老年脑梗死患者恢复期抑郁障碍的临床研究

目的 探讨老年脑梗死患者恢复期抑郁障碍的特点。方法 对87例老年脑梗死患者行汉密尔顿抑郁量表(HAND)和改良爱丁堡-斯堪的那维亚量表(SSS)评定。以HAMD总分20分为界限分为抑郁组和非抑郁组。结果 两组HAMD总分及因子分的差异有统计学意义,抑郁组均高于非抑郁组。两组脑梗死灶数量的差异无统计学意义。两组左侧、右侧及双侧梗死比较无显著性差异。两组SSS总分的差异有统计学意义,抑郁组神经功能缺损程度比非抑郁组严重。HAMD总分和因子分与神经功能缺损程度呈正相关。结论 抑郁是老年脑梗死患者恢复期常见的并发症,且抑郁已达中等严重程度。神经功能缺损严重的病人易产生抑郁障碍。     

老年脑梗死患者恢复期抑郁障碍的临床研究

目的 探讨老年脑梗死患者恢复期抑郁障碍的特点。方法 对87例老年脑梗死患者行汉密尔顿抑郁量表(HAMD)和改良爱丁堡-斯堪的那维亚量袁(SSS)评定。以HAMD总分20分为界限分为抑郁组和非抑郁组。结果 两组HAMD总分及因子分的差异有统计学意义，抑郁组均高于非抑郁组。两组脑梗死灶数量的差异无统计学意义。两组左侧、右侧及双侧梗死比较无显著性差异。两组SSS总分的差异有统计学意义，抑郁组神经功能缺损程度比非抑郁组严重。HAMD总分和因子分与神经功能缺损程度呈正相关。结论 抑郁是老年脑梗死患者恢复期常见的并发症，且抑郁已达中等严重程度。神经功能缺损严重的病人易产生抑郁障碍．     

躯体化症状为主抑郁症患者的述情障碍

目的:探讨以躯体化症状为主抑郁症患者和以情绪症状为主抑郁症患者述情障碍的差异。方法:50例以躯体化症状为主抑郁症患者(躯体症状组)、50例以情绪症状为主抑郁症患者(情绪症状组)和50名正常健康者(正常对照组)参加研究,采用90项症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和多伦多述情障碍量表进行评定。结果:躯体症状组SCL-90总分、躯体化、焦虑、人际敏感、恐怖、偏执因子分及HAMD的焦虑/躯体化因子评分均高于情绪症状组(P<0.01或P<0.05),情绪症状组在强迫、抑郁因子评分及HAMD的认知障碍、阻滞、日夜变化、睡眠障碍及绝望因子分高于躯体症状组(P<0.05或P<0.01)。躯体症状组与情绪症状组仅在述情障碍因子II评分差异有统计学意义(P<0.05),而在述情障碍总分及因子分上均高于正常对照组(P<0.05或P<0.001)。结论:以躯体化症状为主和以情绪症状为主抑郁症患者均存在述情障碍,以前者更缺乏识别情绪和躯体感受能力。     

失眠症患者心理社会因素分析

目的:探讨失眠症患者的应付方式,心理健康状况和社会支持状况.方法:采用应付方式问卷(CSQ)、症状自评量表(SCL-90)和社会支持量表(SSS)对失眠症患者和正常对照者各88例进行测评.结果:失眠症组自责、幻想和退避分量表的得分显著高于对照组,求助分量表的得分显著低于对照组(P＜0.01);失眠症组SCL-90总分及躯体化、抑郁、焦虑、睡眠障碍各因子分与对照组比较,有显著差异(P＜0.01).失眠症组社会支持总分、客观支持和对社会支持的利用度评分显著低于正常对照组(P＜0.05).失眠症组自责与躯体化症状、焦虑、抑郁等因子及总分呈显著正相关,而求助与焦虑、抑郁、偏执和总分呈显著负相关(P＜0.05).结论:失眠症患者多采用不成熟的应付方式,且有较多的心身症状,应付方式和身心健康有相关性.失眠症患者缺乏社会支持.     

精神病患者康复期焦虑、抑郁反应调查及心理护理干预

目的 探讨康复期精神病患者的心理状态,焦虑、抑郁反应的发生率及心理护理干预方法.方法 采用症状自评量表(SCL-90)及焦虑自评量表(SAS)抑郁自评量表(SDS),对康复期精神病患者进行调查,随机抽取在本院住院治疗的康复期患者68例为调查对象,对出院1年内的患者做随访调查,并与正常人群进行对照.结果 康复期患者SCL-90阳性数目数、抑郁、焦虑及悲观因子分均高于对照组.康复期患者焦虑发生率为80%,抑郁发生率为65%.针对康复期患者出现的焦虑、抑郁情绪,实行针对性的心理护理干预.结论 通过针对性的心理护理干预,可明显缓解患者的焦虑抑郁情绪,提高患者的健康水平和生活质量.     

脑电生物反馈治疗躯体形式障碍的对照研究

目的 研究脑电生物反馈治疗躯体形式障碍的安全有效性.方法 入组54例患者随机分为研究组（帕罗西汀联合脑电生物反馈治疗）和对照组（单用帕罗西汀治疗）,治疗6周;采用症状自评量表（SCL-90）评定疗效,副反应量表（ TESS） 评定不良反应.结果治疗后2组SCL-90躯体化、抑郁、焦虑、恐怖、强迫各因子分较治疗前明显减少,研究组SCL-90躯体化、抑郁、焦虑因子分明显低于对照组（P＜0.05）,2组各时期TESS评分比较差异无统计学意义（P＞0.05）.结论脑电生物反馈治疗联合帕罗西汀治疗躯体形式障碍疗效更为显著,不增加不良反应.     

综合医院内科门诊患者心理障碍研究

目的探讨综合医院内科门诊患者的心理健康状况并与心理门诊对照分析,为开展心理社会干预提供依据。方法采用症状自评量表(SCL-90)调查了综合医院558例门诊患者,分为心理门诊组、内科疾病组、内科非疾病组。结果内科疾病组的总分、阳性项目数、躯体化、强迫、抑郁、焦虑4个因子分的得分均显著高于内科非疾病组(P<0.01)。而心理门诊组的总分、阳性项目数、强迫、人际关系、抑郁、焦虑、恐怖5个因子的得分均显著高于内科疾病组(P<0.01)。结论内科患者伴发心理障碍并不少见,建议在生物学治疗内科疾病的同时合并心理干预。     

80例脑梗死患者情绪障碍的调查分析

目的了解脑梗死患者的焦虑、抑郁情绪。方法用焦虑自评量表(SAS)和抑郁自评量表(SDS)对80例脑梗死患者进行调查,并与70名健康自愿者进行配比对照分析。结果脑梗死患者的焦虑抑郁总分明显高于对照组,患者中已确诊焦虑占48%,抑郁占49%。结论部分脑梗死患者有明显的情绪障碍,临床医师在治疗躯体疾病的同时还要注意患者的焦虑和抑郁症状。     

社交焦虑障碍患者父母的人格特征和心理健康状况调查

目的探索社交焦虑障碍(SAD)患者父母的人格特征和心理健康状况。方法设研究组(SAD患者的父母)和对照组。入组时按要求进行艾森克人格问卷(EPQ)和症状自评量表(SCL-90)评定。结果SAD患者的父母在EPQ量表测验中的内外向因子标准分低于对照组;SAD患者的父母SCL-90各项因子除强迫和敌对因子,标准分低于对照组。结论SAD患者的父母的人格特征倾向内向,易安静、内省、离群、不喜欢接触人;SAD患者的父母更容易表现出躯体化症状、人际交往的困惑、抑郁、焦虑、恐怖和偏执。     

度洛西汀联合喹硫平治疗躯体化障碍的临床研究

目的探讨度洛西汀联合喹硫平治疗躯体化障碍的疗效及安全性。方法 100例躯体化障碍患者随机分为研究组(度洛西汀联合喹硫平组)和对照组(度洛西汀组),疗程8周。用症状自评量表(SCL-90)、汉密尔顿抑郁、焦虑量表(HAMD、HAMA)评定严重程度,用副反应量表(TESS)评定不良反应;用SCL-90躯体化因子分和HAMD量表减分率评定疗效。结果1治疗8周后,两组SCL-90各因子分、HAMD及HAMA分均呈下降趋势;研究组HAMD、HAMA、SCL-90躯体化、强迫、抑郁、焦虑及偏执因子分均较对照组下降显著(P0.05或0.01)。研究组和对照组有效率分别为81.6%和64.0%,差异有统计学意义(P0.05)。2研究组和对照组不良反应发生率分别为42%和36%(P0.05),TESS评分为[(5.21±3.60)vs.(4.80±3.80),P0.05]。结论度洛西汀联合喹硫平治疗躯体化障碍疗效优于单用度洛西汀,且安全性好。     

驻舰艇军人心理状况与人格特征的相关研究

目的:探讨驻舰艇军人心理健康状态及相关因素。方法:采用症状自评量表(SCL-90)、艾森克人格问卷(EPQ)评估海军某水面舰艇200名驻舰航行(长航)前后的心理健康状况。结果:长航前,除人际关系因子外,驻舰军人SCL-90总分及其他因子分均较男性军人常模显著低(P<0.01)。长航后SCL-90总分及各因子分均有所提高,其中总分、躯体化、焦虑、恐惧及精神病性因子分变化有统计学意义(P<0.05或P<0.01)。驻舰军人EPQ各分量表得分与男性常模比较差异均无显著性(P均>0.05)。SCL-90各因子分与EPQ精神质、神经质呈显著正相关(P<0.01),与掩饰性呈显著负相关(P<0.01);而人际关系、抑郁、恐惧因子分与内外向呈负相关(P<0.05或P<0.01)。结论:驻舰军人心理健康水平较好。人格特征与应激状态下心理健康水平关系密切。     

The frequency of the psychiatric symptoms in the patients with dyspepsia at a university hospital

OBJECTIVE: According to the psychiatric hypothesis, the symptoms of dyspepsia may be due to depression, anxiety or a somatization disorder. We investigated the frequency of psychiatric symptoms in patients undergoing endoscopic procedures with dyspepsia, either with or without pathological findings, and compared this with control subjects without dyspeptic symptoms. METHODS: Ninety patients with dyspeptic symptoms and 90 control subjects participated in the study. Both the patients and the controls were asked to complete a questionnaire about socio-demographic characteristics, the Turkish version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Symptom Check List-90 (SCL-90). In order for us to determine whether the criteria for any of the conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were met, the patients were asked to take part in the Structured Clinical Interview for DSM-IV disorders. RESULTS: Of the participants, 47.8% had a psychiatric disorder according to DSM-IV criteria, somatoform disorder (44.2%) being the most common. While 42.2% patients were determined to have a pathological finding using endoscopic evaluation, 57.8% had no findings. Together with the somatization and obsessive-compulsive disorder subscale scores, the total SCL-90 score and the mean trait anxiety score were statistically significantly higher in participants with no pathological findings. There were trends for anxiety (13.2% vs. 7.7%) and mood (2.6% vs. 0.0%) disorders to be more frequent in patients with pathological findings, while somatoform disorder+depressive disorder (17.3% vs. 5.2%) was more frequent in patients with no findings, although the differences were not statistically significant (Z=0.7, P>.05). The scores of state-trait anxiety, somatization, obsession-compulsion, depression, anxiety, phobic anxiety and psychotism subscales, and the total SCL-90 score were statistically significantly higher in those participants without a pathological finding than in the controls. CONCLUSIONS: Regarding the high frequency of psychiatric disorders in patients with dyspeptic symptoms, we think that such patients should be evaluated by two separate departments, gastroenterology and psychiatry.     

2型糖尿病患者负性情绪研究

目的：探讨负性情绪与2型糖尿病的关系。方法：对51例2型糖尿病患者与50例正常对照者进行负性情绪比较，采用生活事件量表（LES）、社会支持评定量表（SSRS）、症状自评量表（SCL-90）、抑郁自评量表（SDS）及焦虑自评量表（SAS）测评。结果：与对照组比较，糖尿病组的负性生活事件刺激量和总刺激量得分均显著较高（P均〈0．01）；而社会支持总分、主观支持分及支持利用度分均显著较低（P均〈0．01）。糖尿病组SCL-90总分及躯体化、人际关系敏感、抑郁、焦虑、敌对、恐惧6个因子分与SDS、SAS评分均显著高于对照组（P〈0．05或P〈0．01）。结论：2型糖尿病患者存在明显的负性情绪，有针对性的心理干预可能对其防治起重要作用。     

艾司西酞普兰对女性灼口综合征伴焦虑抑郁患者的疗效及细胞因子的影响

目的探讨艾司西酞普兰对女性灼口综合征伴焦虑抑郁患者的疗效及细胞因子的影响。方法选取2017年6月~2019年6月我院收治的91例女性灼口综合征伴焦虑抑郁患者作为主要研究对象,采用随机数字表法将患者分为观察组和对照组,两组患者均给予维生素B口服治疗,对照组(45例)给予心理治疗,观察组(46例)在对照组基础上增加艾司西酞普兰口服治疗,观察对比两组患者治疗前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、症状自评量表(SCL-90)评分和血清细胞因子水平及治疗后简明健康状况调查表(SF-36)评分和临床疗效。结果治疗后,观察组SF-36评分、总有效率高于对照组(P<0.05);观察组血清IL-6、TNF-α水平及SDS、SAS、SCL-90评分低于对照组(P<0.05)。结论艾司西酞普兰能够有效缓解女性灼口综合征伴焦虑抑郁患者不良情绪,调节细胞因子水平,改善患者心理健康水平及生活质量,从而提高治疗疗效。     

Predictors of symptom resolution in panic disorder after one year of pharmacological treatment: a naturalistic study

OBJECTIVE: In this naturalistic and prospective study, patients with panic disorder (PD) were treated for one year 1) to verify the rate of patients achieving the resolution of full-symptom attacks, limited-symptom attacks, anticipatory anxiety, phobic avoidance and depression; and 2) to identify the predictors of symptom resolution for each domain. METHOD: One hundred patients with PD, according to DSM-IV criteria, participated in the study. In all patients, a baseline and a follow-up with monthly evaluations of SCL-90, Ham-A, Ham-D and panic diaries were carried out over a one-year period. All patients were treated with paroxetine or citalopram. RESULTS: Seventy-one patients completed the study, whereas the remaining 29 dropped out. Among completers, remission of full- and limited-symptom panic attacks was observed in 76 % of patients, whereas complete remission (resolution of panic attacks, anticipatory anxiety, phobic anxiety, and depression) was achieved by only 46 % of patients. Predictors of absence of symptom remissions were obsessive-compulsive disorder (OCD) and recurrent major depression (MD) comorbidity (for panic attacks), pre-treatment severity of anxious symptoms (for anticipatory anxiety), phobic anxiety (for phobic avoidance), and depressive symptoms (for depression). CONCLUSION: This naturalistic study shows that the high comorbidity of OCD and MD and the greater pre-treatment severity of anxious, phobic and depressive symptoms reduced the likelihood of achieving complete remission of symptoms in PD patients who completed the protocol, even though they were adequately treated with SSRI medication.     

Is SCL‐90R helpful for the clinician in assessing DSM‐IV symptom disorders?

OBJECTIVE: To investigate associations between six of the Symptom Check-List 90R (SCL-90R) subscales and specific DSM-IV symptom disorders in a sample of patients with high comorbidity of axis I and axis II disorders. METHOD: SCL-90R questionnaires from 1202 patients admitted for treatment in the Norwegian Network of Psychotherapeutic Day Hospitals. Mean score differences on subscales among diagnostic categories were investigated. With diagnoses as external criteria, cut-off scores for different diagnostic groups were used to calculate diagnostic efficacy. Multiple regressions were conducted in order to disentangle variance of the subscales accounted for by symptom disorders. Frequency distributions of subscales for patients with and without symptom disorders were compared. RESULTS: Poor diagnostic efficacy was found for most of the subscales, except for the phobic anxiety subscale. The strongest association with each subscale was with its associated symptom disorder, except for dysthymia. CONCLUSION: Diagnostic inferences about DSM-IV symptom disorders based on SCL-90R should be conducted with care.     

脑梗死患者的生活质量与其焦虑、抑郁情绪的相关性研究

目的 探讨脑梗死患者的生活质量与其焦虑、抑郁情绪的关系。方法 采用Zung焦虑自评量表（SAS）、Zung抑郁自评量表（SDS）及生活质量综合评定问卷（GQOLI）对80例脑梗死患者（脑梗死组）及80名健康人（对照组）进行问卷调查，并对生活质量与其焦虑、抑郁情绪作相关分析。结果 脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均明显低于对照组（P〈0．01），而SAS及SDS评分均明显高于对照组（P〈0．01）。脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均与SAS及SDS评分呈显著性负相关。结论 脑梗死患者的生活质量较差，焦虑、抑郁情绪明显；其生活质量与焦虑、抑郁情绪密切相关。     

脑卒中后情感障碍的心理干预及帕罗西汀治疗的临床研究

目的 探讨脑卒中后情感障碍的发生率、脑卒中部位与情感障碍的关系,以及口服帕罗西汀合并早期心理干预对脑卒中后情感障碍患者日常生活能力和神经功能康复的影响.方法 采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对181例脑卒中患者进行筛查,对脑卒中后同时出现抑郁和焦虑的54例患者随机分成治疗组和对照组,在接受脑血管病常规治疗的基础上,治疗组加用帕罗西汀和心理干预.采用斯堪的那维亚脑卒中量表(SSS)、Barthel指数(BI)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)分别于治疗前、治疗后2周、4周及6周末进行评测.结果 181例患者中发生情感障碍81例(44.75 %),其中66.67%(54例)同时出现抑郁和焦虑,情感障碍的发生与额叶、左侧大脑半球、基底节病灶有关(P<0.05～0.001);治疗后治疗组HAMD、HAMA、SSS评分减少和BI评分增加,与对照组比较差异有统计学意义(均P<0.01),治疗后2～6周显效率显著优于对照组(P<0.05～0.01).结论 脑卒中后抑郁/焦虑的发生与脑卒中部位相关;对脑卒中后抑郁/焦虑的患者应用帕罗西汀合并心理干预治疗能显著提高患者神经功能康复程度,促进生活能力的恢复.