女性抑郁症患者人格特征与生活应激事件及家庭教养方式的关系

目的:探讨生活应激事件与家庭教养方式对女性抑郁症患者人格特征神经质倾向的影响。方法:采用顺序入组方式,由经过专门培训的访谈员使用电脑评估系统进行一对一访谈,入组南京医科大学附属脑科医院住院及门诊精神科或心理科确诊的女性复发性抑郁症患者。主要采用艾森克神经质量表、生活应激事件量表、父母亲情关系量表(parental bonding instrument,PBI)及一般情况调查表进行访谈,同时与正常女性作对照。结果:共访谈女性复发性抑郁症患者193例,正常女性对照571名。抑郁症组神经质维度评分为(11.21±6.08),对照组评分(2.04±2.95),协方差分析(控制年龄与婚姻)结果显示,组间差异有统计学意义(P<0.05);抑郁症组在生活应激事件、PBI照料维度/母亲、PBI控制维度/母亲、PBI照料维度/父亲、PBI控制维度/父亲5个维度得分均高于对照组,差异有统计学意义(P<0.05)。多元逐步回归分析结果显示,生活应激事件、PBI照料维度/父亲及PBI控制维度/父亲(β值分别为0.342,0.144,0.111)三者进入回归方程,且均可预测神经质倾向(P<0.01)。其中生活应激事件对神经质倾向的预测作用大于PBI照料维度/父亲及PBI控制维度/父亲两个维度。结论:女性抑郁症患者神经质人格特质与父母不良教养方式及个体经历的不良生活应激事件有关联。     

少年儿童精神疾病患者病前生活事件分析

目的:探讨少年儿童精神障碍患者病前生活事件。方法:回顾性分析2 225例住院治疗的3～18岁精神障碍患儿病前生活事件及其与患者年龄、性别、精神疾病诊断的关系。结果:699例入组者(31.42%)起病过程中存在至少1件生活事件;依次为学习压力类309例、受惩罚类181例、健康适应类142例、丧失类105例、其他69例、人际关系类66例;生活事件阳性率:675例儿童组中为31.70%,1 550例少年组中为31.29%,两组间比较差异无统计学意义;1 148例女性组中为34.41%,显著高于男性组(28.23%)(χ~2=9.85,P0.01)。其中女性组学习压力类生活事件明显多于男性组(P0.05);生活事件在精神疾病出现最多的依次为创伤及应激相关障碍(100.00%)、躯体形式障碍及分离性障碍(71.59%)、抑郁障碍(43.09%)、焦虑障碍(41.67%)以及进食障碍(39.02%)。结论:儿童少年精神障碍患者病前生活事件发生率较高;女性患者更易遭遇生活事件影响,以学习压力为甚;创伤及应激相关障碍等均与生活事件相关。     

青少年生活事件应激的绘画特征

目的 探索青少年生活事件应激与房树人测验绘画特征的联系,为青少年生活事件应激评估研究提供新思路.方法 对937名青少年进行生活事件评定和房树人测验.对具有不同绘画特征的青少年生活事件总应激量及各因子应激量进行统计分析.结果 青少年生活事件应激相关的绘画特征有果实（β=-4.887）、房子大小（β=-2.378）、地平线（β=4.420）、人物涂黑（β=3.324）、尖锐部分（β=-3.135）、动物（β=4.605）、下雨雪花（β=-9.655）和画面简单（β=3.283）.结论 房树人测验对青少年生活事件应激评定具有一定的辅助参考价值.     

上海市中学生心理健康状况与生活事件之间关系的横断面研究(英文)

背景 在国内,学生的人口学特征及负性生活事件与其心理健康的关系尚未得到充分的研究。目的 评估中学生中各种生活应激事件的发生率,确定与中学生自我感知的心理健康问题密切相关的人口学特征和生活事件的类型。方法 采用分层随机抽样的方法进行横断面调查,抽取上海市2个区4所中学共1818名学生,应用2种自评问卷进行评估:长处与困难问卷(Strengths and Difficulties Questionnaire,SDQ)学生版和用于评估11项负性生活事件的简易版青少年生活事件量表(Adolescent Self-rating Life Events Checklist,ASLEC)。结果 中学生报告的常见负性生活事件为学习压力(74%),受到批评(66%),家庭冲突(29%)以及受人欺负、歧视或人际关系紧张(26%),但是这些事件的发生率因学生的性别、学校类型以及所处城郊位置不同而有所差异。同样,不同组别的学生其生活事件所致心理应激水平、心理困难总分以及社会行为水平亦有所不同。多因素线性回归分析表明,评估前6个月内心理困难的独立预测因素依次为(按照重要性先后顺序):过去一年内负性生活事件所致的应激总评分高,受人欺负、歧视或人际关系紧张,没有发生亲人死亡,男性,学校位于郊区,以及未患重病或残疾。社会行为水平的独立预测因素依次为负性生活事件所致的应激总评分高,学校位于城区,女性,普通中学(与重点中学比),受人欺负、歧视或人际关系紧张,没有发生亲人死亡,初中(与高中比)。结论 与中学生的应激和社会行为相关的众多因素之一是负性生活事件。进一步需要开展前瞻性研究以阐明中学生应激与负性生活事件的因果关系,开展并验证人群特异性的干预方法以减轻应激、增加适应性社会行为。     

自杀研究中生活事件量表不同信息来源的一致性

目的比较生活事件量表在自杀研究中不同信息来源下的一致性。方法纳入104例自杀未遂和147例自杀死亡案例。每个案例都分别由1名家属和1名亲友报告案例对象在自杀行为前经历过的生活事件,自杀未遂者本人也报告自己在自杀行为前经历过的生活事件,用生活事件量表进行评估。采用Kappa值、组内相关系数(intraclass correlation coefficient,ICC)等指标评估生活事件量表的不同信息来源之间的一致性。结果自杀未遂者本人和2名知情人报告的夫妻关系、自身患病、家庭关系、家人去世等类型生活事件的一致性接近中等及以上水平(Kappa≥0.39),而本人与知情人之间慢性压力总分及急性应激强度得分的一致性较低(ICC为0.11~0.24)。自杀者的2名知情人在配偶去世、工作学习、自身患病类生活事件上的一致性达到中等及以上水平(Kappa≥0.49),慢性压力总分一致性一般(ICC=0.47)。结论在自杀研究中运用结构化的生活事件量表从知情人处获得自杀者或未遂者的生活事件信息比较可靠。     

精神创伤后应激障碍的应激原类型分析

目的:了解20世纪90年代与70年代妇女精神创伤后应激障碍(PTSD)的应激原类型差别.方法:对1994-1998年因各种心理事件住院的妇女患者进行调查,参照中国正常人生活事件评定常模表列出29个项目与70年代比较,并与同期男性进行比较.结果:PTSD占住院患者1.18%-1.47%,男性发病年龄显著较大,70年代女性应激原以被强奸,被羞辱显著较多,90年代以家庭破裂,恶性婚外恋较多,男性以在社会活动,事业荣誉方面的精神压力较多,结论:心理,社会,文化等因素可导致应激事件的时代变迁,两性间差异可能与生物学因素有关.     

有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激的比较研究

目的:探讨有无自杀意念抑郁症患者抑郁情绪、认知应对策略及应激性生活事件的差异。方法:对143例抑郁症患者进行自编一般情况问卷、Beck抑郁自评量表(BDI)、认知情绪调节问卷中文版(CERQ-C)评定。结果:有自杀意念抑郁症发作患者BDI总分、婚姻家庭应激及社会生活应激分及CERQ-C适应性策略与不适应性策略总分显著高于无自杀意念抑郁症患者(P<0.05或P<0.01)。有自杀意念抑郁症患者抑郁总分与工作学习应激、婚姻家庭应激、社会生活应激及CERQ-C不适应性策略分呈显著正相关(r=0.569,0.470,0.341,0.303,P<0.05或P<0.01);无自杀意念抑郁症患者抑郁总分仅与婚姻家庭应激呈显著正相关(r=0.361,P<0.01)。结论:有自杀意念较无自杀意念抑郁症患者经历更多的负性生活事件,存在更严重的抑郁情绪,较多地采用认知应对策略。     

影响大学生自尊的相关因素分析

目的了解和分析大学生自尊的影响因素。方法采用自尊量表、青少年生活事件量表、情感量表对416位大学生进行了调查,并封部分同学进行了访谈。结果大学生在性别、城乡、家庭教养方式、体育运动水平、交际能力上其自尊均存在着显性差异。正性情感、情感平衡、人际关系方面的应激、学习成绩封大学生的自尊存在着较好的预测作用。结论大学生的自尊水平受多种因素的影响,我们应从多个角度、采用多种方式封大学生进行自尊教育。     

社会心理应激与自杀

自杀者比一般人群有更多的应激 ,本文初步探讨了自杀者中常见的生活事件类型、生活事件与自杀的关系以及针对生活事件的干预措施     

社会心理应激与自杀

自杀者比一般人群有更多的应激，本文初步探讨了自杀者中常见的生活事件类型、生活事件与自杀的关系以及针对生活事件的干预措施。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -