整体护理在初产妇产后抑郁中的效果分析

目的观察整体干预护理对初产妇产后抑郁的影响,以期寻找合适的护理干预方法减少产后抑郁的发生。方法纳入我院妇产科住院分娩的初产妇120例,随机分为观察组和对照组各60例,对照组给予常规护理,观察组给予整体护理,应用焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)对产妇进行心境评分,同时观察不同产褥时间抑郁发生率。结果经过整体护理干预措施后,观察组产妇SAS、SDS量表评分明显低于对照组(P<0.05);产褥期内观察组产妇抑郁发生率明显低于对照组,2组比较差异有统计学意义(P<0.05)。结论对初产妇进行整体护理可以改善产妇心理状况,减少产后抑郁的发生,提高母婴安全。     

心理护理在自然分娩产妇中的效果及对妊娠结局的影响

目的探讨心理护理在自然分娩产妇中的效果及对妊娠结局的影响。方法选取2015年6月~2016年6月我院收治的自然分娩产妇96例,平均分成两组,对照组予以常规护理,研究组在常规护理基础上提供心理护理,对比两组产妇的护理效果以及妊娠结局。结果两组产妇护理干预之前汉密尔顿抑郁量表(HAMD)评分以及汉密尔顿焦虑量表(HAMA)评分无明显区别,护理之后研究组产妇的HAMD评分以及HAMA评分明显低于对照组(P0.05);两组产妇护理干预之前焦虑自评量表(SAS)评分以及抑郁自评量表(SDS)评分无明显区别,护理之后研究组产妇的SAS评分和SDS评分明显低于对照组(P0.05);研究组产妇妊娠结局明显好于对照组(P0.05)。结论心理护理有利于降低自然分娩产妇的焦虑以及抑郁水平,改善妊娠结局。     

心理行为护理干预对剖宫产初产妇产后焦虑、抑郁及疼痛状态的影响

目的探讨心理行为护理干预对于剖宫产初产妇产后焦虑、抑郁及疼痛状态的影响。方法将102例择期剖宫产初产妇随机分为观察组与对照组各51例。对照组给予常规护理,观察组给予常规护理联合心理行为护理干预。干预前后评价两组Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,比较术后72h疼痛程度及术后并发症发生率。结果护理后两组的SAS、SDS评分均较护理前显著降低,且观察组显著低于对照组(P0.05);术后72h,观察组的疼痛程度显著轻于对照组(P0.05);观察组术后并发症发生率为5.88%,显著低于对照组的19.61%(P0.05)。结论心理行为干预能够有效缓解初产妇剖宫产术后焦虑、抑郁情绪,减轻术后疼痛程度并降低并发症发生率。     

综合干预对精神分裂症患者亲属抑郁与焦虑情绪的影响

目的:探讨综合干预对精神分裂症患者亲属抑郁、焦虑情绪的影响。方法:对114位精神分裂症患者家属进行综合干预6个月;干预前、干预3及6个月后分别采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对入组者的抑郁、焦虑情绪进行评估,分析影响其抑郁、焦虑情绪的因素。结果:干预前患者亲属SDS和SAS评分明显高于国内常模(t=12.10,t=10.81;P均0.001);女性亲属SDS和SAS评分明显高于男性亲属(t=3.35,P=0.001;t=2.32,P=0.022);无固定职业的患者亲属SDS和SAS评分明显高于有固定职业的患者亲属(t=2.00,P=0.048;t=2.06,P=0.042);不同教育程度的患者亲属的SDS和SAS评分比较差异有统计学意义(F=3.18,P=0.046;F=3.24,P,0.043);但不同亲属关系的患者亲属间SDS和SAS评分比较差异无统计学意义。干预3个月后及6个月后,患者亲属的SDS和SAS评分较基线有明显下降(P均0.05),但与国内常模相比,差异仍有统计学意义(P均0.05)。结论:精神分裂症患者家属有明显的抑郁、焦虑情绪,并与其性别、受教育程度和职业状况有关。综合干预能有效改善精神分裂症患者家属的焦虑、抑郁情绪。     

术前心理护理干预对剖宫产手术患者负性情绪、自我效能及满意度的影响

目的探讨术前心理干预对剖宫产手术患者负性情绪、自我效能及满意度的影响。方法选取2015年6月至2016年6月本院收治的220例剖宫产患者,根据随机数字表法将患者分为干预组(n=110)及对照组(n=110),对照组应用围手术期常规性护理,干预组在对照组基础上应用术前心理干预,比较两组患者干预前后负性情绪、自我效能、产后出血、产后抑郁及患者满意度情况。结果干预组干预后焦虑自评量表(Self-rating Anxiety Scale,SAS)、抑郁自评量表(Selfrating Depressive Scale,SDS)均低于对照组(P0.05)。干预组干预后自我效能感评分显著高于对照组(P0.05)。干预组患者术后出血率、产后抑郁发生率显著低于对照组(P0.05),而满意率显著高于对照组(P0.05)。结论术前心理干预能有效提高剖宫产手术患者自我效能,改善产妇焦虑、抑郁情绪,降低产妇产后出血及产后抑郁的发生率,提高产妇满意度。     

综合护理干预用于颅脑肿瘤术后伴发焦虑抑郁情绪的临床效果观察

目的研究和观察综合护理干预用于颅脑肿瘤术后伴发焦虑抑郁情绪的临床效果。方法选取本院2012年1月至2015年2月100例颅脑肿瘤术后伴发焦虑抑郁情绪患者为研究对象,以抽签法随机分为观察组与对照组,对照组患者在术后采取常规护理,观察组在常规护理基础上增加综合护理干预措施。干预前后,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者焦虑、抑郁情况,并采用视觉模拟评分(VAS)评价患者的疼痛情况。结果观察组干预后的SAS评分和SDS评分分别为(41.2±4.5)和(36.8±3.6),均显着低于干预前的SAS评分(52.8±5.2)以及SDS评分(43.6±4.2)(P0.05),并且显著低于对照组干预后的SAS评分和SDS评分(P0.05)。干预后,观察患者组及对照组患者VAS评分均较干预前明显降低(P0.05),且观察组患者干预后的VAS评分明显低于对照组干预后的VAS评分(P0.05)。结论对颅脑肿瘤术后伴发焦虑抑郁情绪患者采取综合护理可显着改善其焦虑抑郁情绪,并减轻其疼痛感觉,可能值得推广。     

心理干预对骨结核患者焦虑抑郁情绪、护理满意度及生活质量的影响

目的探讨心理干预对骨结核患者焦虑抑郁情绪、护理满意度及生活质量的影响。方法选取我院2014年5月至2016年5月收治的骨结核患者80例,依据随机数字表法将其分为心理干预组(n=40)和常规护理组(n=40),对两组患者的焦虑抑郁情绪、护理满意度及生活质量进行评价分析。结果心理干预组患者的焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分均显著低于常规护理组(P0.05),护理满意度95.0%(38/40)显著高于常规护理组77.5%(31/40)(P0.05),生活质量高所占比例80.0%(32/40)显著高于常规护理组60.0%(24/40)(P0.05),生活质量低所占比例5.0%(2/40)显著低于常规护理组30.0%(12/40)(P0.05)。结论心理干预能够有效缓解骨结核患者的焦虑抑郁情绪,提高患者的护理满意度及生活质量,值得临床推广。     

系统性心理护理对骨折患者焦虑抑郁情绪及护理满意度的影响

目的探讨系统性心理护理对骨折患者焦虑抑郁情绪及护理满意度的影响。方法选取我院2015年4月～2017年4月收治的80例骨折患者,随机分为常规基础护理组(n=40)和常规基础护理联合系统性心理护理组(系统性心理护理组,n=40)两组。对两组患者的焦虑抑郁情绪、疼痛程度及护理满意度进行统计分析。结果护理治疗后,系统性心理护理组患者的焦虑自评量表(SAS)、抑郁自评量表(SDS)均显著低于常规基础护理组(P0.05),视觉模拟评分(VAS)评分显著低于常规基础护理组(P0.05),护理满意度评分显著高于常规基础护理组(P0.05)。结论系统性心理护理能够有效缓解骨折患者的焦虑抑郁情绪及疼痛,提升患者的护理满意度,值得在临床推广。     

正念练习对产妇负性情绪的效果

目的 探讨正念练习对产妇负性情绪的干预效果。方法 采用目的性抽样法选取2020年1月～2020年12月期间到本院进行产检、分娩的100例产妇。随机数字表法分为两组,各50例。对照组给予常规护理,研究组在常规护理同时应用正念练习。比较两组干预效果。结果 干预后,研究组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,五因素心智觉知度量表(FFMQ)评分高于对照组(P0.05);研究组第1产程、第2产程、第3产程视觉模拟评分法(VAS)评分均低于对照组(P0.05);研究组无一例出现产后抑郁,对照组发生率为12.00%(P0.05)。结论 产妇护理中实施正念练习可减轻其负性情绪,提升正念水平,缓解产程疼痛程度,减少产后抑郁发生。     

综合性康复护理对脑卒中合并抑郁、焦虑患者的疗效

目的分析综合性康复护理对脑卒中合并焦虑抑郁患者的疗效。方法选取我院2014年1月至2015年1月脑卒中合并焦虑抑郁患者共100例,按照随机数字表法平均分为实验组和对照组。对照组予以常规药物治疗和护理;实验组在常规药物治疗和护理的基础上,增加综合性康复护理。分别于护理干预前及开始后的2周、4周、6周对两组患者评估汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD);两组患者分别于护理干预前及开始6周后评估抑郁自评量表(SDS)、焦虑自评量表(SAS)。并对比两组患者护理干预6周后的临床疗效。结果两组患者实施护理干预前HAMA、HAMD、SDS和SAS组间对比无明显差异(P0.05)。两组患者护理干预后的2周、4周、6周的HAMA和HAMD评分较护理干预前均逐渐下降(P0.05),且实验组护理干预后的2周、4周、6周的HAMA和HAMD评分显著低于对照组(P0.05)。两组患者护理干预6周后的SDS和SAS评分显著低于护理干预前(P0.05),且实验组护理干预6周后的SDS、SAS评分显著低于对照组(P0.05)。实验组护理干预6周后的焦虑和抑郁症状改善率显著高于对照组(P0.05)。结论在常规药物治疗及护理的基础上,增加综合性康复护理可更有效地改善脑卒中患者焦虑抑郁情绪,更有效地提高患者的临床疗效,因此值得在临床护理工作中推广和应用。     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor (DRD4) and polymorphisms of the dopamine D3 receptor (DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 -521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Modulators and inhibitors of gamma- and beta-secretases

Most gene mutations associated with Alzheimer's disease point to the metabolism of amyloid precursor protein as a potential cause. The beta- and gamma-secretases are two executioners of amyloid precursor protein processing resulting in amyloid-beta. Significant progress has been made in the selective inhibition of both proteases, regardless of structural information for gamma-secretase. Several peptidic and nonpeptidic leads were identified for both targets.