精神科医护人员心理健康状况调查与相关干预

目的 对精神科医护人员的心理健康状况进行调查并探讨心理干预的作用.方法 30名精神科医护人员作为研究组和34名一般人群作为对照组,对两组焦虑、抑郁情绪和幸福感进行评估,比较两组间的差异.对研究组进行5周的心理干预,比较其情绪和幸福感在干预前后的差异,并与一般群体相比较.结果 ①研究组焦虑程度显著高于对照组(t=3.21,P＜0.05);总体幸福感量表(GWB)得分低于对照组且差异具有统计学意义(t=5.78,P＜0.05);抑郁自评量表(SDS)分数没有显著性差异(t=0.96,P＞0.05);②研究组在心理干预后焦虑自评量表(SAS)、抑郁自评量表(SDS)和总体幸福感量表(GWB)分数均有所改变,其中,SAS分数显著性降低(t=3.52,P＜0.05);GWB分数提高且有统计学意义(t=4.28,P＜0.05);③研究组经心理干预后与对照组相比,焦虑和抑郁水平没有显著性差异,幸福感仍较低且有统计学意义(t=4.81,P＜0.05).结论 精神科医护人员心理健康状况较一般人群差,心理干预可提高其心理健康水平.     

团体心理治疗对接受体外受精-胚胎移植者情绪的作用

目的:初步探讨团体心理治疗对接受体外受精-胚胎移植(In Vitro Fertilization and Embryo Transfer,IVF-ET)治疗者情绪的作用。方法:从接受IVF-ET治疗的门诊患者(均为女性)中选取自愿参与本研究者100名,随机分为对照组和干预组,每组各50人。对照组(脱落3例)仅接受常规IVF-ET治疗,干预组(脱落8例)除接受常规IVF-ET治疗外同时参加总计6次,每周2次的团体心理干预。用焦虑状态-特质问卷(State-Trait Anxiety Inventory,STAI)及抑郁自评量表(Self-rating Depression Scale,SDS)比较两组患者干预前后焦虑、抑郁水平的差异。结果:干预组SAI、SDS的前后测得分差异均无统计学意义(均P0.05);对照组SAI、SDS的后测得分均高于前测[(39.6±7.9)vs.(42.7±8.7),(43.8±10.1)vs.(49.0±10.4);P0.05或0.01]。干预组SAI前后测差值低于对照组[(0.6±7.8)vs.(3.2±9.9),P0.05],而SDS前后测差值在两组间差异无统计学意义(P0.05)]。干预组与对照组的临床妊娠率差异无统计学意义(35.7%vs.29.8%,P0.05)。结论:团体心理干预可以缓解接受体外受精-胚胎移植治疗患者的焦虑情绪,有临床应用价值。     

心理健康教育对促进中学生心理健康水平的作用

目的:探讨心理健康教育对提高中学生心理健康水平的作用.方法:选择两所有代表性的学校初、高中学生8个班为研究对象,随机分为干预组与对照组,针对男女生进行心理健康教育.结果:干预前两组女生抑郁、焦虑、恐怖因子分均偏高,与男生差异有统计学意义(P＜0.05).两组男生敌对、偏执、强迫因子分均偏高,与女生差异有统计学意义(P＜0.05).干预后干预组男女生各因子分均降低,除女生抑郁因子分偏高,男生敌对因子分偏高外(P＜0.05),其余各项均无差异;干预组与对照组比较,男女各因子分均降低,差异有统计学意义(P＜0.05).结论:综合性的心理健康教育有助于改善中学生心理健康.     

心理健康教育对缓解大学生焦虑抑郁情绪的作用

目的:探讨心理健康教育对缓解大学生焦虑抑郁情绪的作用。方法:随机选取某大学434名学生作为研究对象,并分为研究组和对照组。前者参加心理健康教育,后者不参加心理健康教育。采用焦虑自评量表(SAS)、抑郁自评量表(SDS),分别在干预前后对两组进行评定并进行分析比较。结果:总样本焦虑和抑郁的总检出率分别为10.37%、16.82%。研究组干预后SAS评分、SDS评分(37.00±8.06、36.80±8.51)均较干预前(38.85±9.44、39.58±10.40)降低且差异具有显著性(t=2.194、3.615,P<0.05),中度以上焦虑和抑郁的检出率也明显下降(χ2=9.353、5.802,P<0.05)。而对照组各量表评分差异均无显著性。结论:心理健康教育对缓解大学生焦虑抑郁情绪有一定的作用。     

心理健康教育月活动对缓解医学生焦虑抑郁情绪的效果

目的比较分析心理健康教育月活动对缓解医学生焦虑抑郁情绪的效果。方法随机选取本校三年级456名文、理科学生为研究对象,分为观察组（226人）和对照组（230人）。两组采用焦虑自评量表（SAS）和抑郁自评量表（SDS）评分,对前组开展以人际交往的心理健康、恋爱的心理健康、应急与心理健康、心理防御的措施、常见心理健康问题处理、寻求和利用社会支持等为内容的心理健康教育月活动,后组不参加心理健康月教育。两个月后,对两组进行干预前后评定和比较分析。结果总样本焦虑和抑郁的总检出率分别为10．42％、16．72％。观察组干预后SAS和SDS的评分与干预前比较均降低有显著性差异（t=2．194,3．615;P〈005）,中度以上焦虑和抑郁的检出率也明显下降（X2=9．353,5．802;P〈0．05）。对照组各量表评分均无显著性差异。结论心理健康教育月活动对缓解医学生焦虑抑郁情绪有一定的作用。     

家庭医生签约管理对社区居民抑郁症状的干预效果

目的:评价社区家庭医生签约管理对居民抑郁症状的社区干预效果,为家庭医生发挥提前预警、早期发现抑郁症并进行社区干预提供科学依据。方法:选取北京市某社区卫生服务站2017年8月随访的506例家庭医生签约管理居民作为干预组,同期社区门诊居民506例作为非干预对照组,两组均填写9条目患者健康问卷(PHQ-9)和自评抑郁量表(SDS)。入组后家庭医生对干预组居民管理干预,每年至少4次,持续2年。对照组居民按照门诊流程诊治并随访。于2019年9月两组居民再次填写PHQ-9和SDS,比较两组干预前后量表分变化,采用多重线性回归筛选PHQ-9和SDS的影响因素。结果:干预组居民2年后PHQ-9[(3.7±1.0)vs.(3.3±1.1)]和SDS得分[(39.4±9.2) vs.(35.2±9.1)]降低(均P<0.05);对照组居民2年后SDS量表[(40.0±9.0) vs.(41.0±13.3)]得分增加(P<0.05)。PHQ-9量表分的影响因素有家庭医生签约管理干预、年龄、婚姻状况、受教育程度、收入;SDS量表分的影响因素有家庭医生签约管理干预、婚姻状况、受教育程度、收入(均P<0.05)。结论:社区家庭医生签约管理干预可有效改善居民抑郁症状,是有益的社区干预模式。     

跟进式电话随访在出院心肌梗死患者中的应用

目的:探讨跟进式电话随访在出院心肌梗死(myocardial infarction,MI)患者中的应用价值.方法:选取2015年1月至2016年5月滨州医学院烟台附属医院收治的MI患者128例.采用随机数字表法将患者分为观察组和对照组,每组64例.对照组只进行出院健康教育,观察组接受为期6个月的跟进式电话随访.结果:干预前,两组健康调查简表(short from health survey,SF-36)量表各维度得分比较差异均无统计学意义(P＞0.05).干预6个月后,观察组生活质量显著上升,差异有统计学意义(P＜0.05),对照组无明显变化,差异无统计学意义(P＞0.05).干预前,两组自护能力测定量表(exercise of selfcare agency scale,ESCA)各维度得分比较差异均无统计学意义(P＞0.05).干预6个月后,观察组自护能力显著上升,差异有统计学意义(P＜0.05),对照组无明显变化(P＞0.05).干预前,两组焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-depression anxiety scale,SDS)得分比较差异均无统计学意义(P＞0.05).干预6个月后,观察组焦虑、抑郁状况显著改善(P＜0.05),对照组无明显变化(P＞0.05).结论:跟进式电话随访有助于提高MI出院患者的生活质量和自护能力,改善心理健康状况,值得临床推荐.     

社区人群抑郁障碍早期心理干预效果随访

目的 探索心理教育时社区抑郁障碍患者及高危人群的近期效果.方法 干预对象为社区抑郁障碍患者12例及阈下抑郁者40例.干预形式包括发放健康教育手册及讲座形式,内容包括抑郁障碍知识及认知行为治疗取向的心理教育.结果 干预后抑郁障碍知晓率显著提高,熟悉率由7.5％升至30.5％(x2=11.80,P=0.00).干预后汉密尔顿抑郁量表(HAMD)总分及应对方式消极应对分均显著降低(t=2.01,P=0.05;t=2.28,P=0.03).女性汉密尔顿抑郁(HAMD)、汉密尔顿焦虑(HAMA)减分值均显著高于男性(P分别为0.01、0.00),内向者HAMD减分值亦显著低于性格外向及一般者(F=3.38,P=0.04),女性特质应对方式问卷(TCSQ)消极应对分减分值亦显著高于男性(F=9.77,P=0.00).年龄与HAMD减分值呈显著负相关(r=-0.27,P=0.05).干预1年后随访,HAMD、HAMA总分均显著低于基线(t=3.82,2.97;P＜0.01).结论 心理教育能提高社区抑郁症患者及高危人群抑郁症知晓率,改善抑郁症状及应对方式,女性改善较佳.     

综合心理干预对社区老人抑郁情绪调整的效果分析

目的:探讨综合心理干预对社区老人抑郁情绪调整的效果。方法:2011年1-7月对社区60岁以上老人236例,随机分成综合心理干预实验组和对照组各118例,将两组采用自编的健康知识掌握评分量表、生活质量状况问卷和汉密尔顿抑郁量表(HAMD)评定,将结果进行对比。结果:实验组接受综合心理干预后老年人在躯体健康、心理健康、社会生活3个维度存在问题的比率都低于对照组;实验前后两组HAMD评分比较,实验组实验前后评分差值明显高于对照组,差异有显著性意义(t=-4.43,P0.01)。结论:专业综合心理干预能有效提高社区老年人的心理健康知识掌握程度,降低社区老年人健康问题比率,能改善老人消极、抑郁情绪,提高社区老人的生活质量。     

互动式讲座对社区焦虑、抑郁早期人群的干预效果研究

目的应用互动式讲座对社区焦虑、抑郁早期人群进行干预,缓解他们的焦虑、抑郁情绪状态,提高其心理健康水平。方法以试点社区中筛查出的144例焦虑、抑郁早期人群作为研究对象,分为干预组69人,对照组75人;运用每周1次,每次2小时,共4次的互动式讲座对干预组进行干预;2组均采用焦虑自评量表(SA S)、抑郁自评量表(SDS)、非理性信念量表(IBS)进行干预前后的问卷调查,并进行相关数据统计分析。结果①干预前,干预组和对照组在3个量表上的得分差异无统计学意义(SA S:t=0.991,P>0.05;SDS:t=-0.801,P>0.05;IBS:t=0.000,P>0.05),干预后得分差异均有统计学意义(SA S:t=-2.373,P<0.05;SDS:t=-4.823,P<0.001;IBS:t=-3.067,P<0.05);②干预组在干预前后焦虑、抑郁2个量表得分差异均有统计学意义(SA S:t=4.871,P<0.001;SDS:t=3.915,P<0.001),非理性信念量表得分有所下降,差异无统计学意义(IBS:t=1.313,P>0.05);③对照组焦虑、抑郁2个量表得分差异均无统计学意义(SA S:t=1.519,P>0.05;SDS:t=1.514,P>0.05),非理性信念量表得分明显上升,差异有统计学意义(IBS:t=-2.425,P<0.05)。结论互动式讲座可显著缓解和改善社区焦虑、抑郁早期人群的情绪状态;此干预模式值得在其它地区推广,可进一步探索完善此模式。     

围产期女性不同时点抑郁症状检出率及影响因素

目的:了解妇女在围产期不同时点的抑郁症状检出率及其影响因素。方法:2016年9月到2017年2月,在两家妇幼保健院进行产检的508名妇女中完成了全部时点的随访(从孕早期至产后6周,随访7次),使用爱丁堡产后抑郁量表(EPDS)进行抑郁筛查,计算所有时点的抑郁症状检出率,同时在各个时点测量抑郁影响因素。结果:7次随访的抑郁症状检出率为24.8%~37.6%;产后两个时点的中重度抑郁症状检出率均高于轻度抑郁症状(13.0%~14.3%vs.11.8%~13.0%,均P<0.05)。孕早期抑郁症状(OR=2.54、2.05)和产后焦虑(OR=1.43、1.13)与产后1周及产后6周的抑郁症状均正向关联;孕早期焦虑与孕12周至40周共5个时点的抑郁症状正向关联(OR=7.27、1.28、1.18、1.18、1.18)。结论:围产期不同时点的抑郁症状检出率不同,焦虑在整个围产期都与抑郁持续相关。     

情绪反应、个性特征与月经失调的关系

目的：了解月经失调在女学生中的发生情况，探讨月经失调与情绪状态、个性特征等心理社会因素之间的关系。方法：本研究采用分层整群抽样的调查法和心理测验法，对521名调查对象实施了月经健康问卷、状态特质焦虑问卷、流调中心用抑郁量表、艾森克个性问卷调查。结果：月经失调占总调查人数的44．7％；应激时的焦虑、抑郁评分均值显著高于平时；女生月经失调发生率有随年龄、考试应激时焦虑、抑郁反应强度以及特质焦虑水平增加而增加的趋势。结论：情绪状态、个性特征等心理社会因素对女生月经失调的发病起重要作用,临床应重视相应心理干预对策的运用。     

Sex-specific causal factors and effects of common environment for symptoms of anxiety and depression in twins

Two thousand five hundred seventy intact pairs and 724 single responders from Norwegian twins aged 18–25 years completed questionnaires with information about anxiety and depression and perceived cotwin closeness. The aim of the study was the univariate estimation of sex-specific genetic and environmental effects on an index tapping symptoms of anxiety and depression. An index of social closeness between cotwins was significantly related to the cotwin correlation for anxiety/depression scores. MZ pairs were reported to be closer than DZ pairs, and like-sexed DZ pairs were closer than unlikesexed pairs. The symptom data were adjusted for this apparent violation of the equalenvironment assumption in twin studies, but the adjustment did not dramatically affect the parameter estimates of genetic and environmental effects on anxiety/depression. A model specifying male (a _M ) and female (a _F ) genetic additive effects, shared environment for males (c _M ), and individual environmental effects (e _M ande _F ) fitted the adjusted data very well. An alternative model, specifyinga _M =a _F ,c _M =c _F , ande _M =e _F , and no correlation between those environmental factors shared by brothers and those shared by sisters, fitted equally well. Estimated proportions of total variance from the first model werea _M ²=.30,a _F ²=.52, andc _M ²=.21.The estimates from the second model werea _M ²=a _F ²=.43 andc _M ²=c _F ²=.11.     

ApoE基因多态性与冠心病患者抑郁情绪的关系

目的:了解ApoE基因多态性与冠心病患者抑郁情绪的关系。方法: 用聚合酶链反应扩增技术和限制性片段长度多态性技术(PCR-RFLP)对26例冠心病伴抑郁者、30例冠心病不伴抑郁者和30例健康对照组的载脂蛋白E基因(ApoE)进行分析,用汉密尔顿抑郁量表(HRSD)评定抑郁。结果: 冠心病伴抑郁组的ApoEε4等位基因频率显著高于对照组(P<0.05),而其它等位基因频率在各组中的差异无统计学显著性(P>0.05)。携带ε4等位基因者HRSD(因子分中的运动迟缓、绝望感分)、HAD(包括D因子分和A因子分)总分以及总胆固醇水平均高于非携带ε4等位基因的患者,但在认知损害、体重、睡眠障碍因子得分上的差异没有统计学显著性。结论: ApoE基因多态性与冠心病抑郁情绪有一定的关联,尤其是ApoEε4等位基因在冠心病患者抑郁情绪的发生中可能起重要作用。     

认知倾向在大学生压力与负性情绪关系中的中介作用

目的:探讨认知倾向在大学生压力与负性情绪之间的中介作用.方法:采用压力感问卷、流调中心用抑郁问卷(CES-D)、状态焦虑问卷(STAI)和认知倾向问卷对391名大学生进行测查.结果:(1)压力与负性情绪关系密切,但存在明显的个体差异;(2)无论压力情境如何,持有乐观认知倾向的个体比持有悲观认知倾向的个体较少体验到抑郁、焦虑.其中,在较高压力情境下悲观倾向组的抑郁、焦虑体验最多,而在较低压力情境下乐观倾向组的抑郁、焦虑体验最少;(3)回归分析表明,认知倾向在压力与负性情绪的关系中发挥了显著的调节作用;(4)在较低压力情境下,认知倾向在负性情绪的性别差异中起着重要的调节作用.结论:认知倾向作为一种内在资源,在大学生压力与负性情绪关系中发挥着重要的中介作用.预防和矫治负性情绪,应重视帮助个体建构积极乐观的认知倾向.     

Common mental disorders in women and men in the first six months after the birth of their first infant: A community study in Victoria,Australia

Introduction

Studies of postpartum mental health have focused predominantly on women and on depression. There is limited evidence regarding men's postpartum mental health and about other common mental disorders, such as anxiety and adjustment disorders, which may also be relevant at this life phase. The main aim of this study was to establish the period prevalence of depression, anxiety, and adjustment disorders in primiparous women and their male partners in the first six months postpartum

Methods

English-speaking couples were recruited in five local government areas in Victoria, Australia. Women and men completed separate telephone interviews which included the Edinburgh Postnatal Depression Scale (EPDS) and selected Depression and Anxiety modules of the Composite International Diagnostic Interview. DSM-IV criteria were used to classify adjustment disorders, based on subclinical symptoms not meeting criteria for diagnoses of major or minor depression or generalised anxiety disorder. The main outcome was any common mental disorder (depression, anxiety or adjustment disorder) in the first six months postpartum

Results

Complete data were available for 172 couples. The 6-month period prevalence of mental health problems was 33% for women and 17% for men. The most common diagnosis in both women and men was adjustment disorder with anxiety symptoms

Limitations

Unpartnered women and men, women whose partners were not willing to participate and those who did not have sufficient English fluency to complete the interviews were excluded from the sample. The results of this study cannot be generalised to these populations.

Conclusion

The most common postnatal mental health problem in both women and men in this community sample was anxiety.     

Changes in the Health of Adolescent Athletes: A Comparison of Health Measures Collected Before and During the COVID-19 Pandemic

ContextIn spring 2020, schools closed to in-person teaching and sports were cancelled to control the transmission of COVID-19. The changes that affected the physical and mental health among young athletes during this time remain unknown.ObjectiveTo identify changes in the health (mental health, physical activity, and quality of life) of athletes that occurred during the COVID-19 pandemic.DesignCross-sectional study.SettingSample recruited via social media.Patients or Other ParticipantsA total of 3243 Wisconsin adolescent athletes (age = 16.2 ± 1.2 years, 58% female) were surveyed in May 2020 (During COVID-19). Measures for this cohort were compared with previously reported data for Wisconsin adolescent athletes (n = 5231; age = 15.7 ± 1.2 years, 47% female) collected in 2016 to 2018 (PreCOVID-19).Main Outcome Measure(s)Demographic information included sex, grade, and sport(s) played. Health assessments included the Patient Health Questionnaire-9 Item to identify depression symptoms, the Pediatric Functional Activity Brief Scale to gauge physical activity, and the Pediatric Quality of Life Inventory 4.0 to evaluate health-related quality of life. Univariable comparisons of these variables between groups were conducted via t or χ² tests. Means and 95% CIs for each group were estimated using survey-weighted analysis-of-variance models.ResultsCompared with preCOVID-19 participants, a larger proportion of During COVID-19 participants reported moderate to severe levels of depression (9.7% versus 32.9%, P < .001). Scores of the During COVID-19 participants were 50% lower (worse) on the Pediatric Functional Activity Brief Scale (mean [95% CI] = 12.2 [11.9, 12.5] versus 24.7 [24.5, 24.9], P < .001) and the Pediatric Quality of Life Inventory 4.0 compared with the PreCOVID-19 participants (78.4 [78.0, 78.8] versus 90.9 [90.5, 91.3], P < .001).ConclusionsDuring the COVID-19 pandemic, adolescent athletes described increased symptoms of depression, decreased physical activity, and decreased quality of life compared with adolescent athletes in previous years.     

Health-related quality of life in postpartum depressed women

Summary The objectives of this study were a) to evaluate health-related quality of life (HRQoL) among women with postpartum depression, b) examine the association between severity of depressive symptoms and level of impairment in physical and mental HRQoL and c) to identify contributors to physical and mental HRQoL. Seventy-eight women scoring ≥10 on the Edinburgh Postnatal Depression Scale completed the questionnaires measuring: HRQoL (Medical Outcomes Study 36-item short form SF-36), sleep quality, life stress, and social support. All women underwent a cardiovascular stress test to determine aerobic capacity. Compared to Canadian normative data, women experiencing postpartum depressed mood scored significantly lower on all SF-36 domains, as well as on the SF-36 physical and mental component summary score. Severity of depressed mood was not associated to worse physical health status, while poorer aerobic capacity emerged as a significant independent contributor of physical health status. Severity of depressed mood contributed to worse mental health status. After controlling for severity of depressed mood, the occurrence of pregnancy complications, cesarean delivery, poorer sleep quality, life stress, and less social support predicted poorer mental health status.