or the level of plasma MHPG resulted in relapse during the reduction process. (2) Several biological items at discharge related to the relapse in schizophrenia during one year follow-up. (3) Depot antipsychotic injection clearly decreased the rate of relapse or rehospitalization in schizophrenics, but did not influence their psycho-social function. Less

对难治性精神分裂症的调查结果如下。(1)日文版曼彻斯特量表(MS)具有较高的信度、内部结构和效度，具有较高的实用价值。(2)以ICD-10诊断为精神分裂症，(Ii)连续住院至少两年，(Iii)总体评定量表<40分，(Iv)6个MS条目中至少有3个条目得分显著或严重(情感平淡、精神运动发育迟缓、妄想、幻觉、言语不连贯、言语贫乏)为难治性精神分裂症。(3)随着精神分裂症病程的延长，言语不连贯由明显症状转变为部分阴性症状，焦虑抑郁症状和幻觉妄想症状的复合体分离为独立的症状。(4)难治性精神分裂症患者均有严重的…阴性症状多，阳性症状重，大剂量抗精神病药物治疗耐药。(5)难治性精神分裂症患者住院期间阳性症状改善较差，血浆HVA和MHPG水平未见下降。(6)住院精神分裂症患者血液学和血生化异常发生率较高，多种非选择性药物引起异常。(7)干燥症引起的粒细胞缺乏症在精神病学领域并不少见，成功的治疗方法是停用因果药物和注射粒细胞集落刺激因子。(8)通过英国的实际案例，对难治性精神病的法医学问题进行了探讨。(1)精神分裂症患者复发的原因是抗精神病药物的减少，而不是心理社会压力的减少。焦虑抑郁症状评分的升高或血浆MHPG水平的升高导致在减少的过程中复发。(2)一年随访中与精神分裂症复发有关的几项出院生物学指标。(3)库抗精神病药物注射剂能明显降低精神分裂症患者的复发或再住院率，但不影响其心理社会功能。较少

项目成果

寺田倫,大沼悌一,堀彰: "てんかん精神病の精神症状評価" 精神医学. 38・3. 295-300 (1996)

寺田凛、大沼正一、堀晃：“癫痫性精神病的精神症状评估”《精神病学》38・3（1996）。

A.Hori: "Predictor of Relapse in Schizophrenia. (in Japanese)" Seishin Igaku Review. 12. 74-80 (1994)

A.Hori：“精神分裂症复发的预测因子。（日语）”Seishin Igaku Review。

SperKG,schwartzer C,Hoflehner J,Tsunashima K,et al.: "The Hippocampus : Function and Clinical Relevance,“Neuropeptides as markers for functional changes in the hippocampus of epileptic rats"" 265-274 (1996)

SperKG、schwartzer C、Hoflehner J、Tsunashima K 等人：“海马：功能和临床相关性，“神经肽作为癫痫大鼠海马功能变化的标记”265-274 (1996)

Arinomi T, LiL, Mitsushio H, Itokawa M, Hamaguchi H, Toru M: "An insertion/depletion polymorphtsin in the angiotensin converting enzyme gehe is associoted with both broin substance P contents and affective disorders" Biological Psychiatry. (in press).

Arinomi T、LiL、Mitsushio H、Itokawa M、Hamaguchi H、Toru M：“血管紧张素转换酶 gehe 中的插入/耗尽多态蛋白与布洛因 P 物质含量和情感障碍有关”生物精神病学。

寺田倫,堀彰,綱島浩一,他: "難治性精神分裂病の精神症状・行動評価と薬物療法の特徴" 精神医学. 36. 1245-1250 (1994)

Michin Terada、Akira Hori、Koichi Tsunashima 等人：“顽固性精神分裂症的精神症状/行为评估和药物治疗的特征”精神病学。36。1245-1250 (1994)