伴自杀意念抑郁症患者人格特征、家庭环境与应对方式分析

目的对伴有自杀意念抑郁症患者的人格特征、家庭环境及应对方式进行研究,为抑郁症的心理治疗及预防提供参考依据。方法随机选取抑郁症患者200例,自制一般情况调查表,进行汉密尔顿抑郁量表(HAMD)、自杀意念自评量表(SIOSS)、艾森克人格问卷(EPQ)、家庭环境量表(FES-CV)、简易应对方式问卷(SCSQ)测评。结果抑郁症伴自杀意念的发生率为38.5%。单因素相关分析显示,EPQ的精神质维度与FES-CV的亲密度、情感表达、知识性、娱乐性、组织性等因子呈负相关(P0.05或0.01),与矛盾性、控制性因子呈正相关(P0.05或0.01);神经质维度与亲密度、情感表达、知识性、娱乐性、道德宗教观、组织性因子呈负相关(P0.05或0.01),与矛盾性因子呈正相关(P0.05)。多元逐步回归分析显示,亲密度、矛盾性分别进入以精神质、内外向、神经质为因变量的多元回归方程,积极应对方式分别进入以精神质、内外向为自变量的多元回归方程,情感表达进入以精神质为因变量的多元回归方程(P0.05或0.01)。结论伴自杀意念抑郁症患者往往存在一定的人格特征,其家庭环境对人格的形成和疾病的康复有一定的影响,如个体采取积极的应对方式处理生活事件则对康复有所帮助。     

精神分裂症患者直系子女早期人格特征及家庭环境的相关性研究

目的 探讨精神分裂症患者直系子女的人格特征、家庭环境模式以及家庭环境因素对其人格特征的影响.方法 采用艾森克个性问卷(幼年版)(EPQ)及家庭环境量表中文版(FES-CV)评估35例精神分裂症患者直系子女(研究组)和35例正常对照(对照组)的人格特征及家庭环境模式.结果 (1)研究组的精神质、神经质两个维度评分显著高于对照组(P ＜0.05,P＜0.01),内-外向维度评分显著低于对照组(P＜0.05).(2)研究组亲密度、成功性、娱乐性3个因子评分显著低于对照组(P＜0.01),矛盾性、独立性及控制性3个因子评分显著高于对照组(P＜0.05).(3)研究组精神质与亲密度、娱乐性呈显著负相关(P ＜0.05,P＜0.01),与矛盾性、控制性呈显著正相关(P＜0.05);内外向与亲密度、成功性、娱乐性呈显著正相关(P ＜0.05,P＜0.01);神经质与亲密度、娱乐性呈显著负相关(P＜0.05),与控制性呈显著正相关(P＜0.05).结论 家庭环境对精神分裂症患者直系子女发育早期的人格特征可能产生不利影响.     

“一站式”社区系统家庭治疗模式对精神分裂症康复效果分析

目的探讨"一站式"社区系统家庭治疗模式对精神分裂症患者家庭环境和自测健康状况的影响。方法将病情处于缓解期的精神分裂症患者120例分为研究组和对照组各60例,两组病例均维持抗精神病药物治疗和一般性健康教育,研究组在"社区工疗站"定期接受系统家庭治疗,对照组不参与"社区工疗站"活动。采用阳性和阴性症状量表(PANSS)、自测健康评定量表(SRHMS)、家庭环境量表中文版(FES-CV)在治疗前及治疗两年后对两组患者进行评定。结果治疗后研究组和对照组PANSS评分、SRHMS总评分差异均有统计学意义[(50.01±13.93)分vs.(78.59±14.88)分,(339.97±41.86)分vs.(290.46±41.84)分,P均0.01]。结论 "一站式"社区系统家庭治疗可能有助于稳定精神分裂症患者的病情,减少复发,提高患者的健康自测水平。     

孤独症儿童父母人格特征调查

目的探讨孤独症儿童父母人格特征,为干预儿童孤独症提供科学依据。方法选取符合《精神疾病诊断与统计手册(第4版)》(DSM-IV)中孤独症诊断标准的26例孤独症儿童和26例正常儿童,采用孤独症行为量表(ABC)和艾森克人格问卷(EPQ)分别对两组儿童及其父母其进行测评。结果孤独症儿童父母内外向维度(E维度)得分低于正常儿童父母[(41.75±9.80)vs.(54.21±8.25)],差异有统计学意义(P0.00l),孤独症儿童父母情绪稳定性维度(N维度)、精神质维度(P维度)得分高于正常儿童父母[(59.86±8.72)vs.(49.63±7.79),(53.17±9.16)vs.(46.43±8.44)],差异有统计学意义(P0.00l)。结论孤独症儿童父母人格以偏内向,情绪波动性大,固执已见为主要特征。     

精神分裂症患者一级亲属人格特征的研究

目的 探讨精神分裂症患者一级亲属的人格特征.方法 采用分裂型人格问卷(SPQ)及三维人格问卷(TPQ)评定181例精神分裂症患者一级亲属(高危组)、321名正常对照个体(对照组)的人格特征.结果 高危组sPQ阴性分裂型人格维度评分[(9.80±7.05)分]高于对照组[(8.42±5.87)分],差异有统计学意义(P＜0.05).高危组在TPQ寻求新奇维度评分[(15.60±5.62)分]、奖赏依赖维度评分[(17.41 ±1.13)分]与对照组[(14.20±2.83)分,(18.22±3.26)分]的差异均有统计学意义(P均＜0.01).高危组的阴性分裂型人格维度分数与寻求新奇维度、奖赏依赖维度分数显著相关(r=0.17和-0.23).结论 精神分裂症患者一级亲属具有阴性分裂型维度、寻求新奇维度、奖赏依赖维度的人格特征.     

多胎家庭中儿童青少年情绪障碍患者家庭环境调查

目的调查多胎家庭中儿童青少年情绪障碍患者的家庭环境特征,为优化家庭环境、改善其情绪问题提供参考。方法选取2015年8月-2017年8月在武汉市精神卫生中心住院的、符合《国际疾病分类(第10版)》(ICD-10)通常起病于童年与少年期的行为和情绪障碍诊断标准的36例患者为研究组,同时选取36例健康志愿者(研究组同一家庭内同父同母所生的健康同胞)为对照组。收集两组一般人口学资料,并采用家庭环境量表中文版(FES-CV)进行评定。结果研究组FES-CV中知识性因子[(3. 47±1. 36)分vs.(4. 69±2. 07)分,t=-2. 961,P=0. 004]、娱乐性因子[(2. 44±2. 03)分vs.(3. 83±2. 68)分,t=-2. 478,P=0. 016]和道德宗教观因子[(4. 22±1. 62)分vs.(5. 28±1. 78)分,t=-2. 627,P=0. 011]评分均低于对照组,而矛盾性因子评分高于对照组[(5. 25±1. 83)分vs.(3. 89±1. 69)分,t=3. 285,P=0. 002]。在有儿童青少年情绪障碍患者的多胎家庭中,家庭环境影响因素有:父母婚姻状况、家庭经济情况、母亲受教育程度、出生顺序、学历和年龄(P0. 05或0. 01)。结论在多胎家庭中,儿童青少年情绪障碍患者及其同胞所感受到的家庭环境各因素之间存在差异。     

青少年抑郁障碍患者心理社会学特征

目的探讨青少年抑郁障碍患者的心理社会学特点。方法收集符合《国际疾病分类(第10版)》(ICD-10)抑郁障碍诊断标准的96例青少年抑郁症患者。所有患者均未经治疗,且均为首次就诊。正常对照组按性别、年龄等一般特征与病例组进行1∶1匹配。采用自编一般资料调查表、艾森克人格问卷(EPQ)、家庭环境量表中文版(FES-CV)、父母教养方式评价量表(EMBU)、青少年生活事件量表(ASLEC)和抑郁自评量表(SDS)进行测评。结果病例组EPQ的神经质(N)维度评分高于对照组,内外向(E)维度评分低于对照组(P0.01);病例组中独立性、亲密度、知识性、娱乐性、情感表达、成功性评分均较对照组低,差异均有统计学意义(P均0.01);父母情感温暖与理解因子评分低于对照组,差异有统计学意义(P0.01)。结论青少年抑郁障碍可能与其成长环境、父母因素、人格、应激生活事件、社会支持、同伴关系等有关。     

违法犯罪青少年的家庭环境特点

目的 探讨违法犯罪青少年的家庭环境特点.方法 选取200例广州地区违法犯罪青少年为研究对象,采用家庭环境量表中文版( FES-CV)自评方法进行研究.结果 共获得有效自评问卷173份,年龄平均(16.7±1)岁,受教育年限(6.9±2.0)年.内部一致性较好的四个分量表中,亲密度(5.4±2.6)、知识性(3.4±1.9)、组织性(4.8±1.6)均值均低于中国常模,但矛盾性(4.1±2.3)均值却高于中国常模.内部一致性稍差的三个分量表中,成功性(4.1±1.5)、娱乐性(3.2±2.0)均值也低于中国常模,但控制性(3.7±2.3)却高于中国常模控制性(3.6±1.8).根据学员既往情况,分为暴力行为组131人(75.7％)、非暴力行为组42人(24.3％)进行比较,结果在上述7个分量表中的差异均无统计学意义.结论 违法犯罪青少年的家庭环境存在一定缺陷,与正常家庭相比矛盾性、拉制性高,亲密度、知识性、组织性低.     

遗传负荷对精神分裂症患者认知功能的影响

目的 研究精神分裂症单发家系和高发家系患者及其亲属的认知功能,探讨遗传负荷对精神分裂症患者认知功能的影响.方法 使用威斯康星卡片分类测验(WCST)、修订韦氏成人智力量表(WAIS-R)的词汇测验(VS)、多维记忆评估量表(MMAS)的数字广度、汉词广度和空间广度测验及持续注意测验(CPT)对精神分裂症单发家系患者组(21例)及其一级亲属(单发家系亲属组,55例),高发家系患者组(30例)及其一级亲属(高发家系亲属组,26例),对照家系组(14名)及其一级亲属(对照家系亲属组,29名)进行研究.结果 高发家系患者组和高发家系亲属组的VS[(9.3±3.9)分vs(13.6±2.2)分和(10.7±4.0)分vs(13.9±2.3)分]和部分记忆广度成绩均明显低于对照家系组分及对照家系亲属组,其WCST卡片总数、持续错误数[(27.9±13.0)分vs(18.3±8.4)分和(26.0±16.3)分vs(18.3±8.7)分]和随机错误数及CPT视觉、听觉漏报数和反应时间均明显多于对照家系组分和对照家系亲属组分,差异有统计学意义(ANOVA,P＜0.05);单发家系患者组CPT视觉漏报[(68.7±18.4)分vs(49.0±3.4)分]和反应时间、听觉错报和漏报多于对照家系组,差异有统计学意义(ANOVA,P＜0.05),单发家系亲属组的VS低于对照家系亲属组[(12.0±3.9)分vs(13.9±2.3)分],WCST卡片总数多于对照家系亲属组,差异有统计学意义(ANOVA,P＜0.05).结论 精神分裂症高发家系认知成绩最差,单发家系患者及亲属大部分认知成绩介于高发家系和对照家系之间;随着遗传负荷的增加,患者及亲属的认知缺陷更为明显,认知功能缺陷可能是精神分裂症遗传易感性的标志之一.     

应届与往届考生高考前心理状态对照研究

目的调查参加2014年高考的应届、往届考生考前心理状态,为其心理辅导提供参考依据。方法采用随机数字法选取2014年天水市应届考生及往届高中毕业生各184名为调查对象,采用状态-特质焦虑问卷(STAI)、匹茨堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)对两组考生进行考前测评。结果 1SAI评分应届考生高于往届考生,差异有统计学意义[(58.38±7.88)分vs.(58.38±7.88)分,(P<0.05)];而TAI评分往届考生高于应届考生,差异有统计学意义[(48.97±8.28)分vs.(50.24±6.29)分,(P<0.05)];2PSQI评分往届考生高于应届考生,差异有统计学意义[(12.38±5.37)分vs.(15.08±5.70)分,(P<0.01)];3SAS和HAMA评分往届考生高于应届考生[(53.46±6.48)分vs.(55.18±4.94)分]、[(13.87±1.53)分vs.(1.23±1.62)分](P均<0.01)。结论高考生参加高考前均出现明显的焦虑症状,且往届考生较应届考生更明显、检出率高,同时往届考生睡眠质量明显较应届考生差。     

Mechanisms of the suppression of the nociceptive reflex of the opening of the mouth during stimulation of the structures of the limbic brain

The comparative effectiveness of the inhibitory influence of tetanic stimulation of hypothalamus, amygdala and limbic cortex on EMG-response of m. digastricus evoked by electrical stimulation of tooth pulp nociceptive afferents was studied in cats anesthetized with a mixture of chloralose and nembutal. It was found that inhibition of the EMG-component of the jaw-opening reflex is most pronounced in case of stimulation of medial and lateral region of the hypothalamus, the inhibitory effect of central and medial nuclei of the amygdala is less pronounced and the effect of the limbic cortex is the weakest. It was shown that the mechanism of the antinociceptive effect of tetanic stimulation of the hypothalamus is not related to the concomitant increase of the blood pressure. After stabilization of the blood pressure the suppressive effect of the hypothalamus remains without changes, that points out to a direct, primary, not baro-afferent mechanism of the inhibition of the activity of nociceptive neurons of the trigeminal sensory nuclei. Noradrenaline, injected intravenously, induced a large increase of the blood pressure accompanied by a pronounced inhibition of the pain reflex. Angiotensin causes the same degree of blood pressure elevation without changes in the amplitude of the EMG-response of the pain reflex. Hypothalamic and noradrenergic mechanisms for control of pain sensitivity are discussed.     

药物治疗与合并认知行为治疗对强迫症疗效的比较

目的探讨认知行为心理治疗(CBT)在强迫症(OCD)患者各亚型治疗中的有效性和规律性。方法本研究为临床对照研究。符合入组标准的强迫症患者按患者自愿原则分为两组,治疗观察3、6、12个月。疗效评定分别运用Yale-Brown强迫量表,自拟的自评好转程度量表和临床疗效评定。结果认知行为心理治疗合并药物治疗组31例,临床有效率70.9%,其中治愈率1.8%。单纯药物治疗组24例,临床有效率33.3%。Yale-Brown强迫量表和自评量表得分在6个月和12个月两组有显著差异(P<0.05)。其中强迫症亚型(怕脏型、反复检查型和反复担心型)的疗效比较,怕脏型在治疗3个月末两组间自评量表评分有显著性差异(P<0.05);反复担心型在治疗6个月末两组间Yale-Brown强迫量表总分有显著性差异(P<0.05);反复检查型两组间无统计学差异。结论认知行为心理治疗合并药物治疗强迫症的疗效明显优于单纯药物治疗。强迫症的亚型在治疗中的有效性次序为:反复担心型>怕脏型>反复检查型。     

Characteristics of the sympathetic innervation of the nictitating membrane and of the vasculature of the nose and tongue of the cat

Summary Vasomotor responses from the nasal mucosa and tongue, and contractions of the nictitating membrane, were recorded on stimulation of the cervical sympathetic or internal carotid nerves.Preganglionic sympathetic nerve fibres which elicited a membrane response possessed a lower threshold than those which evoked nasal vasoconstriction, while the latter displayed a lower threshold than fibres which evoked tongue vasoconstriction. The sympathetic vasodilator fibres to the tongue, whose activity was revealed after-receptor blockade, had a similar threshold to the vasoconstrictor fibres.Membrane contraction, nasal vasoconstriction and occasionally tongue vasoconstriction could be evoked by stimulating the internal carotid nerve. The postganglionic fibres innervating the nasal mucosa had a similar threshold to those of the nictitating membrane, which may indicate that there are small myelinated fibres innervating the mucosa.The preganglionic compound nerve action potential had four major components, S₁–S₄. S₁, S₂ and usually S₃ fibres were associated with membrane contraction; S₂, S₃ and sometimes S₁ fibres were associated with nasal vasoconstriction; and S₃, usually S₂ and occasionally S₁ fibres were associated with vasoconstriction in the tongue. It is concluded that each of these three groups of nerve fibres, but not S₄ fibres, may include fibres associated functionally with the three effectors.There was a considerable difference between the relative amplitude of the responses of the three effectors elicited by stimulation of the cervical sympathetic nerve at frequencies between 0.2 and 2 Hz. Vasoconstrictor responses were relatively larger than membrane contractions suggesting differences in the mechanisms of neurotransmission at the neuroeffector junctions.     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

A contribution to the study of the architecture of the autonomic nervous system of the digestive tract of the rat

Summary The distribution of aminergic and non-aminergic nerve fibres to the different constituents of the wall of the digestive tract in various regions is described. Aminergic fibres synapse with all nervous perikarya. Densely interlacing networks of nerve fibres are found in both layers of the tunica muscularis and in the lamina muscularis mucosae. A finely meshed plexus is observed in relation to the wall of the blood vessels in the wall of the gut. There are many fibres connecting the muscular and the vascular plexus. No nerve fibres have been observed in direct relation to the epithelium.The functional implications of these findings are discussed.