失眠症相关因素的调查

目的探讨失眠症病人的人格特性、负性情绪等相关因素.方法采用自制失眠一般情况调查(其中包括影响睡眠相关因素调查表)、匹兹堡睡眠质量指数量表(PSQI)、EPQ、焦虑自评量表(SAS)、抑郁自评量表(SDS)对106例门诊失眠症病人进行调查,与90例健康对照组进行比较.结果①失眠组的E分低于正常组,N分、L分高于正常组(P＜0.01);②失眠组SAS、SDS评分高于正常对照组;③E分与N、SAS、SDS评分呈负相关,N分与SAS、SDS评分呈正相关,P分与SAS、SDS评分呈正相关,SAS与SDS评分呈正相关(P＜0.01);④对影响睡眠质量相关因素进行多元逐步回归分析得出焦虑、病程、经济状况、轮班制进入回归方程.结论失眠患者的人格具有内倾性和不稳定性,其负性情绪与人格特征有关,失眠可受病程、经济状况、轮班制、负性情绪的影响.     

Alprazolam in clinically anxious patients with depressed mood

A double-blind study compared alprazolam and placebo in 462 clinically anxious patients with accompanying depressed mood. Alprazolam was more effective than placebo as measured by the Hamilton Anxiety Rating Scale, the Self-Rating Symptom Scale, Target Symptoms, Physician's Global Impressions, and Patient's Global Impressions. Alprazolam was not significantly different from placebo in the number of patients reporting drowsiness, the most frequent side effect.     

Assessing depression and anxiety in chronic dialysis patients

One hundred and twenty-eight patients on chronic dialysis were studied by the Zung Self-Rating Depression Scale and Self-Rating Anxiety Scale, the Differential Emotion Scale (DES), the Test of Emotional Styles (TES), and the Social Dysfunction Rating Scale (SDRS). As measured by the Zung scales, approximately half of the sample manifested depression and anxiety symptoms at clinically relevant levels. The data suggested an inverse correlation between depression and anxiety levels and patients' total length of time on dialysis, which may explain some of the variation in depression and anxiety results obtained with different samples. Depression and anxiety scores were correlated with related DES and SDRS factors, but patients' scores on the DES, TES, and SDRS generally indicated positive mood and functioning. Scales containing disease-related somatic items may yield exaggerated depression and anxiety scores for dialysis patients. It may be useful to assess patients' psychological functioning with several different instruments.     

Comorbidity of obsessive-compulsive disorder and depression: prevalence,symptom severity,and treatment effect

BACKGROUND: The goal of this study was to investigate the co-occurrence of depressive disorders in obsessive-compulsive disorder (OCD) and the effect of these disorders on combined pharmacologic and behavioral treatment for OCD. METHOD: A retrospective chart analysis was performed on baseline ratings of 120 OCD patients and posttreatment ratings of 72 of these patients. For depressive symptoms, the Montgomery-Asberg Depression Rating Scale and the Self-Rating Depression Scale were applied; for obsessive-compulsive symptoms, the Yale-Brown Obsessive Compulsive Scale and the Maudsley Obsessive Compulsive Inventory were used; and for general anxiety symptoms, the Self-Rating Anxiety Scale, the Clinical Anxiety Scale, and the State-Trait Anxiety Inventory were given. RESULTS: One third of the OCD patients in our sample were found to be depressed. Symptom severity on OCD symptoms at baseline did not differ between depressed and nondepressed OCD patients; on general anxiety symptoms, the comorbid group was more severely affected. Both depressed and nondepressed OCD patients responded well to treatment, as reflected in assessments for depressive, obsessive-compulsive, and general anxiety symptoms. However, comorbid depression had a negative effect on treatment: depressed OCD patients showed less improvement than nondepressed OCD patients on most scales. CONCLUSION: Depression frequently accompanies OCD and appears to affect treatment outcome negatively. While both groups of patients improved with combination treatment, the OCD-alone group had more improvement than the group that had comorbid depression.     

The prediction of suicidal intent in depressed patients

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in-patients. A total of 338 adult depressed psychiatric in-patients were examined and classified according to DSM-III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self-Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self-rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self-esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.     

后循环短暂性脑缺血发作患者的负性情绪研究

目的 探讨后循环短暂性脑缺血发作（transient ischemic attack，TIA）患者的负性情绪及影响因素，以指导心理干预，提高患者生活质量。方法 选用Zung焦虑自评量表（SAS）和抑郁自评量表（SDS）、艾森克人格问卷（EPQ），对257例后循环TIA患者进行调查。结果 后循环TIA组 SAS和SDS评分与国内常模比较，差异有统计学意义（P <0.01）。结论 后循环TIA患者多伴有焦虑和抑郁情绪，并与患者的人格特征有一定的相关性。     

Anxiety,depression and quality of life in patients with a treated or untreated unruptured intracranial aneurysm

Living with an untreated unruptured intracranial aneurysm(UIA) is stressful, this study was aimed to assess the influence of UIA treatment (surgery clipping and endovascular coiling) on behavior such as anxiety and depression, as well as QoL. A series of 296 UIA patients (including 162 treated and 134 untreated) were analyzed. Postal questionnaires were sent to these patients, included Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale(SDS) and Short Form-36(SF-36). In total, 198 (66.9%) patients responded to our questionnaires. Patients with surgical clipping or endovascular coiling had a significant improvement in the physical function, body pain and mental health domains. No significant difference in the SAS, SDS and SF-36 was observed between the clipping and coiling group, while SF-36 in body pain domain was significant higher in the coiling group. Moreover, patients diagnosed 5 years ago with or without treatment got lower score of SAS and SDS, higher SF-36 score than those diagnosed one year ago. Neurological complications may be an important factor causing lower quality of life. The QoL of patients with endovascular coiling appear to be better than those of surgical clipping, with no difference in anxiety or depression.     

Confirmation of the neurophysiologically predicted therapeutic effects of trazodone on its target symptoms depression, anxiety and insomnia by postmarketing clinical studies with a controlled-release formulation in depressed outpatients

Early human pharmaco-EEG and subsequent sleep laboratory studies identified trazodone, a 5-HT(2) antagonist and 5-HT reuptake inhibitor (SARI), as an antidepressant with therapeutic effects on its target symptoms depressed mood, anxiety and insomnia. On the occasion of the introduction of a controlled-release (CR) formulation (Trittico 150 mg retard, marketed in Austria by CSC Pharmaceuticals Handels GmbH, Vienna, Austria) in Austria in July 2000, a multi-center, open, clinical post-marketing study on the therapeutic effects, safety and target symptoms of trazodone CR in depression was carried out at 80 offices of Austrian neuropsychiatrists. 549 outpatients (63% females) of all age groups suffering from five different subtypes of depression were enrolled in the study. After a 2-week fixed dose-titration regimen up to 150 mg and a 4-week adjustment period to the optimum dose, 66% of the patients remained on 150 mg, 20% increased the dose and 11% decreased it. Only 3.7% discontinued treatment. Rating by the neuropsychiatrists based on the Clinical Global Impression showed very much to much improvement in 78.3% of the patients, and no change or a deterioration in only 3.6%. In the Hamilton Depression Scale (HAMD) a statistically significant improvement from a baseline score of 21 to a score of 14 after 2 weeks was found, and a normalization to a score of 8 after 6 weeks. Therapeutic effects were similar in the five groups suffering from different subtypes of depression and in patients with and without comedication. Self-rating by the patients based on the Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) also showed a significant improvement in the 2nd and 6th week of therapy. Evaluation of the target symptoms of trazodone by ranking the most improved symptoms identified insomnia as the most improved psychopathological item in all three scales. While in the observer ratings also suicidal tendencies and weight loss were found much improved, in the self-rated Zung SDS sadness and loss of drive came second and third in the improvement ranking, in the self-rated Zung SAS anxiety and the feeling of falling apart. Tolerability was very good. In the 2nd week only 16.9% and in the 6th week only 7.6% of the patients reported side effects, mostly characterized by tiredness and rarely by nausea and vertigo. The present clinical study is in agreement with previous studies identifying trazodone as a safe and effective antidepressant, specifically regarding its target symptoms insomnia, depression and anxiety. It also confirms our own early predictions based on neurophysiological investigations concerning the mode of action of the drug.     

海军舰艇兵心理健康状况的调查分析

目的　了解海军舰艇兵的心理健康状况。方法　应用症状自评量表 (SCL 90 )、焦虑自评量表(SAS)、抑郁自评量表 (SDS)及心理健康相关问卷对海军舰艇兵进行心理健康状况调查。结果　除阳性项目数和焦虑因子外 ,SCL 90总分及其余 8项因子分均明显低于中国军人常模、中国新兵常模及中国正常人常模。SAS、SDS评分显著低于国内常模。结论　海军舰艇兵心理健康状况良好 ,应继续加强军人的心理健康教育和干预     

未治疗的未破裂颅内动脉瘤患者的精神心理调查分析

目的 调查并评价未经治疗的未破裂颅内动脉瘤(UIA)患者的精神心理问题.方法 选择上海同济大学附属同济医院神经外科自2008年1月至2011年1月就诊的70例未经治疗的UIA患者和48例健康体检者(对照组)进行调查问卷,应用症状自评量表(SCL-90)、抑郁自评量表(SDS)及焦虑自评量表(SAS)评价未经治疗的UIA患者的精神心理状况.结果 与对照组比较,未经治疗的UIA患者组SCL-90中躯体化、抑郁、焦虑、恐怖四项因子分及总分均较高,未经治疗的UIA组患者更易抑郁、焦虑,差异均有统计学意义(P＜0.05)；内向性格抑郁发生率高于外向和中性性格,外向性格患者焦虑发生率低于中性及内向性格,大学文化程度患者抑郁、焦虑发生率低于高中及初中文化程度患者,差异均有统计学意义(P＜0.05)；多因素Logistic回归分析显示性格、文化程度是影响未经治疗UIA患者抑郁、焦虑的独立危险因素.结论 未治疗的颅内动脉瘤患者容易出现抑郁或焦虑,文化程度低、内向型的患者表现更明显.     

老年期痴呆患者照料者负担及其相关因素调查

目的 调查老年期痴呆患者的基本情况、家庭关系、照料者的负担、躯体与心理状况. 方法采用统一自行设计的调查问卷及焦虑自评量表(SAS)、抑郁自评量表(SDS)、临床痴呆评定量表(CDR)由调查员入户调查.根据CDR评分分为轻度痴呆组(20例)、中度痴呆组(16例)、重度痴呆组(27例). 结果调查老年期痴呆患者63例.不同严重程度的老年期痴呆患者总经济损失(F=-15.40, P=0.00)、医疗护理费用(F=-14.48,P=0.00)、照料者经济损失(F=-13.57、P=0.00)、每日照料时间(F=-16.72,P=0.00)方面存在统计学差异.照料者的SAS得分平均(30.98±5.14)分,SDS得分平均为(32.27±5.39)分,不同严重程度的痴呆患者的照料者SAS(F=14.818,P=0.000)、SDS(F=5.592, P=0.040)得分有统计学差异. 结论不同严重程度的老年期痴呆患者的照料者的负担不同.痴呆的严重程度影响照料者的心理状况.     

Clinical presentation of anxiety among patients with epilepsy

Different factors have been related with interictal anxiety, reported in 10%–25% of patients with epilepsy. We determined the frequency of interictal anxiety in 196 patients with active epilepsy in a cross-sectional survey to know which symptoms of anxiety were most frequently reported in patients with epilepsy and to analyze the factors associated with their presence. Patients were assessed with the Beck Depression Inventory (BDI), Montgomery-Asberg Depression Rating Scale (MADRS), and the Hamilton Anxiety Scale (HAMA). Data were analyzed with a logistic regression model. The HAMA ratings revealed that 38.8% experienced significant anxiety symptoms, as defined by a rating above 18 points. Use of primidone, depression, cryptogenic, and posttraumatic etiologies significantly predicted anxiety after logistic regression. Symptoms related to higher scores on HAMA were anxious mood, tension, insomnia, intellectual function, depressed mood, cardiovascular and genitourinary symptoms. Further studies should be performed to define the role of psychosocial factors in the development and evolution of anxiety among these patients.     

Anxiety and depression in bronchial asthma

The aim of the study was to establish the frequency and follow the clinical course of depression and anxiety in patients with bronchial asthma. 57 patients (37 atopic and 20 nonatopic) with mild and moderate bronchial asthma and 53 subjects matched for age and sex as control groups were included in the study. The following questionnaires: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate anxiety and mood state. The level and prevalence of anxiety and depression were significantly higher in both groups of asthmatics in comparison to healthy subjects. Symptoms were mild and moderate. Nonatopic patients were more depressed and anxious than atopics.     

Psychiatric evaluation of physical rehabilitation patients

We conducted a study to demonstrate the frequency and types of psychiatric/psychological symptoms. A Structured Interview according to the DSM-III-R was conducted which demonstrated that 46 (41.4%) of 111 rehabilitation inpatients met the criteria for some forms of psychiatric disorders: 34 patients for major depression, 10 for adjustment disorder with anxious mood, and 2 for posttraumatic stress disorder. The remaining 65 patients (58.6%) showed normal reactions to their diseases. Average length of hospital stay for patients with major depression was significantly longer than those with no or the other types of psychiatric disease. They were also tested with Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), and Profile of Mood States (POMS). Three psychological tests were useful in detecting depression or adjustment disorder among rehabilitation patients; however, these tests are not always specific to the type of psychiatric disorders. Patients with higher scores in those three tests should be referred to a psychiatric consultant for detailed examinations and proper treatments, if necessary.     

Prevalence of depression in a 12-month consecutive sample of patients with ALS

There is an impression both in clinical practice and in research literature that patients with amyotrophic lateral sclerosis (ALS) possess 'heroic stoicism with a low frequency of depression'. Reliance on specific interview methods may have contributed to differing estimates of mood disorder in people with ALS. The objective of the current study was to compare prevalence rates of depression and anxiety in ALS using different assessment tools. The Beck Depression Inventory (BDI), The Hospital Anxiety and Depression Scale (HADS) and the Spielberger State-Trait Anxiety Inventory (STAI) were sent to a 12-month consecutive sample of 190 patients with ALS attending a tertiary referral clinic in the UK. Data were collected from 104 patients with ALS. Using BDI scores, 44% were categorized as not depressed, 37% were mild-moderately depressed, 13% were moderately-severely depressed, and 6% were severely depressed. In contrast, the HADS depression subscale identified 75% as not depressed, 13% were in the borderline range, and 13% were categorized as meeting 'caseness' for depression. Twenty-five percent of the patients were using antidepressant medication. The estimated prevalence of mood disorder amongst patients with ALS may vary significantly depending on the measure used.     

北京市围产营养门诊妊娠期糖尿病孕妇的焦虑、抑郁状况及相关影响因素

目的 了解市北京市围产营养门诊妊娠期糖尿病(GDM)孕妇的焦虑、抑郁和社会支持情况.方法 于2016年1~8月按照地区代表性分层随机抽样方法,抽取北京市城区、郊区妇幼保健院、综合医院共8家围产营养门诊(其中城区三级综合医院3家、三级妇幼专科医院1家,郊区二级综合医院1家、妇幼专科医院3家)就诊的孕24~28周,首次诊断GDM的456例孕妇进行问卷调查.调查内容包括一般资料问卷、焦虑自评量表(SAS)、抑郁自评量表(SDS)和社会支持量表,并进行统计分析.结果 GDM孕妇的SAS得分为(57.12±4.61)分、SDS得分为(59.62±4.38)分,存在一定程度的焦虑、抑郁情绪.GDM孕妇的焦虑、抑郁分别与社会支持利用度、社会支持总分和主观支持呈负相关(P<0.05).高龄初产妇、孕前体质量指数(BMI)≥25kg/m2、受教育程度高、不良孕史、居住在城区是GDM孕妇发生焦虑、抑郁的高危因素,社会支持是GDM孕妇减少焦虑、抑郁状态发生的保护因素,而郊区GDM孕妇获得的社会支持低.结论 GDM孕妇易出现抑郁焦虑状态,建议在围产营养门诊开设健康教育课堂,提供心理辅导,加强社会支持,关注GDM孕妇的心理健康.     

新诊断癫痫患儿主要照顾者情绪状态调查研究

目的调查新诊断癫痫患儿主要照顾者的情绪状态,分析其主要影响因素,为进一步心理干预提供依据。方法便利抽样法选取空军军医大学西京医院神经内科门诊新诊断(1个月以内)的40例癫痫患儿及其主要照顾者,收集一般资料并采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评定患儿家长焦虑和抑郁状况,采用Logistic回归模型分别对照顾者SAS和SDS得分的影响因素进行多元统计学分析。结果40例新诊断癫痫患儿主要照顾者SDS分值高于正常占67%,平均为(44.73±6.44)分,高于全国常模的(27.82±14.42)分;SAS高于正常分值占40%,平均为(38.57±5.12)分,高于全国常模的(29.78±10.07)分。多元回归分析显示,SDS得分与家庭年收入呈负相关关系(P<0.05),SAS得分与文化程度呈负相关关系(P<0.05)。结论新诊断癫痫患儿主要照顾者焦虑、抑郁得分均高于全国常模,家庭年收入为抑郁状态的主要影响因素,文化程度为焦虑状态的主要影响因素。     

慢性乙肝、乙肝后肝硬化患者及正常对照组随访8周的抑郁和焦虑症状

背景慢性乙肝（ChronicHepatitisB,CHB）和乙肝后肝硬化（HepatitisBCirrhosis,HBC）患者经常伴发抑郁、焦虑症状,但病程进展中的心理状况和CHB、HBC患者的病情之间的关系尚不清楚。目的对住院治疗的CHB和HBC急性发作患者的抑郁和焦虑症状的变化进行评估。方法对71例CHB和75例HBC患者在入院治疗时进行测评,其后治疗期间随访8周。同时,以健康志愿者65人作对照组。分别对3组对象在入院时和随访第8周时进行90项症状自评量表（SymptomCheckList-90,SCL-90）测评。采用汉密尔顿焦虑量表（HamiltonAnxietyScale,HAMA）、汉密尔顿抑郁量表（HamiltonDepressionScale,HAMD）、焦虑自评量表（Self—RatingAnxietyScale,SAS）及抑郁自评量表（Self—RmingDepressionScale,SDS）分别对3组研究对象每隔2周,即人院时、随访第2周、第4周、第6周、第8周时进行评定。结果每组均有60例对象完成测评。CHB组和HBC组的基线SCL-90总均分、大部分SCL-90因子分、HAMA、HAMD、SAS及SDS评分的均分均高于健康对照组。HAMA、HAMD评定显示,在入院时40％的CHB和80％的HBC患者有明显焦虑症状,78％的CHB和87％的HBC患者有明显的抑郁。治疗8周后,两组患者的SCL-90总均分、大部分SCL-90因子分均显著下降。治疗6周后,两组患者的HAMA、HAMD、SAS及SDS评分的均分也显著下降。治疗8周后,5％的CHB和28％的HBC患者仍有明显焦虑,7％的CHB和36％的HBC患者有明显抑郁。基线和4次测评分均提示,HBC组比CHB组患者的心理症状严重。结论在CHB、HBC患者急性发作入院时和经临床治疗急性症状缓解后,两组患者自评、他评的心理症状均比健康对照组严重。HBC组比CHB组患者的心理症状更严重。对急性发作的CHB、HBC患者的躯体症状治疗8周后,其。心理症状也可改善,但并不能完全消除。     

远距离转移对汶川地震后幸存者心理健康的影响

目的 评价跨省远距离转移对汶川地震后幸存者心理健康的影响.方法 采用焦虑自评量表(SAS)与抑郁自评量表(SOS)分别评价跨省转移前后汶川地震后幸存者的心理健康状况.结果 跨省转移后汶川地震后幸存者SAS、SDS评分(38.15±7.55、40.84±9.20)均明显低于跨省转移前(42.78±7.95、45.40±9.30).差异有统计学意义(P<0.05);把幸存者分为受伤者与非受伤者两组分别比较时,两组跨省转移后SAS、SDS评分均明显低于跨省转移前,差异有统计学意义(P<0.05);但幸存受伤者与非受伤者两组间同期比较时,仅SAS评分差异有统计学意义(P<0.05),SDS评分差异均无统计学意义(P>0.05).结论 跨省远距离转移可以在短期内明显减轻汶川地震后幸存者的焦虑与抑郁症状,且对幸存受伤者与非受伤者同样有效,能快速促进地震后所有幸存者心理健康的恢复.     

Generalized anxiety or depression measured by the Hamilton Anxiety Scale and the Melancholia Scale in patients before and after cardiac surgery

We have examined the applicability of the Hamilton Anxiety Scale (HAS) and our Melancholia Scale (MES) on a group of patients suffering from cardiac disease. They were assessed before surgery and again 1, 3, and 6 months after the operation. The results showed that the median for this group of patients even preoperatively was below the cut-off scores for both rating scales with a monotonous fall in score on the follow-ups. Item analysis showed that it was the psychic or cognitive symptoms of the HAS rather than the somatic symptoms of anxiety that explained the score variation. On the MES it was symptoms like depressed mood, psychic anxiety, pains, emotional and intellectual retardation rather than symptoms of guilt, motor retardation or suicidal impulses that were present. From both scales a total of 10 items emerged which were considered to measure generalized anxiety (Generalized Anxiety Scale). When the patients were classified into groups by a global assessment according to their ability to verbalize preoperative anxiety it was found that patients who were less able to verbalize had the lowest rating scale score. It was argued that preoperative anxiety is an introspective perception of fluctuating somatic manifestations of anxiety, whereas the rating scale procedure focuses on the persistent or cognitive part of anxiety which mostly is retrospectively perceived.