mental and behavioral disorders

精神和行为障碍
  • 文章类型: English Abstract
    根据官方数据,全世界近10亿人患有精神疾病,包括10-19岁的青少年在内,约占该年龄组全球疾病负担的13%.儿童和青少年心理健康问题的现状,它是在环境因素的影响下形成的,对个人来说至关重要,一个人在随后的生活阶段的社会和社会经济发展,被考虑。监测俄罗斯联邦儿童人口心理健康的结果,在0-14岁和15-17岁时分化,包括在COVID-19大流行的影响下,这是改善预防精神障碍和特遣队行为障碍的综合措施的基础。分析使用的术语。这项研究的目的是分析近年来儿童和青少年心理健康统计指标的状态和动态的主要趋势,重点是理解基本概念工具,从公共卫生和医疗保健领域的专家的角度来看,问题的理论方面。
    According to official figures, almost 1 billion people suffer from mental disorders worldwide, including adolescents 10-19 years old account for about 13% of the global burden of disease in this age group. The current state of the problem of mental health of children and adolescents, which is formed under the influence of environmental factors and is critical for the personal, social and socio-economic development of a person in subsequent stages of life, is considered. The results of monitoring the mental health of the children\'s population of the Russian Federation, differentiated at the age of 0-14 and 15-17 years, including under the influence of the COVID-19 pandemic, which were the basis for improving the complex of measures for the prevention of mental disorders and disorders of the contingent\'s behavior. The terminology used is analyzed. The purpose of the study is to analyze the leading trends in recent years of the state and dynamics of statistical indicators of mental health of children and adolescents with an emphasis on understanding the basic conceptual apparatus, theoretical aspects of the problem from the standpoint of specialists in the field of public health and healthcare.
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  • 文章类型: Journal Article
    背景:本研究旨在探讨和评估2015-2019年暴露组(重灾区)和对照组(一般灾区)地震幸存者精神和行为障碍患病率的发展趋势和差异变化,并探讨潜在影响因素。
    方法:数据来自四川省卫生信息系统和四川省卫生年鉴,计算暴露组和对照组的患病率,使用患病率比评估两组之间的差异,并建立了固定效应模型来研究患病率的潜在影响因素。
    结果:暴露组的性别和年龄患病率始终大于对照组(RR>1),尽管两者之间的差距随着时间的推移而逐渐缩小。城市化率(β=0.0448,P<0.05)和受灾地区水平(β=0.0104,P<0.05)是精神行为障碍患病率的危险因素。
    结论:该研究仅收集了汶川地震后的群体数据。因此,调查结果仅适用于团体层面。此外,没有提供各类精神和行为障碍疾病的诊断标准.
    结论:地震对心理健康具有重大的长期影响。有必要持续监测汶川地震幸存者的心理健康状况,并采取相应的灾后干预措施。
    BACKGROUND: This study aimed to explore and evaluate the development trends and differential changes in the prevalence of mental and behavioral disorders among the earthquake survivors in exposure groups (highly hard-hit areas) and control groups (general disaster areas) from 2015 to 2019, as well as to investigate the potential influencing factors.
    METHODS: Data was obtained from the Sichuan Health Information System and the Sichuan Health Yearbook, the prevalence of the exposure group and the control group were calculated, the difference between the two groups was evaluated using the prevalence rate ratio, and a fixed effect model was developed to investigate the potential influencing factors of the prevalence.
    RESULTS: The prevalence by gender and age in the exposure group was always greater than those in the control group (RR>1), although the disparity between the two proceeded to diminish with time. The urbanization rate (β = 0.0448, P < 0.05) and disaster area levels (β = 0.0104, P < 0.05) were risk factors for the prevalence of mental and behavioral disorders.
    CONCLUSIONS: The study only collected data at the group level following the Wenchuan earthquake. Consequently, the findings are only applicable at the group level. Furthermore, diagnostic criteria for various types of mental and behavioral disorders diseases were not provided.
    CONCLUSIONS: The earthquake has a significant long-term impact on mental health. It is necessary to continuously monitor the mental health of Wenchuan earthquake survivors and take appropriate post-disaster intervention measures.
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  • 文章类型: Journal Article
    温度相关指标与精神和行为障碍(MBD)之间的精确关联尚未完全阐明。我们的研究旨在确定最有效的温度相关指标,并评估其对深圳MBD导致的紧急救护车派遣(EAD)的直接影响。中国。
    收集了2013年1月1日至2020年12月31日深圳的EAD数据和气象数据。分布式滞后非线性模型(DLNMs)用于检查温度相关指标对MBD引起的EAD的非线性和滞后影响。在标准化与温度相关的指标后,使用准Akaike信息标准(QAIC)来确定最佳指标。在调整模型中的混杂因素后,我们估计了温度对MBD的直接和累积影响。
    对MBD对EAD的短期温度影响的分析表明,Humidex是最合适的指标。参考最优Humidex(3.2百分位数,12.00°C),我们观察到Humidex对阈值有显著影响(第34.6百分位数,26.80°C)在滞后0-5的MBD引起的EAD上。高温的累积相对风险(第90百分位数,41.90°C)和极端高温(第99百分位数,44.20°C)在滞后0-5时为1.318(95%CI:1.159-1.499)和1.338(95%CI:1.153-1.553),分别。由于MBD,对EAD没有观察到明显的冷效应。
    由于亚热带地区的MBD,高Humidex与更多的EAD相关。卫生当局应采取有效措施,提高公众对高温相关风险的认识,保护弱势群体。
    UNASSIGNED: The precise associations between temperature-related indices and mental and behavioral disorders (MBDs) have yet to be fully elucidated. Our study aims to ascertain the most effective temperature-related index and assess its immediate impact on emergency ambulance dispatches (EADs) due to MBDs in Shenzhen, China.
    UNASSIGNED: EADs data and meteorological data from January 1, 2013, to December 31, 2020, in Shenzhen were collected. Distributed lag non-linear models (DLNMs) were utilized to examine the non-linear and lagged effects of temperature-related indices on EADs due to MBDs. The Quasi Akaike Information criterion (QAIC) was used to determine the optimal index after standardizing temperature-related indices. After adjusting for confounding factors in the model, we estimated the immediate and cumulative effects of temperature on EADs due to MBDs.
    UNASSIGNED: The analysis of short-term temperature effects on EADs due to MBDs revealed Humidex as the most suitable index. Referring to the optimal Humidex (3.2th percentile, 12.00°C), we observed a significant effect of Humidex over the threshold (34.6th percentile, 26.80°C) on EADs due to MBDs at lag 0-5. The cumulative relative risks for high temperature (90th percentile, 41.90°C) and extreme high temperature (99th percentile, 44.20°C) at lag 0-5 were 1.318 (95% CI: 1.159-1.499) and 1.338 (95% CI: 1.153-1.553), respectively. No significant cold effect was observed on EADs due to MBDs.
    UNASSIGNED: High Humidex was associated with more EADs due to MBDs in subtropical regions. Health authorities should implement effective measures to raise public awareness of risks related to high temperature and protect vulnerable populations.
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  • 文章类型: Journal Article
    相关研究发现,空气污染是影响精神和行为障碍的重要因素。因此,我们进行了这项时间序列研究,目的是评估中国东北地区精神和行为障碍患者短期暴露于环境空气污染物与就诊之间的关系.
    我们使用准泊松回归模型和广义加性模型来探索空气污染与精神和行为障碍之间的联系。还按季节分层探索了可能的影响,年龄和性别。
    我们发现二氧化硫(SO2)对lag04-lag07的精神和行为障碍有累积作用,对lag07的影响最大[相对风险(RR)=1.068,95CI=1.021-1.117]。大小为2.5μm的颗粒物(PM2.5)和SO2对抑郁症有累积作用,并且在lag07时都有最大的影响(RR=1.021,95CI=1.002-1.041;RR=1.103,95CI=1.032-1.178);SO2对焦虑症也有累积作用,在lag06时影响最大(RR=1.058,95CI=1.009-1.110)。在分层分析中,与温暖季节相比,人们在寒冷季节更容易受到影响,女性和18-60岁年龄组对空气污染物更敏感。建议加强管理和预防措施,减少空气污染暴露。
    这项研究发现空气污染物浓度增加与精神和行为障碍门诊量增加之间存在关联。我们建议应加强预防和保护措施,以减少接触空气污染,以保持身心健康。
    UNASSIGNED: Related studies have found that air pollution is an important factor affecting mental and behavioral disorders. Thus, we performed this time-series study to evaluate the relationship between short-term exposure to ambient air pollutants and visits to hospital by patients with mental and behavioral disorders in northeastern China.
    UNASSIGNED: We used quasi-Poisson regression models and generalized additive models to probe the links between air pollution and mental and behavioral disorders. The possible influences were also explored stratified by season, age and gender.
    UNASSIGNED: We found that sulfur dioxide (SO2) had a cumulative effect on mental and behavioral disorders at lag04-lag07 and had the greatest effect at lag07 [Relative risk (RR) = 1.068, 95%CI = 1.021-1.117]. Particulate matter of size 2.5 μm (PM2.5) and SO2 had a cumulative effect on depression and both had the largest effect at lag07 (RR = 1.021, 95%CI = 1.002-1.041; RR = 1.103, 95%CI = 1.032-1.178); SO2 also had a cumulative effect on anxiety disorders, with the largest effect at lag06 (RR = 1.058, 95%CI = 1.009-1.110). In the stratified analysis, people are more susceptible in the cold season compared to the warm season and females and the 18-60-year age group are more sensitive to air pollutants. It is suggested to strengthen management and preventive measures to decrease air pollution exposure.
    UNASSIGNED: This study found an association between increased concentrations of air pollutants and increased outpatient visits for mental and behavioral disorders. We recommend that preventive and protective measures should be strengthened in an effort to reduce exposure to air pollution in order to maintain physical and mental health.
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  • 文章类型: Journal Article
    背景物质使用障碍对社会影响的持续挑战促使人们需要深入了解其死亡率趋势。这项研究调查了1999年至2020年与精神活性物质相关的精神和行为障碍患者的流行病学模式和与死亡率相关的因素。方法本研究采用回顾性观察设计。该研究分析了疾病控制和预防中心(CDC)的广泛的流行病学研究在线数据(WONDER)数据库信息,包括死亡率和基于人口的数据。数据提取侧重于特定标准,如年龄、性别,种族/民族,和地理位置。采用描述性统计数据来描述研究人群并揭示流行病学趋势。结果该研究涵盖了1999年至2020年间因使用精神活性物质相关的精神和行为障碍而死亡的239,573人的数据。在整个研究期间,总死亡率为3.55/100,000个体(95%置信区间(CI)=3.55-3.54)。不同地理区域的死亡率出现明显差异,性别,种族,和年龄组。男性(每100,000人中有5.32人)的死亡率明显高于女性(每100,000人中有1.80人),而与25-34岁年龄组(每100,000人中有1.71人)相比,55-64岁年龄组面临较高的死亡风险(每100,000人中有8.24人).不同种族和族裔群体的死亡率也存在显著差异。结论在1999年至2020年之间,该研究探讨了与精神活性物质使用相关的精神和行为障碍患者的死亡率。这项分析揭示了不同性别的死亡率差异,年龄(与25-34岁年龄组相比,55-64岁年龄组面临更高的风险),和种族。值得注意的是,男性的死亡率高于女性。此外,在不同地理区域之间观察到不同的比率。这些见解可以为公共卫生举措提供信息,并支持制定有针对性的战略,以降低死亡率并改善受影响个人的福祉。
    Background The persisting challenge of substance use disorder\'s impact on society prompts the need for insights into its mortality trends. This study examines epidemiological patterns and factors tied to mortality rates in individuals with psychoactive substance-related mental and behavioral disorders from 1999 to 2020. Methodology This study used a retrospective observational design. The study analyzed the Centers for Disease Control and Prevention\'s (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database information, encompassing mortality and population-based data. Data extraction focused on specific criteria such as age, sex, race/ethnicity, and geographic location. Descriptive statistics were employed to depict the study population and reveal epidemiological trends. Results The study encompassed data from 239,573 individuals who died due to psychoactive substance use-related mental and behavioral disorders between 1999 and 2020. The overall mortality rate was 3.55 per 100,000 individuals (95% confidence interval (CI) = 3.55-3.54) across the study period. Noticeable discrepancies in mortality rates emerged among various geographic regions, genders, races, and age groups. Males (5.32 per 100,000 individuals) experienced notably higher mortality rates than females (1.80 per 100,000 individuals), while the 55-64 age group faced elevated mortality risks (8.24 per 100,000 individuals) compared to the 25-34 age group (1.71 per 100,000 individuals). Significant variations in mortality rates were also evident across different racial and ethnic groups. Conclusions Between 1999 and 2020, the study explored mortality rates in individuals with psychoactive substance use-related mental and behavioral disorders. This analysis revealed variations in mortality across genders, ages (with the 55-64 age group facing higher risks compared to the 25-34 age group), and ethnicities. Notably, males exhibited higher mortality than females. Additionally, divergent rates were observed among different geographic regions. These insights can inform public health initiatives and support the development of targeted strategies to reduce mortality rates and improve the well-being of affected individuals.
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  • 文章类型: Journal Article
    精神障碍患者心血管事件的风险增加。我们的目的是评估过去二十年来美国精神和行为合并症患者的心血管死亡率趋势。
    我们进行了回顾性研究,使用疾病控制和预防中心广泛的流行病学研究在线数据(CDCWONDER)多死因数据集的观察性研究。我们确定了有和没有精神和行为障碍的患者中归因于心血管疾病的年龄标准化死亡率的国家趋势,从1999年到2020年,按精神和行为障碍亚型[ICD10代码F]分层,年龄,性别,种族,和居住地。
    在美国超过1870万例心血管死亡中,13.5%[253万]患者伴有精神和行为障碍。在学习期间,在精神和行为障碍患者中,无精神障碍患者的年龄校正死亡率增加了113.9%,下降了44.8%(均P<0.05).在精神和行为障碍患者中,在精神和行为障碍继发于药物滥用的患者中,年龄调整后的死亡率增加更显著(+532.6%,p<0.05)高于器质性精神障碍患者,如痴呆或谵妄(+6.2%,P-不显著)。男性患者(163.6%)和更多农村地区的居民(128-162%)经历了年龄调整后的心血管死亡率的显着增加。
    尽管在过去的二十年中,美国的心血管死亡率总体上有所下降,我们证实,精神障碍患者的心血管死亡率总体上升.
    UNASSIGNED: Patients with mental disorders are at increased risk of cardiovascular events. We aimed to assess the cardiovascular mortality trends over the last two decades among patients with mental and behavioral co-morbidities in the US.
    UNASSIGNED: We performed a retrospective, observational study using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death dataset. We determined national trends in age-standardized mortality rates attributed to cardiovascular diseases in patients with and without mental and behavioral disorders, from 1999 to 2020, stratified by mental and behavioral disorders subtype [ICD10 codes F], age, gender, race, and place of residence.
    UNASSIGNED: Among more than 18.7 million cardiovascular deaths in the United States (US), 13.5% [2.53 million] were patients with a concomitant mental and behavioral disorder. During the study period, among patients with mental and behavioral disorders, the age-adjusted mortality rate increased by 113.9% Vs a 44.8% decline in patients with no mental disorder (both p<0.05). In patients with mental and behavioral disorders, the age-adjusted mortality rate increased more significantly among patients whose mental and behavioral disorder was secondary to substance abuse (+532.6%, p<0.05) than among those with organic mental disorders, such as dementia or delirium (+6.2%, P- nonsignificant). Male patients (+163.6%) and residents of more rural areas (+128-162%) experienced a more prominent increase in age-adjusted cardiovascular mortality.
    UNASSIGNED: While there was an overall reduction in cardiovascular mortality in the US in the past two decades, we demonstrated an overall increase in cardiovascular mortality among patients with mental disorders.
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  • 文章类型: Journal Article
    越来越多的证据表明,夏季的极端环境条件对精神和行为障碍(MBD)产生不利影响。但是对青年人口的研究有限。这项研究的目的是应用机器学习方法来识别关键变量,这些变量可以预测北卡罗来纳州某些城市青少年人群中与MBD相关的急诊室(ER)就诊。每天与MBD相关的急诊就诊,总计超过42,000条记录,与日常环境条件配对,以及社会人口统计学变量,以确定某些情况是否会导致更容易加剧的心理健康障碍。四种机器学习模型(即,广义线性模型,广义加法模型,极端梯度增强,随机森林)用于评估多个环境和社会人口统计学变量对所有城市MBD相关ER访视的预测性能。然后,将性能最佳的机器学习模型应用于六个城市中的每个城市。作为一个子分析,使用分布滞后非线性模型来确认结果。在所有城市的场景中,社会人口统计学变量对整体MBD预测的贡献最大。在各个城市的场景中,四个城市的最高气温相差24小时,其中两个城市的最低气温相差24小时,最高温度,或归一化植被指数作为MBDER访问的主要预测指标。结果可以告知使用机器学习模型来预测高温事件期间的MBD,并确定在这些事件期间影响青年MBD反应的变量。
    Growing evidence indicates that extreme environmental conditions in summer months have an adverse impact on mental and behavioral disorders (MBD), but there is limited research looking at youth populations. The objective of this study was to apply machine learning approaches to identify key variables that predict MBD-related emergency room (ER) visits in youths in select North Carolina cities among adolescent populations. Daily MBD-related ER visits, which totaled over 42,000 records, were paired with daily environmental conditions, as well as sociodemographic variables to determine if certain conditions lead to higher vulnerability to exacerbated mental health disorders. Four machine learning models (i.e., generalized linear model, generalized additive model, extreme gradient boosting, random forest) were used to assess the predictive performance of multiple environmental and sociodemographic variables on MBD-related ER visits for all cities. The best-performing machine learning model was then applied to each of the six individual cities. As a subanalysis, a distributed lag nonlinear model was used to confirm results. In the all cities scenario, sociodemographic variables contributed the greatest to the overall MBD prediction. In the individual cities scenario, four cities had a 24-hr difference in the maximum temperature, and two of the cities had a 24-hr difference in the minimum temperature, maximum temperature, or Normalized Difference Vegetation Index as a leading predictor of MBD ER visits. Results can inform the use of machine learning models for predicting MBD during high-temperature events and identify variables that affect youth MBD responses during these events.
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  • 文章类型: Journal Article
    世界范围内精神疾病的高发病率是社会的巨大经济负担。体温与精神和行为障碍(MD)的发生似乎有关系,但这还没有得到广泛的研究。因此,本研究旨在探讨温度对中国北方温带季风气候地区MDs患者住院率的影响。
    河北医科大学精神卫生中心住院的MD患者,中国,2014年1月至2019年12月纳入研究.使用准Poisson广义加性模型结合分布滞后非线性模型分析了温度与住院MD患者数量之间的延迟暴露-反应关系。
    以15.3℃(最低住院温度)为基准,低温(-2°C,第10百分位数)增加了患有MD的患者的住院率,虽然累积效应降低了某些MD亚型的住院风险;这是一种急性保护作用。高温的单次和累积滞后效应在统计学上增加了MDs患者的住院率。每种亚型的最佳温度不同,男性和年轻年龄组更容易受到高温的影响。
    低温对患有MD的患者的住院具有急性保护作用。相比之下,高温会增加住院率。男性和年轻人受温度的影响更大,为相应体温变化的患者提供早期预警和健康干预措施。
    UNASSIGNED: The high incidence of mental illness worldwide is a substantial economic burden on society. Temperature and the occurrence of mental and behavioral disorders (MDs) seem to have a relationship, but this has not been widely researched. Therefore, this study aimed to investigate the effect of temperature on the hospitalization rate of patients with MDs in a temperate monsoon climate region of northern China.
    UNASSIGNED: Patients with MDs hospitalized in the Mental Health Center of Hebei Medical University and Psychology Department in The third Hospital of Shijiazhuang, China, from January 2014 to December 2019 were included in the study. The delayed exposure - response relationship between temperature and the number of hospitalized MDs patients was analyzed using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.
    UNASSIGNED: With the reference of 15.3°C (temperature with the minimum hospitalizations), the single lag effect of low temperature (-2°C, 10th percentile) increased the hospitalization of patients with MDs, while the cumulative effect decreased the risk of hospitalization for some MD subtypes; it was an acute protective effect. The single and cumulative lag effect of high temperature statistically increased the hospitalization rates of patients with MDs. The optimum temperature for each subtype was different, and the males and the younger age group were more susceptible to high temperatures.
    UNASSIGNED: Low temperature has an acute protective effect on the hospitalization of patients with MDs. In comparison, high temperature increases hospitalization rates. Men and younger people are more affected by temperature, which provides early warning and health intervention measures for patients with corresponding temperature changes.
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  • 文章类型: Journal Article
    缺乏具有全国代表性的研究,以检查儿童自闭症谱系障碍(ASD)和注意力缺陷/多动障碍(ADHD)的共同发生。这项研究检查了精神疾病,行为,同时发生ASD和ADHD儿童的发育障碍(MBDDs)和相关治疗方式。横断面分析使用2016-2018年全国儿童健康调查汇总数据(样本n=102,341)进行。对社会人口统计学变量估计了具有全国代表性的患病率,合并症,精神药物,和行为治疗。我们评估了同时发生的ASD+ADHD和MBDD之间的多变量关联,使用精神药物,并在调整社会人口统计学混杂因素后接受行为治疗。与没有合并ADHD的ASD儿童相比,ASD+ADHD儿童大多数MBDD的患病率较高,包括焦虑(AOR4.03[95%CI2.77,4.87]),抑郁症(AOR3.08[95%CI1.77,5.36]),行为或行为问题(AOR4.06[95%CI2.72,6.06]),以及其他心理健康状况。同样,与没有ASD的多动症儿童相比,患有ASD+ADHD的儿童有更高的焦虑几率(AOR3.49[95%CI2.65,4.61]),抑郁症(AOR1.67[95%CI1.21,2.29]),行为或行为问题(AOR2.31[95%CI1.68,3.17]),以及其他心理健康状况。与没有ADHD的ASD儿童相比,患有ASDADHD的儿童服用精神药物的可能性更高。在患有ASD+ADHD的儿童中,男性接受行为治疗的几率更高,而年龄较大的儿童和青少年更可能服用精神药物。必须采取多学科方法来支持这些儿童的复杂需求。
    There is a lack of nationally representative studies examining the co-occurrence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children. This study examines comorbid mental, behavioral, and developmental disorders (MBDDs) and associated treatment modalities for children with co-occurring ASD and ADHD. Cross-sectional analyses were conducted using data from the pooled 2016-2018 National Survey of Children\'s Health (sample n = 102,341). Nationally representative prevalences were estimated for sociodemographic variables, comorbidities, psychotropic medication, and behavioral treatment. We assessed multivariable associations between co-occurring ASD + ADHD and MBDDs, use of psychotropic medication, and receipt of behavioral treatment after adjustment for sociodemographic confounders. Compared to children with ASD without co-occurring ADHD, children with ASD + ADHD had higher prevalence of most MBDDs, including anxiety (AOR 4.03 [95% CI 2.77, 4.87]), depression (AOR 3.08 [95% CI 1.77, 5.36]), behavior or conduct problems (AOR 4.06 [95% CI 2.72, 6.06]), and other mental health conditions. Similarly, compared to children with ADHD without ASD, children with ASD + ADHD had higher odds of anxiety (AOR 3.49 [95% CI 2.65, 4.61]), depression (AOR 1.67 [95% CI 1.21, 2.29]), behavior or conduct problems (AOR 2.31 [95% CI 1.68, 3.17]), and other mental health conditions. Children with ASD + ADHD were significantly more likely to take psychotropic medication than children with ASD without ADHD. Among children with ASD + ADHD, males had higher odds of receiving behavioral treatment, whereas older children and adolescents were more likely to take psychotropic medication. A multidisciplinary approach is necessary to support the complex needs of these children.
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  • 文章类型: Case Reports
    神经核包涵体病(NIID)是一种罕见的慢性进行性神经退行性疾病。我们提出了一个68岁的男性阵发性定向障碍1年前,精神和行为障碍2天,并通过皮肤活检证实NIID的诊断。我们建议临床症状不典型的患者在DWI上的皮髓质交界处表现出特征性的高信号;应考虑NIID。
    Neuronal nuclear inclusion disease (NIID) is a rare and chronic progressive neurological degenerative disease. We presented a 68-year-old man with paroxysmal orientation disorder 1 year prior, mental and behavioral disorders for 2 days, and confirmed the diagnosis of NIID with skin biopsy. We suggest that patients with atypical clinical symptoms showed characteristic high signal in the dermatomedullary junction on DWI; NIID should be considered.
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